Do public figures have a responsibility to disclose their medical records?
As Nov. 8 rapidly approaches, election coverage is becoming increasingly prominent in American media. While many news sources report on the candidates’ policies and political histories, others choose to focus on the candidates as people. Countless controversies regarding relationships, appearances, social media presence and more have been reported. While most people would feel uncomfortable with having so many aspects of their lives in constant public view, there’s an expectation that those living in the limelight should not only accept these critiques, but also contribute to the discussion and verify or deny every rumor.
In the 2016 election, health has been central—and not necessarily healthcare policy. From psychiatric diagnoses to examinations of pneumonia, both major candidates have undergone much scrutiny regarding their health. In fact, both have faced pressure to release their medical records with the argument that the American public should be able to estimate the “stamina” of each candidate prior to voting. However, should presidential candidates actually be forced to share these private details, and how should healthcare professionals participate in conversations about the health of celebrities?
Comes with the Territory?
When there is a nearly constant discussion in the media about a person’s personal life, it may seem natural for that person to eventually feel numb to it all. “When a person is a high-profile individual, they are subject to comments, commentary and speculations as a result of being in the news or on air,” said Twila Brase, president and co-founder of the Citizens’ Council for Health Freedom. “It comes with the territory.”
However, that doesn’t mean it’s always right. The Citizens’ Council for Health Freedom (CCHF), which seeks to “protect healthcare choices, individualized patient care and medical and genetic privacy rights,” urges voters to think of their own desire for medical privacy.1,2
“Patients, regardless of who they are, need to feel safe revealing whatever they must reveal and having looked at whatever they need looked at to receive accurate and timely treatment,” Brase wrote on the CCHF site. She added that people should not fear to be honest with their physicians. “If released, our records could divulge secrets only told to a provider-secrets not even the patient’s family knows; secrets that the candidate has moved beyond and should not be resurrected just because they’re running for office.”
Role of Healthcare Professionals
Regardless of the ethical issues, one would be naïve to think that media outlets will simply stop pushing for this information and as long as they publish material about the topic, the discussion will continue. Because news articles thrive on quotations from credible sources, many healthcare professionals have been asked – and will continue to be asked – to contribute input on the candidates’ health. How should they respond?
Expert opinions vary. In August, Maria A. Oquendo, MD, president of the American Psychiatric Association (APA), wrote on the APA website reminding psychiatrists of the “Goldwater Rule.” Coined in 1973 after presidential candidate Barry Goldwater was subject to mass psychoanalysis during the 1964 election, the Goldwater Rule prohibits psychiatrists from offering opinions on people whom they have never treated. Oquendo gave psychiatrists no opportunity to misinterpret her warning, writing, “Simply put, breaking the Goldwater Rule is irresponsible, potentially stigmatizing and definitely unethical.”3
Yet, it’s possible that omitting healthcare professionals from these conversations altogether could do more harm than good. Often, the general public doesn’t understand health issues and medical records, causing misinformation to spread quickly. While electronic health records have enabled healthcare professionals to access comprehensive versions of patients’ health records, these records are rarely fully complete. Minor illnesses may not be recorded. Trips to urgent care clinics may not be recorded. Undiagnosed ailments will not be recorded. These records do paint a picture of a person’s health history, yes, but they are rarely full histories.
Healthcare professionals are put in a unique position in these cases since they have the background knowledge to stop the spread of misinformation, but also have the responsibility to promote patient confidentiality. “News reporters will find someone to ask these questions to, or they’ll speculate themselves,” said Brase. “Healthcare professionals who do answer would do a great service by taking care to answer responsibly and truthfully. They cannot make a diagnosis without a proper history and physical.”
While most healthcare professionals have not actually met, much less examined, the presidential candidates, they have a responsibility to maintain the privacy of these people. Failing to protect their medical history is failing to ensure the general public that health information is truly confidential. If people believe that their own medical histories could also be so easily discussed, they will be less likely to pursue treatment for any future health issues, which could be detrimental to both their own health and that of those around them.
“We live in an age when information on a given individual is easier to access and more abundant than ever before, particularly if that person happens to be a public figure,” Oquendo wrote. “With that in mind, I can understand the desire to get inside the mind of a presidential candidate. I can also understand how a patient might feel if they saw their doctor offering an uninformed medical opinion on someone they have never examined.”3
Healthcare professionals must be careful when discussing the health of people whom they have never met or – anyone at all. They should ask themselves, “Would I comment if this were my patient?” It’s likely that the answer will be no. Remember, that celebrity is a person, just like you, and likely a patient to another healthcare professional. Be careful what you say.
Citizen’s Council for Health Freedom. About CCHF.
Brase T. 7 reasons to protect candidate privacy. Citizen’s Council for Health Freedom. 2016.
Oquendo M. The Goldwater Rule: Why breaking it is unethical and irresponsible. American Psychiatric Association. 2016.