the threat of presidential illness

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Dr. David Blumenthal, Opinion contributor
Published 5:00 a.m. ET Oct. 5, 2020

The president’s health is a matter of national security.

Reforms in how the nation monitors the health of its president are long overdue. President Trump’s unprecedented illness, and the confusion around his diagnosis and the state of his health make it clear that our current system is flawed.

Plenty of presidents have gotten sick, and plenty have kept it secret, some even when their illness impaired their ability to govern. Woodrow Wilson had a stroke that rendered him incapable of governing for the last 18 months of his presidency. His wife effectively became Commander in Chief. Americans never knew.

FDR never revealed his polio-induced paralysis. He also kept secret the long-standing high blood pressure that damaged his heart and left him a sick, physically compromised man in his 1945 meetings in Yalta, where the allies divided up the post-war world. 

John F. Kennedy kept secret his Addison’s disease, while the drugs used to treat the resulting pain may have impaired his alertness when he met Soviet leader Nikita Khrushchev in Vienna in 1961. Historians speculate that Khrushchev came away thinking Kennedy was weak and could be bullied. The result: the Cuban Missile Crisis.

What’s different about Trump getting COVID?

So what’s different about President Trump’s contracting the novel coronavirus? First, unlike all other recorded serious presidential illnesses, Trump’s is infectious. We now know that a large number of people close to the president have tested positive, or are at risk. Those still at risk include the vice president and the president’s chief of staff and an unknown number of other senior officials who the president may have interacted with, unmasked, during the last week to 10 days. It also includes the Democratic candidate for president, former Vice President Joe Biden. There is no precedent for a presidential illness that threatened to take down with him a broad swathe of the nation’s senior leadership, and thus to comprehensively threaten our nation’s ability to govern itself.

President Donald Trump on Oct. 3, 2020, at Walter Reed National Military Medical Center in Bethesda, Maryland. (Photo: Joyce N. Boghosian, The White House/AFP via Getty Images)

Second, no president in recent history has expressed such open contempt for the best medical and scientific opinion of his day or so openly indulged in promoting medical quackery. The president’s championing of hydroxychloroquine as a treatment for COVID-19, even after the best science debunked it, stands out as unique in the annals of the modern presidency. So does his administration’s efforts to manipulate the dissemination of scientific advice to the American people and potentially, to interfere with the process for approving a vaccine. These behavior patterns raise concerns about whether he will take advantage of the superb care he will be offered at Walter Reed Medical Center, or veer off to insist on receiving unproven and perhaps hazardous therapies. They also raise concerns about manipulation of whatever information the president allows his physicians to share with the public about his condition.

After Trumps’ diagnosis: Vaccine or not, COVID-19 isn’t going away

Third, the pace of events in the internet age tests presidents as never before. The volume of information that they must absorb, and the rate at which it flows into the Oval Office are unprecedented in history. Thus, the president’s mental acuity, always important, is now more critical than ever to national security and to the nation’s welfare. Presidential illness, therefore, is just a bigger deal in 2020.

Health of presidents is a matter of national security

This combination of factors raises again a question that surfaces periodically, only to drift out of focus as presidential health crises resolve. Quite simply, the health of the president — and indeed of presidential candidates — is a matter of national security and should be treated as such. The American people deserve to know if their commander in chief is sick, whether he is getting the best possible care, whether he is capable of governing, and whether his illness threatens the health of those around him. They also need to know before they cast votes for presidential candidates whether they are physically capable of rendering the service that the public needs and deserves. 

Trump contracts COVID-19: Presidential illness is a recurring concern in American politics

One way to provide this information to Americans would be for Congress to constitute a national presidential medical commission with responsibility for rendering an objective, scientific assessment of the health of presidential candidates and Oval Office occupants. The commission should include both governmental and non-governmental physicians and scientists, and could be convened under the auspices of the National Academies of Science, Engineering and Medicine, which were chartered during President Abraham Lincoln’s term to provide independent scientific advice to the U.S. Government. This commission should be tasked with informing the American people about the health status of presidential aspirants and incumbents, and also with making recommendations about invoking the 25th Amendment, transferring power from the president to the vice president when necessary.

History shows that we cannot rely on candidates, presidents or their staffs to provide the information the American people need and deserve in an objective and timely fashion. It’s time to take it out of their hands.

Dr. David Blumenthal is president of the Commonwealth Fund. Follow him on Twitter: @DavidBlumenthal  


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