How do you think, in hindsight, the press dealt with Reagan clearly aging toward the second half of his Presidency?
You have to go back in time and try to picture what things were like in 1984, when he was running for reëlection, and during the 1984-88 period, when he was there. One, his doctors said they saw no evidence of his mental deterioration. Two, I don’t think the medical profession at large, and the public, were as perceptive as they are now about the early stages of dementia, whether it’s Alzheimer’s or any other form of dementia, and they may not have been attuned to picking up some of the early signs.
But let’s say for the sake of discussion that there was a lot of support for the fact that he had early Alzheimer’s or early dementia, whatever kind. The question then is: what were you going to do about it? Would doctors then recommend that he not stay in office? What evidence did they have that his decisions were reflecting this mental-status decline in his everyday work? And the ones that I interviewed didn’t give such evidence.
What have you witnessed about the pressure on a doctor when that doctor is taking care of the President?
It goes through in steps. And I think you have to start with a basic point that the ancient tradition of medicine, which is reinforced by HIPAA, says doctors cannot disclose anything about their patients’ health without the permission of the patient. And, at the same time, the doctors are their patients’ advocates, and they’re not obligated to do so. They usually agree to do so. But they have to do it within the realm of permission.
And then it becomes thorny when the patient’s a President or a political leader. I’ve taken from early on the position that political leaders should be transparent in releasing their health information, because I believe the public has a right to know if its leader is able to carry out the duties to which they were elected and take an oath to carry out. The doctor should have an agreement with the President that the doctor has an additional obligation to be candid with the public. I don’t know what agreements Trump and his doctors made, or others.
Something tells me Trump did not negotiate that with his doctors, telling them that they had to be honest with the public, but go on.