Medical privacy

People want to keep their state of health private. I know people who prefer to keep serious health problems even from their family and close friends, mainly because they don’t want others to worry about them or pity them.

This is especially true of lifethreatening illnesses such as cancer, or afflictions characterized by degeneration of physical or cognitive abilities such as dementia and Parkinson’s disease, and sexually transmitted diseases.

The secrecy is greatest for mental health problems. These days, there is better understanding of mental health, but in our society, the stigma attached to psychological problems persists. Few people will admit seeing a mental health professional.

Medical privacy becomes complicated in the case of top public officials. Are they entitled to keep their state of health private? Or is it their duty to keep the public fully informed?

People want public officials to deliver optimum service, which requires physical and mental fitness relative to the official’s age.

In the case of the president of the republic, health disclosure is required. The Constitution provides succession rules in case the president becomes incapacitated or unable in any way to perform the duties of the office.

Health disclosure is sought even from candidates for the presidency.

Privacy issues surrounding the health of public figures is not unique to the Philippines. We’re seeing this in the disclosure, after weeks of secrecy, about the UK’s Princess Kate undergoing preventative chemotherapy for cancer that was detected after she underwent abdominal surgery last January.

Her father-in-law King Charles III also underwent treatment for cancer, which was reportedly detected early, indicating that the 75-year-old monarch is on the way to recovery. Sarah Ferguson, the duchess of York, also announced this year that she has skin cancer.

* * * The disclosure about Princess Kate was surprising because she’s only 42 and until the announcement always looked stunning and in the pink of health.

It’s not unusual, of course, for a 42-year-old to be diagnosed with cancer. It happened to some of my friends, even at a younger age. One died of abdominal cancer at just age 35. But this was about three decades ago. Cancer treatment has dramatically improved since then.

I personally know several cancer survivors, including those below age 60. I have a relative who was diagnosed with colon cancer decades ago. He has outlived his wife, who died suddenly of a heart attack while puttering in their garden about two years ago.

Even with the major advances in cancer treatment, however, many public officials still prefer to keep their affliction a secret.

Dictators in particular regard their state of health as a matter of national security and a factor in their hold on power. Rumors swirl about the health problems of Russian President Vladimir Putin and North Korea’s Kim Jong Un. Putin has dispelled the rumors by, among other things, riding half-naked on a horse. G-7 leaders scoffed at the beefcake images.

The secrecy is not limited to world leaders. At the start of this year, US Defense Secretary Lloyd Austin drew flak for not disclosing a two-week confinement beginning New Year’s Day at the Walter Reed National Military Medical Center. Austin, 70, said he was taking “full responsibility” for the secrecy and failure to report the hospitalization to Congress as required by law.

It was belatedly disclosed that he was hospitalized for complications related to prostate cancer, for which he underwent treatment last December. In February, Austin was again hospitalized for an “emergent bladder issue.” This time, he transferred his duties to his deputy.

* * * In our country, health issues have dogged presidents, most of whom were not forthcoming about the matter. Maybe they didn’t want to hand over the reins of power even temporarily to their constitutional successor the vice president, or invite a coup d’état.

Ferdinand Marcos the elder reportedly suffered from systemic lupus erythematosus complicated by diabetes. US reports said he underwent several kidney transplants – including one allegedly donated by his only son Ferdinand Junior the current President – all of which were unsuccessful.

Corazon Aquino died of colorectal cancer, but she was healthy during her presidency. (Incidentally, March is National Colorectal Awareness Month in our country and the US.) She took time off from her presidential duties only once – when she developed Meniere’s Syndrome, a non-life-threatening fluid imbalance in the inner ear that caused vertigo and a ringing in her ear.

Fidel Ramos during his presidency underwent surgery for a blocked neck artery in 1996. The stock market was spooked and the peso fell amid speculation that then vice president Joseph Estrada might take over the presidency. But Erap was not even designated as government caretaker, and FVR returned to work after just three days.

Erap, during his abbreviated presidency, was hounded by speculation about his poor health. He brushed this aside by publicly noshing on full-fat chicharon Bisaya (including during chats with us in The STAR).

His successor Gloria Macapagal-Arroyo has a history of fatty liver and complex liver cyst. She underwent cervical spine surgery when she was no longer president.

Benigno “Noynoy” Aquino III won the presidency by a landslide despite questions raised about his physical and mental health. He was a chronic smoker, but he died of renal failure, not lung-related disease, at age 61.

Mental health issues also dogged former presidential hopeful Miriam Defensor-Santiago, but she laughed them off. “Brenda daw ako,” she would tell us, followed with a guffaw. “Brenda” is Pinoy slang for braindamaged.

Rodrigo Duterte became open about his health only midway through his presidency. He admitted being prescribed the powerful opioid fentanyl for chronic pain from a spinal injury he sustained in a motorcycle spill. He suffers from Buerger’s Disease and Barrett’s esophagus, which, if not properly managed, can progress into life-threatening afflictions. He also has myasthenia gravis, which causes one of his eyelids to droop.

As for Bongbong Marcos, he has had three COVID infections, but so far we don’t know the state of his kidneys, and he has brushed aside Rodrigo Duterte’s description of him as a cocaine addict.

While some public figures worry about their state of health affecting their political fortunes or business empires, others, like Kate Middleton, make their personal struggle an inspiration to others.

The princess’ message to those battling cancer resonates in this season of introspection: “Please do not lose faith or hope. You are not alone.”