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Published in: Journal of General Internal Medicine 10/2020

01-10-2020 | Perspective

When Disease Strikes Leaders: What Should We Know?

Author: Salvatore Mangione, MD

Published in: Journal of General Internal Medicine | Issue 10/2020

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Abstract

Diseases of heads of state can affect national policy. Yet, cases of cover-up are numerous and involve not only dictatorships but also open and democratic societies. No system of full disclosure is currently in place to ensure that the public has access to all the information needed to establish whether a candidate to the presidency or an elected leader can discharge the powers and duties of the office. Hence, this essay reviews how the illnesses of democratically elected heads of state have changed history; addresses how to ensure greater transparency, so that leaders will not only be unable to conceal incapacitating disabilities, but also be removed from office once impaired; and lastly discusses how illness does not necessarily imply incapacitation, even though separating the two might often be difficult. These are issues of great relevance to national politics and medical ethics. They are particularly important as the 2020 presidential election is underway, and four out of the five leading candidates are well into their 70s.
Footnotes
1
Commencement Address at American University, Washington, D.C., June 10, 1963
 
Literature
4.
go back to reference O’ Toole P. The Moralist: Woodrow Wilson and the World He Made. New York, NY: Simon & Schuster; 2018. O’ Toole P. The Moralist: Woodrow Wilson and the World He Made. New York, NY: Simon & Schuster; 2018.
5.
go back to reference Menger RP, Storey CM, Guthikonda B, Missios S, Nanda A, Cooper JM. Woodrow Wilson's hidden stroke of 1919: the impact of patient-physician confidentiality on United States foreign policy. Neurosurg Focus. 2015;39(1):1-6.CrossRef Menger RP, Storey CM, Guthikonda B, Missios S, Nanda A, Cooper JM. Woodrow Wilson's hidden stroke of 1919: the impact of patient-physician confidentiality on United States foreign policy. Neurosurg Focus. 2015;39(1):1-6.CrossRef
6.
go back to reference Toole JF. Dementia in world leaders and its effects upon international events: the examples of Franklin D. Roosevelt and T. Woodrow Wilson. Eur J Neurol. 1999;6(2):115-9.CrossRef Toole JF. Dementia in world leaders and its effects upon international events: the examples of Franklin D. Roosevelt and T. Woodrow Wilson. Eur J Neurol. 1999;6(2):115-9.CrossRef
7.
go back to reference Weinstein EA. Woodrow Wilson's Neurological Illness. J Am Hist. 1970;57:324-51.CrossRef Weinstein EA. Woodrow Wilson's Neurological Illness. J Am Hist. 1970;57:324-51.CrossRef
8.
go back to reference Crispell KR, CG, Bayh B. Hidden Illness in the White House. Durham, NC: Duke University Press Books; 1988.CrossRef Crispell KR, CG, Bayh B. Hidden Illness in the White House. Durham, NC: Duke University Press Books; 1988.CrossRef
9.
go back to reference Harriman WA, Abel E. Special Envoy to Churchill and Stalin 1941–1946. New York, NY: Random House; 1975 Harriman WA, Abel E. Special Envoy to Churchill and Stalin 1941–1946. New York, NY: Random House; 1975
10.
go back to reference Steinberg D. President Franklin D Roosevelt (1882-1945) and Doctor Frank Howard Lahey's (1880-1953) dilemma: The complexities of medical confidentiality with World Leaders. J Med Biogr. 2016;24(1):50-60.CrossRef Steinberg D. President Franklin D Roosevelt (1882-1945) and Doctor Frank Howard Lahey's (1880-1953) dilemma: The complexities of medical confidentiality with World Leaders. J Med Biogr. 2016;24(1):50-60.CrossRef
11.
go back to reference Braasch JW. Anthony Eden’s (Lord Avon) Biliary Tract Saga. Ann Surg. 2003;238(5):772–775.CrossRef Braasch JW. Anthony Eden’s (Lord Avon) Biliary Tract Saga. Ann Surg. 2003;238(5):772–775.CrossRef
12.
go back to reference The Rt Hon Lord Owen CH. The effect of Prime Minister Anthony Eden's illness on his decision-making during the Suez crisis. Q J Med. 2005;98(6):387–402.CrossRef The Rt Hon Lord Owen CH. The effect of Prime Minister Anthony Eden's illness on his decision-making during the Suez crisis. Q J Med. 2005;98(6):387–402.CrossRef
14.
