Illness and Secrecy on the Supreme Court
http://www.100md.com
《新英格兰医药杂志》
To the Editor: In her Perspective article (Dec. 23 issue),1 Okie reviews the dilemma raised by illness on the Supreme Court. The public's right to know the health status of the justices reflects issues similar to those raised by a president's illness.2,3 A balance must be struck between personal privacy and public disclosure of impairment.
One option is a panel of medical experts who would review, at regular intervals, the health status of the leaders of the three branches of government. The findings would remain confidential unless significant impairment was found, in which case they would be reported to Congress. Constitutional issues would need to be addressed, but the resolution of these matters is overdue.
Constitutional changes regarding the executive branch have come after crises. The Presidential Succession Act of 1947 was a response to President Franklin D. Roosevelt's death in 1945, and the 25th Amendment was a reaction to President Dwight D. Eisenhower's heart attack in 1955 and President John F. Kennedy's assassination in 1963.2 Chief Justice William Rehnquist's illness represents a crisis for the Supreme Court. It is time for Congress to enact a rational process to address issues related to the health of our highest-ranking government officials.
Kevin R. Loughlin, M.D., M.B.A.
Brigham and Women's Hospital
Boston, MA 02115
krloughlin@bics.bwh.harvard.edu
References
Okie S. Illness and secrecy on the Supreme Court. N Engl J Med 2004;351:2675-2678.
Annas GJ. The health of the president and presidential candidates -- the public's right to know. N Engl J Med 1995;333:945-949.
Loughlin KR. Presidential health. N Engl J Med 1996;334:467-468.
To the Editor: In light of Okie's piquant article, we wish to point out that the medical profession as a whole does not come to this issue from the moral high ground. Like Supreme Court justices, physicians are commonly asked to decide questions of life and death, and they are essentially granted "life tenure" when they are licensed.
We believe our profession should demonstrate moral leadership in this area. At the least, we recommend that state medical societies work with legislators to create policies requiring a thorough health and competence evaluation for physicians who sustain an injury or have an illness that might reasonably be expected to have an adverse effect on clinical performance. In addition, we recommend a universal screening program for all physicians who wish to continue to practice beyond a certain age (perhaps 65 years). Some might call this ageism, but we believe it is a public health measure that recognizes the subclinical nature of many diseases that become more prevalent with advancing age.
William A. Norcross, M.D.
Theodore G. Ganiats, M.D.
University of California, San Diego, School of Medicine
La Jolla, CA 92093
wnorcross@ucsd.edu
One option is a panel of medical experts who would review, at regular intervals, the health status of the leaders of the three branches of government. The findings would remain confidential unless significant impairment was found, in which case they would be reported to Congress. Constitutional issues would need to be addressed, but the resolution of these matters is overdue.
Constitutional changes regarding the executive branch have come after crises. The Presidential Succession Act of 1947 was a response to President Franklin D. Roosevelt's death in 1945, and the 25th Amendment was a reaction to President Dwight D. Eisenhower's heart attack in 1955 and President John F. Kennedy's assassination in 1963.2 Chief Justice William Rehnquist's illness represents a crisis for the Supreme Court. It is time for Congress to enact a rational process to address issues related to the health of our highest-ranking government officials.
Kevin R. Loughlin, M.D., M.B.A.
Brigham and Women's Hospital
Boston, MA 02115
krloughlin@bics.bwh.harvard.edu
References
Okie S. Illness and secrecy on the Supreme Court. N Engl J Med 2004;351:2675-2678.
Annas GJ. The health of the president and presidential candidates -- the public's right to know. N Engl J Med 1995;333:945-949.
Loughlin KR. Presidential health. N Engl J Med 1996;334:467-468.
To the Editor: In light of Okie's piquant article, we wish to point out that the medical profession as a whole does not come to this issue from the moral high ground. Like Supreme Court justices, physicians are commonly asked to decide questions of life and death, and they are essentially granted "life tenure" when they are licensed.
We believe our profession should demonstrate moral leadership in this area. At the least, we recommend that state medical societies work with legislators to create policies requiring a thorough health and competence evaluation for physicians who sustain an injury or have an illness that might reasonably be expected to have an adverse effect on clinical performance. In addition, we recommend a universal screening program for all physicians who wish to continue to practice beyond a certain age (perhaps 65 years). Some might call this ageism, but we believe it is a public health measure that recognizes the subclinical nature of many diseases that become more prevalent with advancing age.
William A. Norcross, M.D.
Theodore G. Ganiats, M.D.
University of California, San Diego, School of Medicine
La Jolla, CA 92093
wnorcross@ucsd.edu