Stop Asking the Candidates to Release Their Medical Records

Traditionally, the practice of candidates releasing their medical records has been varied and inconsistent: There is no legal requirement to disclose health information nor a robust established precedent as there is with tax returns (though in this campaign, that too seems optional). In 1996, amid calls to release more medical information, President Bill Clinton said, “The public has a right to know the condition of the president’s health.” In 2008, John McCain released more than 1,000 pages of his medical records to the press. Historically, though, presidents with significant medical illnesses, including John F. Kennedy, Franklin Delano Roosevelt, and Woodrow Wilson, have been far more private. Grover Cleveland had an oral tumor secretly removed aboard a friend’s yacht before emerging from a four-day “fishing trip.”

Still, a recent poll found that 59 percent of voters now think major presidential candidates should release most of their medical records, compared with 38 percent in 2014.

But demands for candidates to release their medical records have far more to do with media curiosity and political maneuvering than any genuine concern about whether Clinton or Trump has a condition that would prevent him or her from serving out his or her terms. The media frenzy around each candidate’s medical history—whose cholesterol is higher? How many colon polyps does each have?—has distracted from an already distracted presidential campaign embarrassingly devoid of substance.

The central question raised by this discussion is not what we—as voters, the media, or politicos—should know about a candidate’s health. It’s why we care so little about a candidate’s policies while we devotedly follow the drama. We’re now obsessed with an apparently exotic disease called pneumonia, but we still care so little about whether millions of Americans can get treatment for it.

Voters have a right to know whether candidates have a condition that would limit their ability to perform their job or prevent them from serving their term in the Oval Office. Both Clinton and Trump have lived so publicly for so long that it seems near impossible either is hiding a medical condition severe enough to actually impede on his or her ability to serve. And beyond a few major illnesses—active cancer, serious neurologic disease, advanced heart failure—medicine has a surprisingly difficult time predicting health going forward. Even in relatively straightforward cases, prognosticating is notoriously hard for physicians, and no amount of disclosure can predict the future.

Consider the history of presidents dying in office. Eight American presidents—or about 18 percent of officeholders—have died before finishing their terms. Of those, half died from natural causes, and two died of infections that would have been impossible to forecast. Careful perusal of medical records, then, is unlikely to give us a clear answer about whether a president will survive his or her term; it is, however, likely to be used as political weaponry to unfairly attack candidates.

We’re now worried about Hillary Clinton’s seasonal allergies; Woodrow Wilson had a stroke.

It could also stigmatize Americans struggling with certain diseases. Medical information is easy to manipulate and mischaracterize. For example, Clinton has hypothyroidism, an exceedingly common and easily treated condition. But it’s not unreasonable to expect her opponents to raise questions about whether it affects her “stamina.” What does that mean for the millions of Americans with hypothyroidism? Are they unfit for their jobs? If you have hypothyroidism, are you?

Similarly, as strange as it is to say, thank goodness Trump’s testosterone level is, apparently, normal. If it wasn’t, how many low-T jokes would we be subjected to? And did you really need to know Bill Clinton had hemorrhoids in 1984? Well, he did. And now you know.

Demanding wholesale release of candidates’ medical records sets a dangerous and inappropriate precedent. For one thing, releasing such reports is no easy business. McCain’s fairly organized release of 1,000-plus pages of records was mostly possible thanks to the highly systemized health care he received as a veteran.

This onslaught of documents would be difficult to execute and hard for reporters and lay people to analyze, and it would offer little insight into whether a person is likely to survive his or her term in office. But it would provide ample ammunition for speculation, manipulation, and stigmatization under the pretense of transparency.

Presidents such as Roosevelt and Kennedy are among our most respected political leaders. Had the American public known their full medical histories at the time of their elections, they may never have taken office. We’re now worried about Hillary Clinton’s seasonal allergies; Woodrow Wilson had a stroke.

Good medical care requires honesty, but it also requires privacy. Without this, we rob people (and even political candidates are people) of the ability to seek support and help. If releasing records becomes routine, aspiring public leaders may forego treatment they need, or withhold information from their doctors, to avoid creating a paper trail documenting their medical conditions.

It is true that we need some basic information about candidates’ health to judge their fitness for office. And ethically, candidates should disclose serious illnesses that might preclude them from fulfilling their duties as commander-in-chief. It would be extraordinary if the Democratic and Republican party sachems had not considered this as they did their own vetting of the candidates. All available evidence suggests that each candidate is physically fit to serve, as much as we can ever know that.

But when asking candidates to release medical records, we should first ask ourselves: What problem are we trying to solve? Is it worth solving? And what are the costs of solving it? The problem with this presidential race is not that we don’t know enough about the health of the candidates running. It’s that we’d rather theorize about that than debate the policies they’re proposing.

Dhruv Khullar is a resident physician at Massachusetts General Hospital and Harvard Medical School. Follow him on Twitter.