go back to reference Dallek R. An Unfinished Life: John F. Kennedy, 1917-1963. Boston, MA: Little Brown & Co; 2003. Dallek R. An Unfinished Life: John F. Kennedy, 1917-1963. Boston, MA: Little Brown & Co; 2003.
15.
go back to reference Mandel LR. Endocrine and Autoimmune Aspects of the Health History of John F. Kennedy. Ann Intern Med. 2009;151(5):350-54.CrossRef Mandel LR. Endocrine and Autoimmune Aspects of the Health History of John F. Kennedy. Ann Intern Med. 2009;151(5):350-54.CrossRef
17.
go back to reference Lertzman RA, Birnes WJ. Dr. Feelgood: The Shocking Story of the Doctor Who May Have Changed History by Treating and Drugging JFK, Marilyn, Elvis, and Other Prominent Figures. New York, NY: Skyhorse Publishing; 2013. Lertzman RA, Birnes WJ. Dr. Feelgood: The Shocking Story of the Doctor Who May Have Changed History by Treating and Drugging JFK, Marilyn, Elvis, and Other Prominent Figures. New York, NY: Skyhorse Publishing; 2013.
18.
go back to reference Hersh SM. The Dark Side of Camelot. Boston, MA: Little Brown & Co; 1997. Hersh SM. The Dark Side of Camelot. Boston, MA: Little Brown & Co; 1997.
20.
go back to reference Beschloss M. The Crisis Years: Kennedy and Khrushchev, 1960-1963. New York, NY: HarperCollins; 1991. Beschloss M. The Crisis Years: Kennedy and Khrushchev, 1960-1963. New York, NY: HarperCollins; 1991.
23.
go back to reference Palo J. The cover-up of President Urho Kekkonen's dementia and its impact on the political life of Finland-a personal account. Eur J Neurol. 1999;6(2):137-40.CrossRef Palo J. The cover-up of President Urho Kekkonen's dementia and its impact on the political life of Finland-a personal account. Eur J Neurol. 1999;6(2):137-40.CrossRef
24.
go back to reference Friedlander WJ. About three old men: an inquiry into how cerebral arteriosclerosis has altered world politics. A neurologist's view. Stroke. 1972;3:467–473.CrossRef Friedlander WJ. About three old men: an inquiry into how cerebral arteriosclerosis has altered world politics. A neurologist's view. Stroke. 1972;3:467–473.CrossRef
25.
go back to reference The Rt Hon Lord Owen CH. Diseased, demented, depressed: serious illness in Heads of State. Q J Med. 2003;96(5):325-36.CrossRef The Rt Hon Lord Owen CH. Diseased, demented, depressed: serious illness in Heads of State. Q J Med. 2003;96(5):325-36.CrossRef
27.
go back to reference Berisha V, Wang S, LaCross A, Liss J. Tracking Discourse Complexity Preceding Alzheimer's Disease Diagnosis: A Case Study Comparing the Press Conferences of Presidents Ronald Reagan and George Herbert Walker Bush. J Alzheimers Dis. 2015;45(3):959-63.CrossRef Berisha V, Wang S, LaCross A, Liss J. Tracking Discourse Complexity Preceding Alzheimer's Disease Diagnosis: A Case Study Comparing the Press Conferences of Presidents Ronald Reagan and George Herbert Walker Bush. J Alzheimers Dis. 2015;45(3):959-63.CrossRef
28.
go back to reference Annas GJ. Some Choice: Law, Medicine, and the Market. Oxford, UK: Oxford University Press; 1998. Annas GJ. Some Choice: Law, Medicine, and the Market. Oxford, UK: Oxford University Press; 1998.
29.
go back to reference Carter J. Presidential Disability and the Twenty-fifth Amendment - A President's Perspective. JAMA. 1994;272(21):1698.CrossRef Carter J. Presidential Disability and the Twenty-fifth Amendment - A President's Perspective. JAMA. 1994;272(21):1698.CrossRef
33.
go back to reference American Medical Association. Principles of Medical Ethics. Appendix F. In: Baker RB, ed. The American Medical Ethics Revolution. Baltimore, MD: Johns Hopkins University Press; 1957:355–257 American Medical Association. Principles of Medical Ethics. Appendix F. In: Baker RB, ed. The American Medical Ethics Revolution. Baltimore, MD: Johns Hopkins University Press; 1957:355–257
35.
go back to reference Shenk JW. Lincoln's Melancholy: How Depression Challenged a President and Fueled His Greatness. Boston, MA: Houghton Mifflin Harcourt; 2005. Shenk JW. Lincoln's Melancholy: How Depression Challenged a President and Fueled His Greatness. Boston, MA: Houghton Mifflin Harcourt; 2005.
Metadata
Title
When Disease Strikes Leaders: What Should We Know?
Author
Salvatore Mangione, MD
Publication date
01-10-2020
Publisher
Springer International Publishing
Published in
Journal of General Internal Medicine / Issue 10/2020
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-020-06060-1

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