epa10293062 Democratic Senate candidate for Pennsylvania John Fetterman speaks at an election eve rally in Pittsburgh, Pennsylvania, USA, 07 November 2022. The US midterm elections are held every four years at the midpoint of each presidential term and this year include elections for all 435 seats in the House of Representatives, 35 of the 100 seats in the Senate and 36 of the 50 state governors as well as numerous other local seats and ballot issues.  EPA-EFE/JIM LO SCALZO

Bioethics Forum Essay

Enough Already with the Medical Cheap Shots

All manner of officials in high places in the United States have been coming under scrutiny lately as to their fitness for office. Donald Trump Jr. piled on to right-wing attacks on Senator John Fetterman (D-Pa.), calling him the “vegetable senator from Pennsylvania” during an episode of his “Triggered” podcast. Shortly thereafter Fetterman checked himself into Walter Reed National Military Medical Center to receive treatment for depression.

Former South Carolina Governor Nikki Haley, age 51, led off her run for the presidency by offering a vision of America in which “We’ll have term limits for Congress and mandatory mental competency tests for politicians over 75 years old.” That just happens to be an age just below that of the only other major Republican in the race. Donald Trump who is 76 years old. Haley’s call for mandatory mental testing would cover one-tenth of the Senate, including Mitch McConnell, Bernie Sanders, and Charles Grassley, all 80 or older.

President Biden just underwent his annual physical. The 80-year-old was declared “fit for duty” by his doctor, Kevin O’Connor. O’Connor said, in a letter published by the White House, that “President Biden remains a healthy, vigorous, 80-year-old male, who is fit to successfully execute the duties of the Presidency, to include those of as Chief Executive, Head of State and Commander in Chief.”

This news was greeted with absolute scorn by former White House physician and now Congressman Ronny Jackson. Jackson, who has himself faced incompetency allegations, said, “The majority of Americans can see that Biden’s mental health is in total decline, yet there is no transparency from the White House on what’s going on, if anything, to address this issue and his inability to do his job.” 

He said that the written physical exam report released by Biden’s physician apparently confirms that this administration is still adamant about “concealing the truth” and “This is alarming, considering I have already sent three letters to the White House demanding that Biden receive a cognitive test and that the results be made public . . . “

Some psychiatrists continue to believe that Donald Trump is utterly mentally unfit to be President. They might be right, but Americans have used allegations about mental fitness against their political enemies almost since the beginning of the Republic, with little attention to medical facts. Thomas Jefferson, who may have been dyslexic, described his archrival John Adams as “sometimes absolutely mad.” Lincoln’s bouts of melancholy were well known and spoofed. Eisenhower was widely derided as a buffoon, as was Gerald Ford, of whom Richard Nixon said he played football without his helmet once too often. In a survey, GOP candidate Barry Goldwater was viewed as mentally ill by dozens of psychiatrists. We will never know if Ronald Reagan really suffered from dementia while in office, but his enemies felt free to say so.  Woodrow Wilson, on the other hand, was incapacitated by a stroke but few knew it.

George W. Bush was not celebrated for his IQ, but you can also be called too smart, like “egghead” two-time presidential candidate Adlai Stevenson, or too intellectual like Barack Obama.

Policy debates are boring. Gossip is fun. Perhaps that’s why politicians continue to use candidates’ physical and mental health as cudgels with which to beat each other or to ignore when it suits their self-interest. America deserves much better.

Arthur Caplan, PhD, is the founding head of the Division of Medical Ethics at NYU Grossman School of Medicine. He is a Hastings Center fellow and a member of The Hastings Center’s advisory council.

Jonathan D. Moreno, PhD, is the David and Lyn Silfen University Professor of Ethics at the University of Pennsylvania and a Hastings Center fellow  (@pennprof)

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