A Better Way to Assess a Candidate's Health

WASHINGTON -- American voters have received, we are told, all they are going to get from their presidential candidates in the way of medical information. In light of Hillary Clinton's initially (and, if she had her way, permanently) undisclosed pneumonia, in light of Donald Trump's unhealthy body mass index and buffoonish physician, in light of both candidates' relatively advanced ages, this move-right-along admonition is unsettling and unsatisfying.

Experts have raised reasonable questions about Clinton's medical care and history, including her record of blood clots and the use of the blood thinner Coumadin to treat them. And you don't have to be an expert to know that there are reasonable questions about Trump's health, given the willingness of his doctor to issue the assurance that "unequivocally" Trump "will be the healthiest individual ever elected to the presidency." No one should trust a doctor like that.

One proposed solution would be for the candidates to submit to the "full McCain," a reference to the Arizona Republican senator's decision to allow reporters to review his full medical records, albeit for a single, three-hour window.

This approach is tempting. After all, running for president -- and being president -- essentially means giving up any claim to privacy. The unique power of the office, combined with the risk of a president suffering from undisclosed health issues and the history of presidents' hiding such problems, argues for tipping the scales in favor of more disclosure, not less.

And yet, the implications of making such disclosure a matter of routine expectation in the end tilt against such a demand. Medical records are more intimate and more susceptible to ignorant misinterpretation than tax returns. The totality of a candidate's medical history is not as important as his or her current health, including whether past issues raise the prospect of future problems.

Consider some scenarios. A future female presidential candidate has had an abortion. The decision to terminate her pregnancy has no bearing on her health, but could be politically explosive and is, in any event, a decision that she should be able to choose to keep private.

Or she has a history of miscarriages, about which she has never spoken publicly. Or a male candidate has a low sperm count or other problem that made it difficult for him to father a child and led the couple to use artificial insemination, something they have not previously revealed. Or he has erectile dysfunction. Are we really comfortable forcing such facts into public view?

How should we think about cosmetic surgery? Trump is reported to have had scalp reduction surgery to fix a bald spot. There's lots of unsupported online chatter about whether Clinton has had some work done. This information feels more prurient than informative.

Likewise, and even more difficult because of the strength of arguments either way, are matters of mental health. A female candidate was treated for postpartum depression. A candidate, male or female, sought marital counseling. Or treatment for depression or anxiety. Relevant or immaterial?

Do we really want to establish disincentives for would-be presidents (they have a history of thinking about this for decades in advance, after all) to seek appropriate help? At the same time, is there not some public interest in knowing whether a past history of mental health issues might be relevant to ability to perform in office?

What about attention deficit hyperactivity disorder? According to the Centers for Disease Control and Prevention, 14 percent of boys between 5 and 17 have been diagnosed with ADHD. Have their parents just ruined their presidential chances? Assuming their grown-up selves are functioning effectively, with or without medication, is this information relevant?

One proposed and intriguing alternative to the full McCain is having a panel of esteemed and independent physicians conduct a thorough assessment of the nominees.

There may be an even easier way. Presidents routinely release the results of the physicals conducted by the White House physician, who is generally an active-duty military officer.

The candidates could have a similar checkup, consistent with what they would receive as president. A military physician would be considered an independent and trustworthy source, someone who could use his or her judgment to determine what in a candidate's medical history is relevant in the present.

Surely, the president has authority to order government resources dedicated to this enterprise. And surely the voters are entitled to more information, from a more trustworthy source, than they are now receiving.

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Ruth Marcus' email address is ruthmarcus@washpost.com.