COMMENTARY

Trump's Health: The Public Has No Right to Know Everything

Arthur L. Caplan, PhD

Disclosures

October 13, 2020

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This transcript has been edited for clarity.

Hi. I'm Art Caplan. I'm the head of the Division of Medical Ethics at the New York University Grossman School of Medicine.

A big issue came up when the president got diagnosed with COVID. It wasn't about the president but about the president's medical team. He has the White House physician, who certainly was taking the lead on his care. When the president went for his stay at Walter Reed, other doctors got involved in his care and we saw a number of press conferences where information about his health status was presented.

At the end of the day, it's very important that whatever the medical team or the physician in charge says about presidents, other leaders, or celebrities, they do not lie to us. They may decide that they're not going to say anything. They may be evasive or they may not answer a question, but they shouldn't spin the message.

Hopefully, we can agree that if you're going to speak about the president, a celebrity, or a well-known patient, we expect to be told the truth. If physicians are getting pressure to not tell the truth by their patient — say, the president or White House officials working for the president — then they shouldn't lie. What they have to do is remain quiet. Others say that if you tell White House physicians to remain quiet, how are we going to know what's going on with our president?

It's very important that we know his health condition. Is he capable of carrying out the office? Does there need to be pressure to transfer power of authority to the vice president or another party if those two are ill? Are our adversaries going to be able to take advantage of us if the president is not competent? Are we in a situation where we're approaching an election where the president faces a life-threatening disease and we're not finding out that the person that we are considering voting for might be much more sick or ill than we think? There are probably dozens of other reasons why the public might want to know.

Certainly, the media want to know what's the story with the president's health. It's news. It attracts eyeballs. And they consider themselves messengers to convey this kind of information out to the public who are eager to know how the president is doing. Many are hoping he's doing fine. Others are saying that if he's not, then that will change their voting plans or they're thinking about what they will tell their representatives about who they think should be governing them.

It's interesting because there were disputes about whether doctors have to tell us the truth. There is no legal or ethical standard that demands that. People may want to know what's going on with the president's health. It may be that the media is pressing hard to get all kinds of medical facts about the president's health.

Ultimately, the law in the form of HIPAA, the privacy statute enacted many decades ago, says that the only people who get medical information about any patient, including the president, are those involved in the president's care or those involved in billing for the patient. I don't think the president got a bill from Walter Reed; he has that advantage.

If you're not in need of information so that you can deliver care, you don't have any right to share it or give it to anybody else, whether it's a florist, a reporter, or anyone else.

Similarly, all the codes of ethics — the American Medical Association, the American College of Physicians, and the World Medical Association — say that the patient deserves privacy. They don't say "except for politicians or except for the president"; they say that all patients deserve privacy.

The president controls information that the doctors can reveal, including his chief physician. If he says not to talk, that's it. If the White House convinces the president that it's in his interest not to have information conveyed, that's it. We currently have no right to information about the president.

Personally, I'd like to see that changed. I'd like to see an exception to HIPAA and maybe an exception to codes of ethics, to say, "Should the president require hospitalization or serious medical care, we can expect the public to receive true, transparent information regularly about the president's status."

However, that isn't what the law says and it isn't what ethics says. At the end of the day, we may want to know about President Trump and his health or what's going on with a senator or other high-level officials, but they have to decide that they're going to tell us. We can't force them to do otherwise.

I'm Art Caplan at New York University's Division of Medical Ethics. Thanks for watching.

Arthur L. Caplan, PhD, is director of the Division of Medical Ethics at New York University Langone Medical Center and School of Medicine. He is the author or editor of 35 books and 750 peer-reviewed articles as well as a frequent commentator in the media on bioethical issues.

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