Posted: Thursday 3rd July 2014 at 15:52 pm

PRESIDENTIAL HEALTH AND CONFIDENTIALITY

Many Presidents have suffered illnesses prior to and during their terms of office. Some have died in office of illness. Some political scientists who have studied Presidential health issues have recommended that a panel of physicians be appointed to assist the cabinet secretaries and Vice President in making decisions about when to invoke a statutory amendment in cases when the President appears to be disabled. Other recommendations include appointment of a governing function of presidential executive for smooth operation of country free from external manipulation in times when the president is physically incapacitated. In the 19th century medical problems were often poorly diagnosed and treated. Even after modern medicine permitted accurate diagnoses by the President’s doctors, the custom until the 1950s has been to keep such information confidential. But since Dwight Eisenhower’s heart attack in 1955, the public has come to expect full disclosure, though often the condition of the President is still minimized by the state.

However, the biggest question we might attempt to answer now would be; what are the ethical implications of this new policy of openness about presidential health matters? While it’s clear enough that candidates for the highest office are now subject to differing expectations from the average patient when it comes to medical disclosure, it’s not at all clear where the line should be drawn. But before we can argue that such openness is ‘part of the job,’ we need a public debate about what exactly should and should not be subject to these new requirements.

There is a long tradition in medical ethics about maintaining the confidentiality of health information, which is one of the few ethical rules universally accepted today in medicine that can be found almost word for word in the Hippocratic Oath. There are two sets of reasons why confidentiality remains important. Firstly, it’s respectful of the rights of patients or hospital clients specifically, the right to control who has access to one’s personal information. Secondly, it’s of utilitarian value in medical practice if patients could not trust doctors to keep information private, they’d refuse to divulge many bits of personal history that could prove crucial to diagnosing and treating their diseases correctly. Thus confidentiality leads to better health consequences than the opposite. In the presidential case matters of national security come in and we can’t just guess who would put on a plastic surgery to hijack the presidency in this world of technology and secrecy. If at all you thought that is an-impossibility then it is still held as top secret by powers with vested interest in seeing a rainbow Africa among other things.

Well with that said, the rule of confidentiality is not absolute. One example is a public health need of a patient ,that may not be allowed to keep information about an infectious disease private if the authorities need to know about that infection in order to take action and prevent an epidemic. It is generally held that such threats to other people legitimately override a patient’s right to confidentiality. The most common way that confidentiality is overridden in everyday medical practice, however, is completely consistent with the right to control personal information. It occurs when a patient freely gives consent to information being released to other parties. In an instance where our health facility admits such a significant figure from another country or our own, it is important not to be overzealous and start making statement that would create anxiety and tension because a written consent would still be needed from the closest relative or patient himself to allow divulging of such information.

However, this brings us to the logic of a ‘public right to know’ about a presidential candidate’s health. Presumably, no one put a gun to a candidate’s head and forced him or her to run for office. This leads us to the theory that everyone who throws his or her proverbial hat into the ring freely consented to what’s now generally understood to be the new rules of disclosure regarding presidential health information. Though there is a saying that ‘information is power’ it should certainly not be at an expense of the other. No matter which party we might identify ourselves with, matters of presidential health affects everyone and if at all we are informed of his failing health, then the only crime we should be ready to commit is to wish him well, pray for his quick recovery and ask for divine intervention in the unity of our country and continuum of leadership.

But does this mean that we have no ethical unease to read about presidential medical progress from his medical tour? Well, not quite. The reason is that we are not aware of any clear statement that has ever been made by any authoritative group about what exactly these new rules regarding disclosure are and what limits they allow, if any. The sad thing though is that within the same government system, we still notice that many spokespersons spring up and portray to us that they are economizing on the truth. Without a clear standard on these issues, our president can hardly be considered to have offered his consent and the government may just want to conceal that which might raise eyebrows of prospective presidential aspirants.

Howard Brody, MD, PhD, is Director of the Institute for the Medical Humanities, University of Texas Medical Branch in Galveston, and the author of books on health care ethics, most recently The Future of Bioethics. He wrote an inspirational article titled ‘HOW MUCH ABOUT A PRESIDENT’S HEALTH DOES THE PUBLIC HAVE A RIGHT TO KNOW?’ In his write-up, he enlisted past presidents of United States of America and there illness. He shades light on their maladies and how the government system tried to conceal them leaving the public to speculating. For instance, William Henry Harrison caught pneumonia after delivering his inaugural address; Zachary Taylor and Warren Harding both died of heart disease while their performance in office was being harshly criticized; and Franklin Roosevelt died of a cerebral hemorrhage. In fact, 25 of the 35 deceased American Presidents did not live as long as other people of their generation.

As these presidents have illustrated, anyone can suffer from any diseases, illnesses, and maladies prevalent in our society, from obesity to heart disease, then depression, anxiety, stroke, mental burn out, Viagra overdose and arthritis. They can also fake some conditions in their post presidency to get their diplomatic passport or dodge away from corruption charges. In the end, if we are going to hold a person of having agreed to give up a basic right to medical confidentiality because he chose to play a certain public role, our main concern would be that the nature and extent of the rights given up are clearly known in advance. With the advent of online media, news is been captured faster and the situation calls for smart government to monitor its information channels well so that speculative rumour mongering on sensitive matters can be contained like bird flu.

We are not sure just who the authoritative group would be to tackle this problem whether within medicine, or within government system or the press. But it would seem highly desirable that there exist a clear statement of what health information is expected to be made public and what information, if any, should remain private or if one chooses to become a candidate for presidency or becomes president. Until that time, let’s expect the ethics of presidential health disclosures to only get thornier. With the psychology of ill health at play, economic vultures in the name of investor can take advantage to concretize enslaving economic agreements. Therefore, our prayers remain with our president to bring in more investors on each working visit for the prosperity of our nation as we celebrate a golden jubilee of self-rule.

JONES H. MUNANG’ANDU (author)

Motivational speaker, health commentator &
Health practitioner
Email; [email protected]Skype id; jones .muna

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