SA’S no-comment stance not the norm
THE government is under pressure to disclose more details about Nelson Mandela’s medical condition, sparking a fierce national debate this week over his privacy.
Presidential spokesman Mac Maharaj turned down these requests, citing doctor-patient confidentiality.
But some former and current leaders do share details about their health.
President Barack Obama’s navy doctor routinely discloses his cholesterol levels, blood pressure and what medicine he is taking, and even chides him for dietary and smoking relapses.
This week, Western civil liberties experts and doctors told the Sunday Times that past presidents enjoyed a “higher level of privacy” than sitting executives in most democracies, but that foundations representing them typically empowered hospitals to release basic medical details.
Dr Lawrence Altman, an expert on medical disclosure who has covered US presidents’ health since 1972, said Maharaj’s position was “surprising and not helpful”.
“Because they understand the public interest and because they remain either passively or actively political, former presidents routinely disclose their medical details,” said Altman.
“Mandela clearly remains a passive political force in that the government invokes his example all the time. Bill Clinton disclosed details of his bypass surgery; presidents Ford and Bush [senior] gave out information after they left office.”
Altman, who is a fellow at the Woodrow Wilson Centre and the New York Times’s medical expert, continued: “There are questions that go beyond one person’s treatment — for instance, the competence of the emergency services — that have broad significance for citizens and visitors to South Africa. [Also], by what law has the South African government superseded the family in controlling this information? They may have received the family’s [blessing], but it seems to me that this alone should invite additional reporting.”
Gabe Rottman, legislative counsel for the American Civil Liberties Union, said South Africa was “an unusual case where the government appears to have commandeered the information of a retired president”.
Rottman said that, in the US, public figures and political candidates enjoyed the same privacy protection as citizens, but often disclosed their health details as “a matter of practice” and “to avoid voter backlash”.
He said medical disclosure was governed by a “trust relationship” between public figures and the media, in which editors were trusted to be responsible with medical details and to not, for instance, publish mental health information. “It is now customary to disclose the results of the president’s physical,” he said.
However, Alex Vines, head of the Africa Programme at Chatham House in London, agreed with Maharaj, saying the level of medical disclosure on Mandela, as a former head of state, “should be different to what citizens should expect from Jacob Zuma”.
“I don’t think the public should be entitled to forensic detail on Mandela’s condition,” said Vines.
The US withheld medical records in 1919 when president Woodrow Wilson was incapacitated by a stroke and the country effectively lost executive leadership for more than a year without public knowledge. In contrast, in the UK in December last year a nurse, Jacintha Saldanha, committed suicide after unwittingly giving details of the Duchess of Cambridge’s pregnancy to Australian radio hosts.
Historians agree that the release of even the most sensitive medical detail — haemorrhoids — has done nothing to diminish the dignity of presidential sufferers from Franklin Roosevelt to Bill Clinton and George W Bush.
Mark Caramanica, freedom of information director at the Reporters Committee for Freedom of the Press, said hospitals were allowed to release “directory details” on public figures such as “stable” or “critical”, but that families often authorised the release of details “because they understand that citizens want to know”.
“It’s the same as the release of tax returns. You don’t have to do it and reporters can’t get it through freedom of information requests, but politicians understand that voters will think they’re hiding something if they don’t,” he said.