Il medico e la malattia: la scienza di Ippocrate

which insight into the condition is totally absent, is far more dangerous than the examples of anaemia, heart failure, or gall-bladder disease that are considered here. It is a consideration to bear in mind in reading the final chapter in which Park discusses the implications for the future. His conclusions are not comforting. Now, it is true, constant exposure by the media, especially television, makes it harder to disguise the evidence of gross illness-at least in democracies. Moreover, if a sick leader recognizes and acknowledges his disability (Eisenhower did), there is hope. It is much more sinister if the illness robs a leader of insight. What then? If his colleagues try to intervene they will be accused of acting for their own political advantage. How can a vice-president or deputy prime minister who says 'It is time for you to stand down" hope to escape such a suspicion? And if he calls on his political colleagues, of whichever party, they will suffer from the same disadvantage. Section 4 of the Twenty-fifth Amendment to the Constitution of the United States was designed to meet this problem. It confers on the Vice-President the power to take over if the President shows signs of inability to discharge the duties of his office, but "inability" was left undefined (deliberately), and the President still has powers to challenge any decision. Should power ofdismissal be delegated to a panel of doctors? Ofcourse not. No one, including the medical advisers themselves, would want it, nor could such a panel escape the suspicion of political predjudice. And what about the problem of medical confidentiality, which would be a major consideration in Britain? To Park and probably to most Americans, confidentiality is not the main issue for leading politicians. Indeed, we have become familiar with the way that the details of a President's illness, even the functioning or non-functioning of his bladder and bowels, are broadcast to the world from the USA. Superficially such openness appears to be a welcome safeguard, but it is doubtful if it is. The worry that lies at the centre of this book is how to devise a system, free from suspicion of improper influence or corruption, which can cope with taking the executive power from a leader who is gravely sick but does not, or will not, recognize the fact and agree to stand down. The urgent need for such a system is …