Wednesday, August 03, 2011

Politicians' Medical Records:: Jack Layton's Cancer & the Limits of Transparency

Vidcap of Jack Layton's "#hashtag fail" statement during the 2011 Anglophone debate
Last week, Canada's New Democrat leader, Jack Layton, announced that he was taking a medical leave until September 19th. to undergo treatment for cancer. Last February, Layton announced he had prostate cancer and he announced his current bout is unrelated. The big "news" was his appearance during his recent announcement, which some described as "frail" and "gaunt". This set the speculative wheels in motion, scrutinizing his recent public appearances and some commenters linking his hip surgery to a possible metastasis of his prostate cancer.

The Winnipeg Free Press offered this editorial {see also Jordan Press Postmedia piecethat states Layton should have some privacy and the details of his health condition need not be divulged until of if it becomes relevant to his performance. Andre Picard in the Globe & Mail claims that the public has a right to know politicians' health status and accuses the NDP of not being forthcoming, while engaging in rampant speculation of what might be really happening. Reaching quite a bit, Picard uses this alleged health secrecy to undermine Layton's criticism of Stephen Harper's government::
"The NDP Leader has been an outspoken, eloquent critic of the culture of secrecy that has enveloped federal politics under Stephen Harper’s Conservatives, as exemplified by everything from the refusal to release records on Afghan detainees to the reluctance to disclose that the Prime Minister required emergency-room treatment for a flare-up of his asthma."
 Picard points to how things are different in the US::
"In the United States, full disclosure of politicians’ health records is now the norm. The days when presidents could hide something as inescapable as a crippling case of polio, as Franklin Roosevelt did, are long gone. The details of President Barack Obama’s annual check-up are made public; his HDL (good cholesterol) is 62, LDL (bad cholesterol) is 138 and his PSA is 0.7. John McCain, when he was running for president, released 1,200 pages of medical records to demonstrate he was fit for office."
but failed to disclose how this information is released, which I'll get to later.

Picard equating his speculation of a NDP "coverup" with Layton's concerns about a pattern of a lack of transparency with Stephen Harper is quite a stretch. I couldn't find evidence of Jack Layton criticizing Stephen Harper for his transparency on his asthma, which doesn't mean it didn't happen, but Harper's people initially stated he went to the ER for a cold and later it was determined as an asthma-related visit. I think the point for many regarding Harper is the strong need for control over public perceptions.

The real issue though is that US-style transparency isn't all that transparent. First off, it's voluntary and not under any force of law. Larry Altman, a MD who covers the beltway health beat, cleared the air a few years ago. It's good to keep in mind that it isn't a carte blanche situation with a searchable public database. The information is often released under tight control regarding who is invited to see the information, along with strict time limits and not allowing copies to be made. Releases can be vague and undated. So, access may be granted to over a thousand pages of records, which was the case with John McCain, but only three hours to review them. In the end, it's often a balance between PR and transparency, as opposed to full disclosure.

A general theme with Layton's current cancer is whether or not the "orange crush" in Québec in the May election would have occurred if Layton's health status had an ominous prognosis. My take is that calls for transparency in this area is misguided. Mandatory full health disclosure won't happen and shouldn't happen, unless there's a clear linkage to job performance. Layton isn't Prime Minister and there won't be an election for 4 years, so his health isn't a pressing issue, politically, but easy fodder for punditry and editorials on the fate of the NDP. Moreover, a big problem with medical records is that they are subject to interpretation. Diseases like cancer are complex and scenarios are often ambiguous, which would add to more speculation.

I think what much of this speaks to is the cult of leadership {often fostered by the media and MBA programmes}, raising the status of leaders to mythical levels, instilling beliefs such as "Steve Jobs = Apple Computers" and implying that without him, the firm is sunk. Jack Layton is a charismatic figure and the NDP has unprecedented popularity. The party has branded themselves in the cloak of their newfound status, "the official opposition". The problem I have with how many journalists are approaching the issue is framing Layton's illness as potential doom for the party or how this might create a political power vacuum with infighting around the corner. Speculation trumps real journalism. A more interesting and richer approach would be to examine the nuanced dynamics of the current NDP that's fact-driven, one that examines the NDP as an organization, its breadth, its depth, etc., in an attempt to determine its resilience. Nope, instead, the big debate is over how the interim NDP leader Nycole Turmel was a member of the "Canada-destroying" Bloc Québécois::

Twitterversion:: [blog] Politicians' Medical Records:: Jack Layton's Cancer & the Limits of Transparency @Prof_K

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