Health Screening for Political Candidacy: A Partnership Model

Abstract

HEALTH SCREENING FOR POLITICAL CANDIDACY: A PARTNERSHIP MODEL PAUL R. SCHATTMAN* Public confidence in the physical and mental health of political leaders is particularly important in democratic systems. Where political power is in the gift of the people, misinformed choice can be as dangerous as uninformed choice. One of the chief means of informing the electorate is the political party. Parties bring organization and coherence to politics, and without coherence politics loses accountability. As Schattschneider said, "political parties created democracy and modern democracy is unthinkable save in terms of parties" [1, p. I]. Over the last 30 years, the link between the voter, politics, and party has been severely eroded by spiraling election costs, PACs, television imagery, and personal campaign organizations. But recent events have offered a unique opportunity to begin reforging that linkage and have provided the medical profession with an opportunity to participate in returning coherence and accountability to the political life of the nation. On August 2, 1988, the sudden rash of rumors to the effect that Democratic presidential nominee Michael Dukakis had undergone psychiatric treatment for unspecified mental disorders prompted the Republicans and others to call for disclosure of the candidates' medical records, once again raising the issue of health screening for political leaders. The rumors concerning Dukakis's mental health, as reported by NBC "Nightly News" on August 3, appear to have been a political smear engineered by the supporters of independent presidential candidate Lyndon LaRouche and to have had no basis in fact so far as is known. The Dukakis campaign immediately and specifically denied any and all such claims, and Gerald Plotkin, the candidate's personal physician for 17 years, categorically denied that the governor ever exhibited any psy- *Visiting assistant professor, Department of Political Science, Texas Tech University, Box 4290, Lubbock, Texas 79409-1015.© 1989 by The University of Chicago. All rights reserved. 003 1 -5982/90/330 1-066610 1 .00 Perspectives in Biology and Medicine, 33, 1 ¦ Autumn 1989 \ 45 chiatric symptoms or complications or had ever received any counseling, treatment, or therapy. The furor that erupted over this allegation raises a significant point relative to health screening for office seekers. In the absence of a trustworthy source, incomplete or erroneous medical information can be used to smear the candidate, to undermine his campaign, and to impugn the judgment of his party. Since the Eagleton nomination debacle in 1972, the tendency has been for presidential and vice-presidential candidates to voluntarily but only partially disclose their medical histories. This current controversy, too, is likely to result only in the continuation of that trend of limited disclosure . The voluntary disclosures have been made most often by the candidates and/or by their personal physicians. The public pronouncements usually consist of declarations of the soundness of the candidate's mind and body without disclosure of the actual medical records or an attempt to present a complete medical history. For political or personal reasons, these assertions of good health may be less than candid [2]. The extent to which any office seeker reveals his true medical history remains subject to the discretion of the candidate himself and to the skill and determination of the media to ferret out the facts. The doctor/ patient privilege and the individual's right to privacy under the Constitution can make it extremely difficult for the public and the media to obtain accurate data. This was clearly demonstrated on October 30, 1986, when a Florida court dismissed a suit brought by three Florida newspapers seeking access to Senator Paula Hawkins's medical records on the ground that the individual's right to privacy outweighed any public right to know, and, however public-spirited or well-intentioned, the news media had no independent brief to act in the capacity of a health-screening agency for those seeking public office. The public relies on the media to convey accurate information about the candidates. Despite the possibility of bias, superficiality, and sensationalism in coverage, the media do as well as can be expected under the current system's restraints, but the system needs to be modified to give the media greater access to more accurate medical information about those who seek...