The Genetic Privacy of Presidential Candidates

Robert C. Green, M.D., M.P.H., and George J. Annas, J.D., M.P.H. in the New England Journal of Medicine Volume 359:2192-2193 November 20, 2008 Number 21

In the wake of the often bitter presidential election, with its emphasis on negative campaigning and intermittent controversies over the release of candidates' health information, it is not too soon to begin planning for the next presidential campaign. By then, advances in genomics will make it more likely that DNA will be collected and analyzed to assess genetic risk information that could be used for or, more likely, against presidential candidates.

Since 1972, when George McGovern was forced to replace his vice-presidential running mate, Thomas Eagleton, after it was revealed that he had been hospitalized for depression, the health status of presidential candidates has been seen by the press as fair game.1 More recently, historians have discovered that some presidential candidates, including Franklin Roosevelt, Dwight Eisenhower, and John F. Kennedy, misled the public about their health status and that illness may have adversely affected their ability to perform their duties.

In this year's election, Senator John McCain, who had released extensive medical records in 1999, released an additional 1100 pages of records but gave reporters only a few hours to review them. President-Elect Barack Obama released an undated one-page "medical summary" to the press. News organizations pressed for more details, in the belief that the public has a right to know about a candidate's risk of future disease as an important indication of fitness for office. Although the presence of a disease or health condition is the most salient factor in the prediction of future health, medicine's ability to define levels of risk for individuals is expanding to include family history (a proxy for genetic predispositions to many diseases) and genetic markers.

Family history was used by the McCain campaign, which highlighted the energy and mental sharpness of McCain's 95-year-old mother, in an attempt to counter the notion that McCain's age might be associated with diminished vigor or cognitive function. Little was said about the death of his father and grandfather of heart attacks at 70 and 61 years of age, respectively. By the same token, the Obama campaign remained silent about the death of Obama's grandfather from prostate cancer, which indicates that Obama's own risk is higher than average.

During future campaigns, presidential candidates could release information about parts of their own genomes in order to highlight what might be considered a favorable ethnic background or, if they have already had a disease such as cancer, to highlight the absence of genes that confer a risk of recurrence. But in a climate of negative personal and political messages, it is more likely that persons or groups opposing a candidate will release such information, hoping to harm his or her chances for election or reelection.

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