Recently we have been treated to detailed analyses in the press and on television and radio of President Reagan's bout with a cancerous tumor. These reports have frequently been accompanied by charts graphically illustrating the condition of his internal organs. Considering the nature of this sort of cancer, it is very likely that public discussion of the president's ongoing medical problems will continue for at least the length of his term in office.
Many people are offended by this exhibition of what would be for nearly anyone else an intimate personal problem. They see the media's aggressive coverage as invasive and even degrading, not only for the president but for his family as well. This kind of attention seems to them to cheapen, for all of us, the profound human experience with disease and death. And our society appears to be especially inclined toward the indecent exposure of its public figures.
Others point to the importance, especially in a nuclear era, of knowing that the president of the United States is able to do the job. A physical problem could trigger psychological confusion or emotional depression. Advocates of openness argue that we are lucky to live in a society in which our right to know about such matters is respected, a vivid contrast to the way the Soviet Union handles its leaders' illnesses.
Like so many ethical debates, this one seems to resist rational solution. Each side can marshal a convincing case. So how can it be resolved?
First, we need to reaffirm the importance of knowing the condition of our top leaders. This includes knowing who is in control of governmental power and for how long. The citizens of a representative democracy have a valid claim on information during the acute phase of a physical emergency involving their leaders' well-being. There is no reason to think that the authority of government is undermined by such disclosure, and every good reason to think that it would be compromised by cover-up or confusion. Recall the effect of former Secretary of State Alexander Haig's remarks ("I am in control . . .") after the 1981 assassination attempt.
It is important to understand that the public's right to know does not pierce all the veils of confidentiality, including those of personal privacy and, in the present case, physician-patient relations. Even in an open society, some events are not proper objects of public attention. If, as it appears, the president's condition requires constant vigilance for the rest of his life, then it will be harder to insist on a public right to know beyond the initial emergency.
Second, unless there is very good evidence that the president's condition or his treatment are compromising his ability to fulfill his office, and that this fact is being hidden, then restraint should be the watchword from here on in. Obviously another hospitalization will excite much attention, but in the interim, public inspection of the situation should take a rest. There are several good reasons, including the right of privacy. That right takes hold increasingly as the acute event passes and the process of getting on with life returns. It is one thing to photograph accident victims at the scene but quite another to follow them into the rehabilitation unit and back to their homes.
But there are other, more general reasons for restraint. While it is true that we should take pride in the strength of a democracy that can withstand such public scrutiny of a leader's health, that scrutiny does at some point run up against the limits of decency. After all, the Soviets are not the only ones to keep the physical conditions of their leaders secret. Virtually every other nation in the world does the same thing, including our democratic allies.
This suggests that the reasons are not only political, but cultural. Simply put, cultural traditions tell us we should not leer at illness. As an essential part of the human condition it should be respected and treated in a dignified manner. Apparently the president's family and advisers have already come to see the point of this attitude and are resisting pointless coverage. They are right to do so.
Third, the medical profession should discourage "public consults" by its members, second-guessing the judgment of the president's physicians. If there is evidence of incompetence, then it should be dealt with through the profession's normal mechanisms. Non-physicians do not usually understand the degree to which specialists disagree among themselves. Unintentionally, scientific disagreements can easily degenerate into grandstanding under the press of public attention.
Having a president who is being followed for cancer might give us a chance to grow up a bit as a people. Conventional political wisdom has been that Americans like their presidents robust. We do not deal very well with sickness and infirmity as a society, we do not take very good care of our aged or impaired neighbors, and we seek perfect bodies and babies.
It might be that we have already matured a lot since John F. Kennedy's ailments were concealed from us. He was the last president who was so identified with physical vigor, and perhaps we weren't ready for reality then. When we accept the reality that disease is a natural part of life and not an unnatural disaster, we will make it less of a spectacle.