08/11/2012 05:00 EDT | Updated 10/11/2012 05:12 EDT

Rob Ford Adopts US-Style Approach To Personal Health Information Disclosure

CP/The Globe and Mail
TORONTO - Is a trip to the hospital a matter for private reflection or the public spotlight? When it comes to Canadian politicians, it's anyone's guess.

Canada's leaders have historically been reluctant to divulge details of their personal health struggles, observers said, adding the public has largely accepted the argument that such issues are not the country's collective business.

The matter is more clear-cut south of the border, where details of leaders' routine medical appointments come under nearly as much scrutiny as their policy positions.

One prominent political figure recently made headlines for adopting the American-style approach to health disclosure.

Toronto mayor Rob Ford's two-night stay in hospital this week touched off a spate of local media coverage as he underwent a battery of tests.

Public speculation was kept in check through the regular bulletins coming from the mayor's press office. Torontonians were informed of the allergic reaction that exacerbated Ford's asthma and prompted him to seek medical attention. The mayor's brother Doug Ford told reporters the mayor had been advised to redouble his efforts to lose weight once he was in top form.

Such advice was nearly as familiar to Toronto residents as it was to the mayor himself. Rob Ford's "Cut the Waist" challenge _ a pun on the waste-reduction campaign that propelled him into office in 2010 _ made headlines nearly every week through the first six months of the year.

Ford's efforts to shed 50 pounds between January and June ultimately fizzled in the public spotlight. He managed to lose 17 of his original 330 pounds.

Ford has frequently trumpeted a message of accountability during his time in office, stressing his desire to be transparent to a public who is sharply divided on both his mayoralty and populist persona.

The mayor's office did not respond to repeated requests for comment on Ford's health disclosure policies.

Some political pundits say the mayor's approach amounts to a strategic publicity stunt.

Bryan Evans, associate professor of politics at Ryerson University, said up-front discussion of the mayor's health struggles allows him to secure media airtime while bolstering his reputation as an every-man contending with the same problems as workaday Canadians.

"That's the name of the game, getting as much media exposure as one possibly can. And in this case I'm quite sure it had a little bit to do with creating a little bit more of a human, softer image," Evan said in a telephone interview.

"Here's a person who media have not been generally friendly to for awhile, and it was an opportunity to do some image management.

Others, however, see Ford's approach as a praiseworthy strategy in a culture that skews toward secrecy.

Andre Picard, public health policy expert and health columnist with the Globe and Mail, said politicians have a duty to be frank about any issue that could affect their job performance.

Disclosing medical details, he added, would hold public figures accountable to the people they serve while fulfilling another one of their key mandates.

"Being a political leader, you show leadership in all kinds of ways. Not being squeamish about health is an important leadership thing," Picard said.

"If you're living with asthma, as the mayor of Toronto or our Prime Minister, there's no shame in that. There shouldn't be, and there's an important message to send to kids with asthma."

If anything, Picard felt Ford wasn't forthcoming enough during his most recent health scare. More details would have been welcome, he said, adding leaders in the U.S. have a tradition of openness dating back to the 1940s.

The results of presidential medical checkup are released for all to see. While the public wasn't offered a front row seat to Barack Obama's efforts to quit smoking, the results of his efforts _ along with his revised cholesterol levels and other blood test results _ were made available through yearly White House reports.

Ronald Reagan's struggles with prostate cancer helped open a dialog that's had long-term health benefits for men beyond the U.S. border, Picard said.

The perils of remaining mum on medical details, Picard said, were drastically and tragically illustrated in the aftermath of the NDP's rise to official opposition status during the 2011 federal election. Leader Jack Layton, who had struggled with cancer and a fractured hip in the months leading up to the campaign, died less than four months after propelling his party to historic heights. His rapid decline after the election prompted many to question whether he had been forthcoming about his health and what ramifications such details might have had on the outcome.

Evans cautioned against relying too much on hindsight, adding it's impossible to say how much Layton himself knew about his condition at the time he hit the hustings.

Medical disclosure, he maintains, is a complex issue that can only be evaluated on a case-by-case basis.

"Medicine is a science, but it's also very much an art. What may be true in one case won't be true in another, so it can be difficult to say. I for one wouldn't want to give a harsh judgment that, 'yeah, there should be full, 100 per cent disclosure by each and every person.'"

Picard disagrees, saying reserve on a matter that does have public repercussions could set a dangerous precedent.

"If I can be told half the truth about a politician's health care, why can't I be told half the truth about his financial interests? Either we're going to have openness or we're not going to have openness, and I think that's concerning."

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