Medical Ethics Corner: Presidential Politics

politicsBy: Brent Schillinger, Guest Contributor

Love him or hate him, there’s no denying that Donald Trump has brought presidential politics to a whole new level.  Even the release of his medical records was way beyond routine.  Actually, Trump never provided any medical records.  What he did was release a letter from his personal physician, Harold Bornstein, MD.  This was a rather extravagantly worded letter for a medical document that states, “if elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency.”  Never mind that if elected Mr. Trump would be 70 years old at the time of his inauguration, making him the oldest person ever elected to the presidency.  And did Dr. Bornstein actually have access to the files on Millard Fillmore and John Quincy Adams?

In support of his “medical opinion,” Dr. Bornstein uses some unusual if not extravagant language: “He’s had a complete medical examination that showed only positive results.” It is a bit odd for a doctor to phrase it this way.  Clearly he must have meant to say that everything was normal.   A “positive” result in the language of medicine is not always great news.   Bornstein goes on to describe Trump’s “laboratory test results” as “astonishingly excellent.” I don’t think many doctors would describe themselves as “astonished” with their patient’s lab numbers. While Bornstein praises Trump’s “extraordinary” strength and stamina,  it’s curious how there is no mention of those bone spurs that were so bad they kept him out of serving in Vietnam.

One might think that the Trump medical report is more of a glossy public relations tool than a scientific fact sheet.   The wording is chosen specifically for rhetorical effect.  Given the non-routine activities of this presidential campaign, none of this is out of character for Donald Trump the candidate.  Despite the humor that some medical professionals might find in examining the content of Dr. Bornstein’s letter, there is a serious point that needs to be addressed.  And I thank Donald and his campaign crew for bringing this question to the forefront: Is this kind of letter ethical for a doctor to write?

The chair of medical ethics at NYU, Art Caplan, puts it poignantly when he suggests that candidates for the presidency should be getting independent medical exams and not just hiring these doctors to write advertising scripts.  I agree with Caplan if one decides to run for President or Vice-President of the United Sates there should be an independent medical panel who should be the ones to issue their health report.  The president’s office is so important that voters should have information about the health of the candidates.  This information should not come from the candidate’s personal physicians.  To tackle this conflict of interest Congress should appoint a bipartisan group of doctors to perform the necessary medical exams.   A candidate’s personal physician who may have a friendship as well as a professional medical relationship cannot be totally unbiased.    It’s only fair to the American public.

While not quite as flashy as the Trump medical report, other candidates have released official statements of their health status.  Dr. Lisa Bardack writes that Hillary Clinton “is in excellent physical condition and fit to serve as president.”  But Dr. Bardack has been Clinton’s personal physician for the past fifteen years.  Dr. Brian Monahan writes a letter on his stationary that Bernie Sanders is “in overall very good health.”  Monahan might appear to be a bit more objective as he is a attending physician employed by the United States Congress, but he has been Sanders personal physician for the past 26 years.  Clearly it’s time we to require truly independent medical exams by someone other than the personal physician.

To view Dr. Bornstein’s report:

Click to access trump_health_record.pdf

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