Patient's privacy vs. public's right to know

When Dick Cheney took the microphone Friday and, in an unprecedented step, began fielding questions about an imminent heart procedure, it was a tacit acknowledgement that public interest in his health cannot be held hostage by his privacy rights as a patient.

While basic information about Mr. Cheney's health remains off limits to the media, and hence to the public, the White House opted to be more forthcoming about Saturday's medical procedure than it has been concerning the vice president.

Indeed, after putting a heart-assisting device into their patient, Cheney's doctors detailed the procedure and its implications. Today, with TV cameras whirring, Cheney is expected to return to work.

Until this episode, the White House has played down questions about the vice president's health - and said as little as possible. But Saturday's visit to the hospital was at least Cheney's fourth since his election, and the public announcement this time points to a growing recognition of the need for greater disclosure.

The Cheney story also shows how the media's role has changed over the decades, from accomplice in hiding officials' health problems (as it did during the tenure of Franklin Roosevelt) to watchdog.

Moreover, it hints at an evolving standard in American democracy: Instead of politicians deciding in secret whether they are fit to serve, the voting public - armed with health information - should make the call.

"That's the essence of a democracy: If you're an elected official, you work for the people," says Marlin Fitzwater, press secretary to the first President Bush. "They're your boss." Presidents he has worked for, he says, "felt the people had a right to know the health of the chief executive."

Lies about health

It hasn't always been that way. "Presidents have lied about their health more than any other topic," says Richard Shenkman of HistoryNewsNetwork.org. From Chester Arthur to Grover Cleveland, from Calvin Coolidge to Woodrow Wilson to John Kennedy, presidents have covered up some health issues before and during their time in office.

President Roosevelt is perhaps the most dramatic example. Only those who saw him often and in person knew he was in a wheelchair. Photographers would wait - cameras at their sides - as the president was lifted into his car. One of the few times he let his immobility be seen in public was when he wheeled through World War II hospital wards full of amputee soldiers - an effort to inspire hope.

Later, after Dwight Eisenhower was diagnosed as having had a heart attack in his first term, it was much harder to hide the fact that the president was incapacitated. It was the dawn of the television age, and Americans were getting used to seeing regular footage of their president. Even so, Eisenhower and his aides weren't entirely forthcoming.

"In 1956, after he decided to run for a second term, he started having some problems," says historian Clarence Lasby, author of a book on Eisenhower's health. "But they just didn't let it out."

Then there's the issue of medicines - and whether they impair the judgment of top decisionmakers who use them. President Kennedy, for one, hid his chronic back troubles - and the fact that he took significant amounts of medicine to alleviate them.

After Kennedy's death - and throughout the cold war - scrutiny of the president's health increased. In the age of nuclear missiles set on hair-trigger alert, there was a sense that "the president could never be out of sight for more than five minutes - in case he needed to push the button," says Mr. Fitzwater.

Greater public interest in part

pushed the media toward the role of vigilant investigator. In 1972, vice-presidential candidate Thomas Eagleton withdrew from the race after the press revealed he had been treated for depression. After the assassination attempt on President Ronald Reagan, the national TV networks gave "guided tours" of the president's organs, recalls Fitzwater.

How much media vigilance?

Some argue that the press needs to maintain its aggressive stance. "Given the history on this issue, we should err on the side of transparency," says Mr. Shenkman.

But others say it's enough for the public to have an overview of a politician's health. Zeroing in on every "hiccup" isn't necessary and can "paralyze" the political system, says Richard Harwood of the Harwood Institute, a think tank in Bethesda, Md.

"We're electing these leaders to make phenomenal judgments on our behalf," Mr. Harwood says. If they misjudge the issue, he adds, the public should question their "judgment" and "credibility."

Finally, some say America's democracy is strong and mature enough that the incapacitation of a top officeholder holds only a small risk of chaos.

If something happens to the president or vice president, the Constitution dictates the next steps - and the nation is likely to remain stable, Fitzwater says. "It's a great tragedy in a personal sense, but America knows it's a republic, and we go on."

(c) Copyright 2001. The Christian Science Monitor