Rob Ford tumour diagnosis: Do politicians have a right to medical privacy?

When Toronto Mayor Rob Fords doctorreleased the details of his abdominal tumour, it may have surprised some Canadians, not used to such medical informationbeing revealed about one of their politicians.

While not speculating on his prognosis, Ford's doctor, Dr. Zane Cohen, a colorectal surgeon at Mount Sinai Hospital, said his patienthadundergone CT scans of his abdomen and chest, a biopsy and an ultrasound examination. Cohenalso described the tumour as a "fair size" and said that the results of the biopsy would reveal more.

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It was a rare public detailingof a Canadian politician's medical condition. And itbrought into focus the issue of howmuch medical privacy politicians or political candidates are entitled to and how much information they should be required to disclose.

"I dont think that Canadianreportersand the Canadianpress has that same arrogantpresumption that we have that right to know," saidGil Troy, a history professor atMcGillUniversity, specializing in American presidents.

But Troy said thedoctor'snews conference about Ford's health could also signal a shift in how Canadian politicians disclose details about their health.

'Change expectations'

"I think it'sgoing to be one more point of convergence in terms of American and Canadian politicalculturewhere theres going to be more of a sense of 'we need to know. We should know.'

"I think the wholeRob Ford spectacle haspersonalized politics in Canada in a very dramatic way and this is one more aspect of that. Thesebreakthrough moments do change the conversation and change expectations."

Compared to their American counterparts, Canadian politicians havebeen somewhat more reluctant to disclosedetails of their medical history.

In 2006, then primeminister-designate Stephen Harper sought treatment at an Ottawa hospital for a chest cold. Initially his aides told an Ottawa Citizen reporter that it was a private matter, but later, a spokesperson suggested they would be more open in the future and"follow the same rules and guidelines of previous prime ministries for the most part."

When Jack Layton revealed in 2010 he had prostate cancer, he refused to providedetails about the treatment. Then, only months after his stunning electoral success,he announced he had "a new, non-prostate cancer that will require further treatment",He said hewould be stepping down temporarily, but provided nofurther details about his condition.

Just recently, former finance minister JimFlaherty, who died in April of a massive of heart attack, had months earlier kept quiet about his health, despitequestions and rumours about hisbloated appearance. Heeventually told the press that he had been suffering from a rare skin condition.

Contrast that to the U.S. where, for example, Americans learned everything they ever wanted to know aboutpresident Ronald Reagan's colon and intestines when he had polyps removed.

"I don't ever recall reading about Stephen Harper or Jean Chretien or Paul Martin going off for a day for their medical examination to the Canadian equivalent of the Walter Reed hospital," Troy said. "Whereas every year, whether it's a young man like Barack Obama, or an old man like Ronald Reagan, you do read about the president's annual check up."

'Valid concern for the voters'

"The health of a leader is a valid concern for the voters. If two people are runningfor prime minister and one ofthem knows hes suffering from a serious illness and he doesn'tdisclose it, there'sa certain kind of fraud being perpetuated on the voters."

However, the difficult partis sorting out what aspects of a politician or political candidate's personal health history ispertinent to the public, what thepublic hasa right to know and whataspectsremain the politician's right to control in terms of privacy.

"In America,at least, we have gone rather far in saying that everything about you should be public," said Dr. Howard Brody, director of theInstitute for the Medical Humanities at the University of Texas. "And I don't think thats quite right, but at the same time it could be very difficult to sort out which is which."

The question becomes more complicated depending on thepolitician.Should a small-town mayor be under the same medical scrutiny as the prime minister of Canada or thepresident of the United States?

I do thinkthat the particularrole of the politicianand what theirposition is does play a role in terms of the duty to disclose versus right to privacy," Brodysaid.

The illness itselfand how much it may interfere with a politician to carry out their functionsmakes it difficult to come up with a blanket rule on health disclosures, Brody said.

'Very situational'

"Im afraidit really is very situationalandvery dependenton the circumstances. And I suppose you could say, if in doubt,go a little more toward openness. But I dont think just let it all out, there has got to be some reasonablelimits there."

Americansget it right part of the way, but thengo too far, Troy said.

"I think that what happens in the Americanpress [is that] they go from the legitimate right of the people to know to making everythingup for grabs with no limits.

"The Americans could learn a little discretionfrom Canadians, and Canadianscould learn a little candourfrom the Americans."