Presidents who hid chronic health issues

Fitness to lead has been a hot topic this election season.

But throughout history, several Presidents have lived with chronic illness, sometimes concealing this from the public.

Experts say it can be a delicate balance between keeping the nation informed and respecting a President’s personal privacy.

“You have to balance the benefits to the nation of knowing this information, against the rights of any individual to have their health information kept confidential,” David Cutler, MD, board-certified family medicine physician at Providence Saint John’s Health Center in Santa Monica, California told MDLinx.

There is a lengthy history of Presidents choosing to conceal their health concerns from the public.^[]

Woodrow Wilson experienced several strokes both before and during his presidency. A 1906 stroke caused him to lose sight in his left eye, whilst another stroke in 1913 caused issues with his left arm. In October of 1919 following another stroke, he was paralyzed on his left side, could only partially see out of his right eye, and was bed-bound. During this period, his second wife and his physician managed the presidency on his behalf.^[]

Chester Arthur experienced fatigue in the early days of his presidency. At the time, it was believed to be due to complications from malaria. As Arthur’s symptoms worsened in the fall and winter of 1882, physicians diagnosed him with Bright’s disease. This is a historical classification for what would now be referred to as a chronic kidney disease. It was commonly understood at the time that the condition had a poor prognosis and no cure. Together with his physicians, President Arthur chose to keep the diagnosis private and at one stage referred to suspicions surrounding his illness as “pure fiction.”^[]

As well as being paralyzed due to polio, Franklin Delano Roosevelt (FDR) became ill in his third term due to hypertension and severe heart disease. The Surgeon General of the Navy and FDR’s personal physician Dr. Ross McIntire held a press conference in April of 1944 in which he concealed this information from reporters, stating the president had a “satisfactory” physical.^[]

Dr. Cutler argues Presidents are entitled to some privacy regarding their health unless it would be detrimental toothers.

“We've obviously had people with severe health impairments…FDR being one, John Kennedy being another. Dwight Eisenhower had heart attacks, [but] he was still an effective president. So I think you've had instances where people have had significant disabilities, and yet still function very well as president. So I don't think the rule should be if someone has a condition that someone considers impairing to their health, that they should be restricted from that office.”

There is no requirement for a President to disclose their personal health information. Reports are voluntarily released from the personal physicians of presidents.^[]

“Even if it is not a matter of national security, people are naturally inclined to keep their personal health information private, and may have good reason to fear public reaction to revelations of illness or disability, but these concerns create a difficult tension with an elected leader's obligation to faithfully apprise the public of their capacity to govern,” a March 2024 editorial in The Lancet states.

 The same editorial notes that there have been “relentless armchair diagnoses of both candidates” (at the time Donald Trump and President Biden).^[]

 “That was the concern with President Biden, that people feared that his cognitive issues could put not only other individuals at risk but perhaps the whole nation at risk. I'm not sure that's true. I haven't done a detailed cognitive evaluation of him personally. But I think that's a reasonable concern,” Dr. Cutler said.

“And the way that's addressed in our country is through the 25th Amendment. If the people closest to that person professionally would assess himthe Vice President and cabinet members–to be a risk to others around him or the nation, then they have the ability to remove him from office.”

For as long as Presidents have been concealing health conditions, there have been speculation. 

It’s a trend Dr. Cutler expects to continue.

“I remember back to when Gerald Ford was president, he would stumble frequently, he would occasionally have errors in speech and people contemplated that he was unfit for office for that reason. I think later in his second term, many people speculated that Ronald Reagan suffered from significant cognitive disabilities and he eventually, just a couple of years after his presidency, was formally diagnosed with Alzheimer's disease and died shortly thereafter from that condition,” he said.

“This is nothing new, I think this will always exist. And people will speculate and they'll try to make diagnoses with very limited information. And they'll continue to do it, as long as it serves their political purpose, but I don't think it really helps that individual at all to make those speculations.”