Megan Carpentier 

Medical records must stay private – even for prospective presidents

There’s no reason to pretend that perusing a candidate’s medical records will obviate the need for a vice president to move into the Oval Office
  
  

Obama basketball
Obama plays basketball. He also smokes. Do either of those things influence his ability to be president? Photograph: Rex Features

The cyclical focus on each presidential candidate’s medical records – which has begun in earnest with Hillary Clinton this week and extended to Jeb Bush’s diet – is a political charade designed to allow their opponents to mine for political cudgels what in any other circumstance would be appropriately confidential medical records. But electing a president who later dies in office or becomes physically incapable of serving in the role is an entirely possible and provided-for (if not predictable) circumstance of the US political system, and no amount of listing candidates’ colonoscopy results will prevent it.

To date, eight American presidents – 18% – have died in office: four as a result of violence, and four from natural causes. If past performance were an accurate predictor of future results, those aren’t, one might say, the best odds; but then, medical science provides us with no surety. To poorly paraphrase Ben Franklin, one of the only certainties in life is that we’re all going to die – and that most of us will have no say in when or how.

The writers and amenders of our constitution anticipated that some of our heads of state would die in office, providing first for the office of a vice president with virtually no other responsibilities than to step into a dead man’s shoes, and then for the US Congress to figure it out if that didn’t work; the President Succession Act of 1947 currently delineates that, if the president and vice president are unable to serve, it will fall first to the speaker of the House of Representatives and then to the longest-serving member of the majority party in the US Senate. The 25th amendment, adopted in 1967, even provides for what will happen if the president is only temporarily incapacitated.

We expected it to happen; it has happened; we created a system to deal with it when it does happen. And nothing in life – especially life itself – is guaranteed. So there’s no reason pretend that perusing a presidential candidate’s medical records will obviate the need for a vice presidential candidate to move into the Oval Office.

You could blame our voracious appetite for the most intimate of medical details from our political candidates, as many do, on 1972 presidential candidate George McGovern and his short-lived vice presidential nominee, then-Senator Thomas Eagleton. Eagleton – in a period in which both having mental health issues and seeking appropriate treatment for them were even more stigmatized than they are today – was forced to withdraw his nomination after his political enemies made sure the American public knew about (and looked down on) his condition and his decision to seek treatment. It was, his detractors said at the time, a matter of whether Eagleton would again get depressed and nuke the crap out of Russia – an accusation it’s now hard to take seriously, but which may have contributed to McGovern’s eventual loss in the general election in 1972. (And, as late as 1997, no less than the New York Times – the paper of record in a city notoriously filled with people seeking psychiatric and psychological care – was publishing letters stating that Eagleton’s mental illness should’ve disqualified him from office.)

Or you could blame the veneer of respectability afforded our gawking on the persistent rumors that President Ronald Reagan, who was diagnosed with Alzheimer’s disease in 2004, had symptoms of dementia as early as 1984 or 1986. But Alzheimer’s, unlike depression, could seriously incapacitate a head of state by affecting his judgment and memory and, despite that possibility, Reagan’s well-being was hardly at issue in the 1984 campaign or used to attack his presidency while he remained in office.

In modern American life, the Americans With Disabilities Act, the 1996 Health Insurance Portability and Accountability Act (Hipaa) privacy rule, the 2008 Genetic Information Nondiscrimination Act (Gina) and many state laws either outright forbid (potential) employers from asking about or finding out employees’ medical histories or forbid them from discriminating against those people who choose to disclose their medical conditions in order to seek reasonable accommodations in the workplace. (AOL CEO Tim Armstrong found that out the hard way back in 2014, though the employees whose medical conditions he disclosed never filed suit.) But somehow it’s supposed to matter if President Obama still has the occasional cigarette or how hard Hillary Clinton really hit her head before the Benghazi hearings.

The calls for candidates to release their medical records aren’t an attempt to assure the American people that the candidate will survive a four-year term if elected – no one can guarantee that. But it is an opportunity for a would-be president’s opponents and detractors to dig through the most intimate details of his or her life in order to take advantage of existing stigmas under the guise of transparency.

Goodness knows the Babygate proponents in 2008 weren’t interested in whether Sarah Palin’s running habits were a put-on or not: they wanted to know, in more detail than they received, about the contents of her uterus in order to persuade Americans that she was lying about the parentage of her youngest child. (She was not. And it was absurd to suggest that she was.) Does anyone seriously believe that the same people who have hounded Clinton for two decades wouldn’t love a go at her gynecological records? Is it germane to a candidate’s fitness for office if he sought treatment for, say, cocaine abuse in the 80s? Are records of a man’s hair plugs fair game? A Viagra prescription? If someone wants to Bomb bomb bomb, bomb bomb Iran, do we need to make sure that’s depression talking rather than just an abhorrent neoconservative ideology?

Speculating about it has gained traction because it’s worked, and the sleaziest of campaign operatives hopes it will again. But let those who have never contracted HPV – that’s less than 20% of sexually active adults in the US – and who floss every day cast the first stone: humans are dirty, messy, disease- and infection-prone, and few of us do all that we should to lead healthy lives (and then we die, often suddenly). Medical privacy encourages medical honesty, and honesty with your doctor is a key factor in maintaining your health or identifying disease early.

Let’s let the candidates have most of their privacy back; goodness knows a few of them would probably benefit from the care of a competent mental health professional and I, for one, would like them to get it without worrying that we’ll judge them for it.

 

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