Rob Ford tumour diagnosis: Do politicians have a right to medical privacy?

When Toronto Mayor Rob Ford’s doctor released the details of his abdominal tumour, it may have surprised  some Canadians, not used to such medical information being revealed about one of their politicians.

While not speculating on his prognosis, Ford's doctor,  Dr. Zane Cohen, a colorectal surgeon at Mount Sinai Hospital, said his patient had undergone CT scans of his abdomen and chest, a biopsy and an ultrasound examination. Cohen also described the tumour as a "fair size" and said that the results of the biopsy would reveal more.

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It was a rare public detailing of a Canadian politician's medical condition. And it brought into focus the issue of how much medical privacy politicians or political candidates are entitled to and how much information they should be required to disclose. 

"I don’t think that Canadian reporters and the Canadian press has that same arrogant  presumption that we have that right to know," said Gil Troy, a history professor at McGill University, specializing in American presidents.

But Troy said the doctor's news conference about Ford's health could also signal a shift in how Canadian politicians disclose details about their health.

'Change expectations'

"I think it's going to be one more point of convergence in terms of American and Canadian political culture where there’s going to be more of a  sense of 'we need to know. We should know.' 

"I think the whole Rob Ford spectacle has personalized politics in Canada in a very dramatic way and this is one more aspect of that. These breakthrough moments do change the conversation and change expectations."

Compared to their American counterparts, Canadian politicians have been somewhat more reluctant to disclose details of their medical history.

In 2006, then prime minister-designate Stephen Harper sought treatment at an Ottawa hospital for a chest cold. Initially his aides told an Ottawa Citizen reporter that it was a private matter, but later, a spokesperson suggested they would be more open in the future and "follow the same rules and guidelines of previous prime ministries for the most part."

When Jack Layton revealed in 2010 he had prostate cancer, he refused to provide details about the treatment. Then, only months after his stunning electoral success, he announced he had "a new, non-prostate cancer that will require further treatment", He said he would be stepping down temporarily, but provided no further details about his condition.

Just recently, former finance minister Jim Flaherty, who died in April of a massive of heart attack, had months earlier kept quiet about his health, despite questions and rumours about his bloated appearance. He eventually told the press that he had been suffering from a rare skin condition.

Contrast that to the U.S.  where, for example, Americans learned everything they ever wanted to know about president Ronald Reagan's colon and intestines when he had polyps removed.

"I don't ever recall reading about Stephen Harper or Jean Chretien or Paul Martin going off for a day for their medical examination to the Canadian equivalent of the Walter Reed hospital," Troy said. "Whereas every year, whether it's a young man like Barack Obama, or an old man like Ronald Reagan, you do read about the president's annual check up."

'Valid concern for the voters'

"The health of a leader is a valid concern for the voters. If two people are running for prime minister and one of them knows he’s suffering from a serious  illness and he doesn't disclose it, there's a certain kind of fraud being perpetuated on the voters."

However, the difficult part is sorting out what aspects of a politician or political candidate's personal health history is pertinent to the public, what the public has a right to know and what aspects remain the politician's right to control in terms of privacy. 

"In America, at least, we have gone rather far in saying that everything about you should be public," said Dr. Howard Brody, director of the Institute for the Medical Humanities at the University of Texas. "And I don't think that’s quite right, but at the same time it could be very difficult to sort out which is which."

The question becomes more complicated depending on the politician. Should a small-town mayor be under the same medical scrutiny as the prime minister of Canada or the president of the United States?

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“I do think that the particular role of the politician and what their position is does play a role in terms of the duty to disclose versus right to privacy," Brody said.

The illness itself and how much it may interfere with a politician to carry out their functions makes it difficult to come up with a blanket rule on health disclosures, Brody said. 

'Very situational'

"I’m afraid it really is very situational and very dependent on the circumstances. And I suppose you could say, if in doubt, go a little more toward openness. But I don’t think just let it all out, there has got to be some reasonable limits there." 

Americans get it right part of the way, but then go too far, Troy said. 

"I think that what happens in the American press [is that] they go from the legitimate right of the people to know … to making everything up for grabs with no limits.

"The Americans could learn a little discretion from Canadians, and Canadians could learn a little candour from the Americans."