The White House has announced that President Trump has scheduled an annual physical exam for Jan. 12. The President will go to Walter Reed National Military Medical Center in Bethesda, Md., the largest military hospital in the nation. White House press secretary Sarah Huckabee Sanders says Dr. Ronny Jackson, a rear admiral in the U.S. Navy who has served as physician to the President since 2013, “will give a readout of the exam after it’s completed.”
Some may have greeted this announcement with relief. Finally, concerns about the President’s slurred speech, overall mental health, crummy diet and obesity will be publicly addressed. Don’t get your hopes up.
A physical tends to be just that—an assessment of the physical not the mental. The evaluation of mental health in a standard physical is, to be polite, very cursory.
And while it is good that Trump at 71 will get a physical, he is under no obligation to reveal anything concerning that the exam turns up. When you are Commander-in-Chief and an Admiral reports on your exam, it is very clear that the Admiral had better be prudent about what gets said about the boss. Same goes for those on active duty at Walter Reed who perform the exam. Moreover, Trump has the same right to privacy that you or I do when we choose to get a physical or undergo any other medical procedure. It is up to him what he reveals to the rest of us.
The White House is well aware that they control what we will learn about the President’s health. And control the results they will.
There is a long history of prevarication, distortion, withholding and pretending when it comes to medical information generated when doctors examine a President. Enough to raise enormous doubt about what this White House will permit to be released. Those who served previous Presidents whose livelihood depended on keeping him in office never really let us know what they knew about the health troubles and risks of Wilson (serious stroke), Roosevelt (polio, cardiac disease), Eisenhower (massive heart attack), Kennedy (Addison’s disease), Johnson (bipolar disorder, heart attacks), Nixon (alcohol abuse, depression), Reagan (early signs of Alzheimer’s) or Clinton (hypertension, lipidemia).
We don’t see any easy solution to this problem, which applies to every modern leader who wields immense power. If health information is vetted by the President’s closest allies and confidantes, truth is likely to be hard to find.
Former President Jimmy Carter tried to address the issue in 1994. Under his Carter Center he helped form a Working Group on Presidential Disability, which proposed a non-partisan panel of doctors to monitor the president’s health. It was never created.
President Carter’s proposal needs to be revisited. A physical is not an assessment of someone’s ability to do the job of President. Presidents choose to get physicals for their own benefit. Congress needs to insist on a mandatory, independent, thorough, transparent annual medical assessment of Presidents and Vice Presidents for our benefit.
Arthur Caplan is the head of the Division of Bioethics at New York University Langone Medical Center.
Jonathan D. Moreno PhD is a professor of medical ethics and health policy at the Perelman School of Medicine, University of Pennsylvania.
This blog post originally appeared in Forbes.
“ Finally, concerns about the President … A physical tends to be just that—an assessment of the physical not the mental.”
This sounds nutty. If one were to observe Winston Churchill one could say just about the same things with the addition of drinking and smoking cigars.
If he were CEO of a major corporation, he would have more oversight of his physical and mental health than he will as POTUS. But, we shouldn’t pick on Trump over this. In general, our politicians have little accountability for much of anything.
Agreed. However, the corporate commitment to its social responsibility is uneven.
As a Primary Physician, the real challenge occurred when I was faced with offering health care to a person endowed with thinking skills underlying their intellectual capabilities that were far and away faster than mine. This was even more difficult when their social capabilities were far and away more decisive than mine. When confronted with various diversionary forms of creativity, the odds of misinterpreting them became very precarious. The similarity of that situation could apply to our nation’s Presidents and their health care, now and forever.
The daily stress resulting from anticipating the many forms of betrayal that daily blind-side our Presidents must be horrific. I worry most about the eventual loss of connection within the daily civil life encountered by our nation’s citizens. There is not one of us who hasn’t had a life experience that seriously disturbed our own ‘Personal Survival Plan’ and was caused by a decision in the C Suite of our employer. Unlike some of our Presidents, Mr. Trump seems to have an intact Extended family connected by a set of Family Traditions.
I would not be in favor of any constituted group of experts to act as an arbiter of a President’s fitness to exercise the responsibilities of our nation’s presidency. For unique situations, a long-term Primary Physician, Consulting Physicians, “next of kin” and three constitutionally defined successors should be enough. There is no group of people, however defined, that would have the ultimate skill-set to act precisely in response to all conceivable issues.
Our historical connection with “finding the cure” as the governing paradigm for healthcare has triggered an urge to “label” our President as a basis for fixing his vexatious issues. Its maybe the best reminder that the proximate cause for most of today’s illnesses are driven by the social adversities that each person encounters within the civil life of their community, beginning as an infant. We best move away from the idea that fixing our President will do anything to fix the decline in Social Capital currently occurring within each community that drives the turmoil within our lives. The Caring Relationships within our Family and its Extended Family along with their connection with a neighborhood network would be the best plan to support each citizen’s Personal Survival Plan.