In 1964, Fact magazine asked psychiatrists about Republican candidate Sen. Barry Goldwater’s mental stability. According to the American Psychiatric Association (APA), of 12,356 psychiatrists polled, 2,417 responded, and 1,189 said Goldwater was unfit to be president. None had examined Goldwater, who sued the magazine and won.
Since 1973 the APA has enforced a policy, often called the “Goldwater Rule,” that it is unethical for a psychiatrist to offer a professional opinion about the mental health of a person they haven’t examined.
As a physician, I believe that the same holds true for the physical health of presidential candidates; however, just as the APA allows psychiatrists to share their general expertise, I think it is fair to add a few facts and a little perspective, to the flurry of speculation about Sec. Hillary Clinton’s pneumonia.
We can’t be sure without her medical records, but it’s fair to assume Clinton’s pneumonia was mild, because severe pneumonia is treated in the hospital. Patients can be sent home with antibiotics if their chance of dying of pneumonia in the next 30 days is 0.9 percent or less, based on a list of risk factors. (0.9-2.8 percent is considered borderline.)
How does that compare to other risks? According to the Social Security Administration’s actuarial tables, a woman of Clinton’s 68 years has a 1.4 percent chance of dying within the next year, but her average life expectancy is almost 18 years. In other words, Clinton is likely to survive a two term presidency and have another decade on the lecture circuit, and her pneumonia should worry you less than her age.
If Clinton’s age scares you, Donald Trump’s should panic you: a man of 70 has a 90 percent higher risk of dying in the next year than a woman of 68. Still, it’s only a 2.4 percent chance, and it comes with a 14 year life expectancy, meaning that whoever wins, Trump and Clinton are both likely to be with us two terms.
That’s based on what we know now, which is their ages, Clinton’s pneumonia, and Trump’s bizarre physician’s statement declaring he will be “the healthiest individual elected to the presidency.” That’s not much. The numbers change dramatically if Trump’s penchant for Kentucky Fried Chicken has increased his cholesterol, or if Clinton was predisposed to pneumonia by an underlying lung condition. That kind of medical history, along with information on treatment, is what voters really need to make an informed choice.
I was diagnosed with pneumonia during my residency, and I can’t imagine having gone to an outdoor event two days later. That Clinton tried to fulfill her commitments says much more about her reliability and endurance than a mild pneumonia says about her overall health.
