Even cowgirls get the blues, and even world leaders get sick and die. Sometimes it happens while they were in office, although the public seldom knows. It was a long time before we knew just how much Woodrow Wilson’s stroke affected his second term. John F. Kennedy’s medical problems were successfully concealed throughout his time in public office. When Reagan’s fall to Alzheimer’s first set in will probably be a secret for another couple of decades. Miterrand’s cancer was hidden from the French public. The Italian press wasn’t writing about how serious Bossi’s health problems are.
The Rt Hon Lord David Owen, CH, a former British foreign secretary, tackles this issue in QJM, an Oxford journal on medicine, and not your usual place for political reading
As both a physician and a politician, I was first touched by the question of how illness can affect the decision-making of Heads of State or Government when I met the Shah of Iran in Tehran in May 1977. He appeared to be at the height of his power: self-confident, and enjoying his global role in helping to determine world oil prices. It would have been a great help to have known then, and particularly a year later, that he had been suffering from chronic lymphocytic leukaemia. …
The French Foreign Minister Louis de Guiringaud told me later, when we had both left office, that he had known of the diagnosis. But he never told me when I was Foreign Secretary, or Cyrus Vance, the US Secretary of State. Had I known I would have pressed far more vigorously early in 1978, and certainly been adamant in the late summer and autumn of that year, that the Shah should stand down immediately on health grounds. … However, we were still treating him as an imperial leader, capable of making bold decisions, when in retrospect what he needed was to be told what to do and virtually forced to take treatment in Switzerland. If he had done so, the Revolution in Iran would not have taken place in the way that it did, President Carter might have won a second term, and certainly the history of the Middle East would have been very different.
There aren’t any easy answers to these questions, as Owen suggests at the end of the article
Reluctantly, I must also conclude that if a Head of State or Government becomes ill in office, different considerations apply and there can be no set rules. … Formal procedures for fixed medical examinations for an elected incumbent is a process with a pseudo-objectivity which can be blind to the complexities and dynamics of government, as well as the uncertain relationship between disease and the capacity to make decisions.
Thanks to Electrolite for the tip.