Unfit for Office

This week, there have been rumblings about whether Prime Minister Gordon Brown is taking anti-depressants. Now, I have absolutely no respect for Gordon Brown as a politician - actually, I don't have much respect for Gordon Brown as a person. But it really pisses me off when people use relatively minor health matters to suggest that someone is unfit for office.

So what medical conditions would actually make a difference to someone's ability to lead?


Madness

If Gordon Brown is on anti-depressants, that doesn't point to “psychological flaws” or unfitness. Lots of people take anti-depressants long-term and a huge proportion of us have taken anti-depressants at some point in our lives whilst remaining completely competent in our work. Our most famous (and some say greatest) Prime Minister, Winston Churchill famously experienced "the black dog" of episodic depression, and is often held up as a great stoic.

Depression is not usually a serious long-term mental illness. For some people, it is incapacitating and can effect all aspects of life and relationships. For most people, it is a very unpleasant but relatively mild, short-term condition which need not have a negative impact on work. Someone who is on effective medication may well be free of symptoms.

It has been said that we can't have a Prime Minister with a less than pristine mental health (whatever that looks like) because he has access to the nuclear button. Yet most outrageous irrational acts – murders, rapes, war crimes etc. - are committed by people who have no diagnosable mental illness. We talk about the great tyrants being mad but the evidence for actual illness remains extremely patchy. I'd say it's pretty dangerous giving anyone access to the nuclear button.

Psychosis, when a person has experiences which aren't actually happening, can occur in anyone, triggered by physical illness (such as a virus or hormonal imbalance), a reaction to medication or poison, or an extremely stressful event such as bereavement. People who have had serious mental illnesses like Schizophrenia or Bipolar Disorder/ Manic Depression for many years will be much better equipped to deal with psychosis than someone who was previously healthy. Such people have ways of coping with hearing voices (and so on) without being compelled by them.

In other words, ruling out people with mental health problems from office is no way to protect ourselves against reckless behaviour on the part of our leaders. It would be as ridiculous as saying that only women should be given positions of authority because we would only expect men to behave aggressively, dress badly and create scandals by sleeping with their secretaries.


Autism Spectrum Disorders

The label of Asperger's Syndrome has attached to Gordon Brown more than once, usually the only evidence being that he lacks charisma and can't do a convincing smile. Last time I looked, neither of these feature on any diagnostic criteria. Last time I looked around me, I saw some fairly charismatic people with autism. Some people have suggested that Hitler had Asperger's Syndrome and whilst you may well criticise him for one or two things, you can't fault the guy on his charisma*.

Author Robert Harris wrote an article in 2006 entitled 'Autistic' brown loses the plot which contained the remarkable (by which I mean awful) disability-as-offensive-metaphor

The buttoned-up suit, the mouth slightly agape, the physical awkwardness, the alarming smile which seems to appear from nowhere as if a button marked “smile” has been pressed in his head, the nocturnal brooding on imaginary grievances encouraged by a group of chippy cronies — Brown, like Nixon, suffers from a kind of political Asperger’s syndrome. Intellectually brilliant, he sometimes seems socially barely functional: a little bit . . . odd.

He goes on to diagnoses him with autism and Obsessive Compulsive Disorder and uses nice words like insane and demented. All respect to Robert Harris as a novelist, but this is a nasty article. Could the same rhetoric be used if he had raised questions about the man's race, gender or even sexuality? As for "a little bit ...odd." Not exactly Ciceronian, is it?

As with Brown's supposed depression, his supposed Asperger's is seen as a pscyhological flaw. But there is absolutely no reason why someone on the Autistic Spectrum couldn't be Prime Minister, if they were so inclined and otherwise able to do so. Lots of people on the Autistic Spectrum would run a mile at the thought of public office, others would be incapable of standing. But otherwise, why not? It's not like people with Autism or Asperger's are unfeeling robots with human skins - it's not nearly so simple as "an inability to empathise" (see Lindsay's excellent recent post on this). Nor is a leader overburdened with feeling exactly what we need; Blair had an emotional response to every falling leaf and that didn't do us any good.


Cognitive Dysfunction

Friends, I'm so sorry. I can't be your World President because my brain is not up to the job. But nor is my brain up to running for office or performing any of the tasks which would be necessary in order for me to rise to become a serious candidate. If I could, then there'd be no real reason why I couldn't be a leader.

