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What should we know about presidential candidates’ health?

(CNN)Presidential candidates have long been wary of allowing the public to see them as less than a picture of perfect health.

Over the weekend, Hillary Clinton’s health became a pressing question as she appeared wobbly and stumbled as Secret Service agents helped her into a van to exit a September 11 memorial service on Sunday. Her doctor revealed that Clinton was diagnosed with pneumonia on Friday.
    As Election Day nears, what right does the public have to know the intimate details of a candidate’s medical history?After all, they are shielded by the same federal privacy laws that protect each of us from undue scrutiny.
    “It’s a controversial issue because some illness can be blown out of proportion and with modern medicine, a person can do well,” said Jerrold Post, author of “When Illness Strikes the Leader.” “But if a person is suffering from early Alzheimer’s or another serious disease, it’s quite another story.”


    Ronald Reagan was diagnosed with Alzheimer’s after his presidency. Whether it affected his ability to function while in office is a subject of debate. Today, however, medical science knows Alzheimer’s begins in the brain 20 to 30 years before symptoms begin.
    “Can you rely on the politician’s physician to spot these types of issues? Some illnesses are only known by the symptoms the patient complains of,” Post said. “The softening of mental processes that begin in early Alzheimer’s, for example, may only show up if the politician complains about it.”

    Mental illness

    Mariano adds that even when there are signs, “you have to remember if there is something wrong with a president that kicks him out of office, everyone who comes with him leaves. So everyone wants to keep him in; they want to silence the doctor.”
    And then there’s the specter of mental illness.
    “People have horrible prejudice against mental illness,” said Annas, of Boston University
    Added Mariano, “If you have a mental illness, you’re depressed, you can’t get out of bed, that’s going to affect your ability to do your job.”
    A 2006 study by Duke psychiatrists applied today’s diagnostic criteria to historical records of the first 37 presidents between 1776 and 1974 and found 18 of them met the criteria for psychiatric disorders, mostly depression, anxiety, bipolar disorder or alcohol abuse and dependence.
    The study also found Teddy Roosevelt and Lyndon Johnson might have both been diagnosed with bipolar disorder.
    In fact, say the researchers, 10 of the 18 presidents exhibited enough symptoms of mental illness while in office to have affected their ability to lead the nation.

    Independent presidential health exam?

    In 2008, a high-profile panel of doctors recommended that presidential and vice-presidential candidates be required to undergo a health exam by an independent team of doctors from the American College of Physicians. Mariano was on that committee.
    “So we said in a perfect world, wouldn’t it be great if we had a committee that performed physicals and said this person is good to go, just like we do for airline pilots, or in the military,” Mariano said. “It would say, ‘OK, I’m good for four to eight years, I hopefully won’t die of some disease that I’m aware of, I’m mentally sane and I don’t have any drug or alcohol or psychiatric issues and I want to run for office.'”
    The recommendation didn’t go anywhere. Mariano now thinks it’s not practical in a polarized political world.
    “Part of that is that you have to have compliance by the person who is running for office,” Mariano said. “A lot of them feel like that’s an invasion of their privacy; they’re not willing to share that. And part of it was they’ll say ‘Wait a minute, do the doctors reveal if they’re Democrat or Republican? You know a Republican doctor can say that a Democratic candidate is crazy.'”
    Mariano feels that the only good solution is a free and inquisitive press.
    “The things that happened with Woodrow Wilson and his stroke, and FDR, and Kennedy — can you do that now? It’s harder to hide things today because you have 24/7 news.”

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