Ethical Dilemmas of the President's Physician

Abstract

During the 1984 presidential campaign, questions were raised concerning President Reagan's cognitive integrity in the televised debates. He hesitated before answering questions, appeared to lack attentiveness, and had difficulty remembering and finding words to accurately express his thoughts. These signs, sometimes indicative of early dementia, were reportedly intensified during the 1987 Reykjavik Conference, at which time the President was criticized by James Reston–admittedly an unsympathetic critic–the New York Times columnist. According to Reston, there may be “a human problem at the top of the government [that] … will have to be addressed with uttermost sympathy and care” (December 21, 1986). These questions were again raised by the Iran-Contra affair. For the President of the United States to have even a hint of cognitive dysfunction carries profound implications.

Talking about the Unspeakable in a Secretive Institution: Health and Disability among Supreme Court Justices

“…Individuals whose positions depend upon the justice's patronage are often reluctant to identify their mentor's weaknesses or failings. At the presidential level, this phenomenon is well recognized and documented but difficult to control or prevent (Robins and Rothschild, 1988). In addition, the family or other intimates of the justice may resist the evidence before them, either out of concern for their status (which often depends upon the justice's continuance in office) or, more commonly, a human desire to see the best or hope for the best.…”