The big danger with cognitive dysfunction is when someone doesn't realise there's a problem. So for example, if someone has dyslexia, they know what they can and can't do and they're not going to make any mistakes because they think they can read better than they can. But if someone has Alzheimer's, there is the danger of forgetting so many things that they become very confused without even realising that they are confused. Which could be confusing.

Towards the end of his second term as Prime Minister, Churchill suffered a stroke which was completely covered up by government. It is said that between this point and the point at which he resigned, he really wasn't up to the job. But that only demonstrates the fact that non-disabled leaders can become disabled leaders. You can't screen out unhealthy candidates because health just isn't reliable.


Terminal/ Life-Endangering Illness and Old Age

Of course, it did all right for the fleet in Battlestar Gallactica. Clearly, if someone is about to die, they're not going to be up for any kind of work. But there is a ridiculous anxiety around leaders who might be ever so slightly more vulnerable to death whilst in office.

The joke (or was it an international nightmare?) around the time of the American elections was that John McCain's age meant he only needed to be standing too close to a balloon when it burst and Sarah Palin could be President. But presidents and primeministers do die in office and this is rarely a cause of political chaos – unless, of course, they were killed with violence.

Often politicians who are supposed to be old are not old in any sense we would apply to other people. We also greatly overestimate what old age is - we imagine that everyone over sixty is vulnerable to memory problems, confusion and physical ill health. Whilst this stuff does increase as we age, none of it is inevitable. Even in your eighties, you are most likely not to have dementia; physical impairments are far more common, but they are just physical. I have met very few people in their sixties or seventies who come across as too old for anything and where they do, this is an entirely psychological phenomena.


Physical Conditions

I have wracked my brains, but I can only think of a few physical issues which would have an impact on one's ability to be Prime Minister. If someone has a very weak immune system or if they have chronic pain which requires strong opiate painkillers, then foreign travel is going to be a problem. Inoculations may be dangerous, exotic disease even more so and some painkillers prescribed in the UK are very seriously prohibited elsewhere in the world. So, another two reasons why I can't be your World President. Never mind.

I'm sure that when more politicians with greater physical impairments do come up, a fuss will be made, but political leadership is simply not a physical role. It is a great annoyance the number of times that critics mention Brown's prosthetic eye and broken jaw. There are far more pertinent ways of criticising the man.


Secrets.

The old (entirely circular) argument against homosexual men in politics, military and the secret services was that homosexual men were particularly vulnerable to blackmail. If a high-ranking politician has a condition of which he or she is ashamed and seeks to cover up, this is a problem. And blackmail isn't the only issue.

Whether or not someone who is dishonest with the public about their health (or the state of their marriage, or any other private matter) is necessarily dishonest with the public about the things that matter, I don't know. But any kind of cover-up takes time and energy, could be a distraction and could lead to revelations which might compromise our leader and thus our country, if they come at a delicate political moment.

With some conditions, secrecy is par for the cause; a person might have an eating disorder or addiction for a long time before they are able to acknowledge the fact to themselves, let alone to other people. Once someone is in recovery, these conditions become much less of a problem. Someone who has had alcoholism, for example, may always identify themselves as an alcoholic, but so long as they are open about the fact and continue to avoid relapse, the condition is not nearly so dangerous. George W. Bush was not a dangerous man to have in the White House because he was a former alcoholic. He was a dangerous man because of his ideas.


Shame.

It is difficult to say whether or not Roosevelt would have been allowed to be President Roosevelt had he been out of the disabled closet, but if that had been possible, disabled people in America and the world would probably be a long away along from where we are today. Politicians who cover up medical conditions and impairments today do a great injustice to members of the electorate with the same conditions and insult the intelligence and tolerance of the rest of us. Same with sexuality.

When David Blunkett said he was “not disabled”, he attempted to dissociate himself from all of us lowly cripples who aren't privileged enough to opt out of the label – people he was happy to talk complete bunkum about whilst in Minister for Work and Pensions. I don't think the American system of having candidates disclose medical records is necessary - by even doing this, there is the implication that the health of a candidate might have some significant impact on their ability to do the job. However, a politician who is evasive or in denial about a medical condition or their disability status is very unlikely to be a political friend to disabled people.


* I don't know why anyone thinks Hitler was an Aspie, but I can't see it myself.

Edit: I'm a little behind with blog-reading so only just read these two posts at Autist's Corner about the accusation that "Republicans are Autistic". It's not the first time entire political movements have been accused of having a mental health or neurodevelopmental condition, of course.