Kamala Harris recently released a summary of a medical examination and tried to prod Donald Trump into doing the same, echoing calls that date back to the 2016 campaign for him to be transparent about his health. Some have even argued that it should be legally required for presidential candidates to share their medical records.
But I think that’s a terrible idea. As an ethicist, much of my work has focused on patient rights, including an ACLU handbook from 1975. As part of that research, I have written about what happens when the patient is also the president. I strongly believe that forcing both candidates and office holders to share their medical history would ultimately not serve the public — far from it.
Every president and presidential candidate has a right to medical privacy and to a genuine doctor-patient relationship. The doctor-president relationship matters. The president must be able to seek and receive confidential medical care, especially for conditions that are stigmatizing, such as some mental health conditions. This approach keeps medical tests and treatments confidential. If the president knew that every interaction with a physician could become public knowledge, they might make a treatment decision based on the likely political reaction rather than on the basis of what is the best treatment for the condition. Imagine if a president decided not to tell their doctor that they were experiencing suicidal thoughts or may have a sexually transmitted infection because they don’t want it to get out. Keeping the doctor-president relationship private, then, also protects the public, by ensuring that the commander in chief is getting appropriate, timely care.
At least since the 1972 disclosure that Thomas Eagleton, George McGovern’s first vice-presidential pick, had received electro-shock treatment for depression in a mental institution, presidential candidates have believed that certain types of medical treatment can be toxic to their campaigns. But I would argue that reporters have been consistently more interested in the health of presidents and presidential candidates than the general public. Even if there were a commonly held believe that “the public has a right to know about the president’s health,” it would have to be balanced against the president’s right to privacy, and I believe the president’s right is stronger.
Similarly, it is sometimes argued that physicians, particularly those who have personally examined the president, have a “duty to warn” the public if they believe the president is a danger to the country. Such a duty has no pedigree, and physicians should not have to set themselves up to judge the ability of a president to safely perform their duties.
It is also worth underlining the role of the physicians who currently care for the candidates. The fact that one is a private primary care physician and the other is employed in the White House Military Office does not affect their ethical obligations to respect the doctor-patient relationship with their patient. Biden’s White House physician did not release any medical information that might have shed light on his condition. Nor was it necessary for any decision-making: Biden was no longer himself, and the public could judge his “fitness” for office by observing him.
There is one exception to the rule of presidential medical privacy: The president should be obligated to disclose any medical condition that would, to a medical certainty, make it unlikely that he or she would be able to perform the duties of president for the full four-year term that they are running for, such as advanced cancer or dementia. Note that the obligation under this proposed exception to the doctor-president relationship is on the president, not the physician, though the commander in chief could allow their doctor to speak with the press (with or without specified limits).
The most important health issue at the beginning of the presidential campaign was Joe Biden’s age. Today the most important issue is Donald Trump’s age. As with Biden, Americans don’t need an expert physician to tell them Trump has lost a step or two (although one might suggest after Trump’s half-hour dance during a recent town hall meeting that he may be gaining literal steps). There is no objective test, medical or otherwise, to determine that a candidate (including a previous president) is “fit to perform the duties of president of the United States.” Instead of encouraging presidential candidates to disclose more personal medical information, we should encourage them to take full advantage of the uniquely powerful doctor-president relationship and seek the care they need.
George J. Annas is William Fairfield Warren distinguished professor at Boston University and director of the Center for Health Law, Ethics & Human Rights.