Update March 22, 3:15 pm ET: Since this article first ran on Mar. 21, Catherine, Princess of Wales, announced in a video message Friday that she is undergoing cancer treatment. The princess said she is undergoing “a course of preventative chemotherapy” on the advice of her medical team, but she did not specify what kind of cancer she has.
The health of famous political figures has dominated headlines in recent months. The advanced ages of the two leading presidential candidates — President Joe Biden, 81, and former President Donald Trump, 77 — have had some voters speculating about whether they are fit to be commander in chief again. About six in 10 voters said they lacked confidence in each candidate’s mental capacity, according to an Associated Press-NORC Center for Public Affairs Research poll. Biden released the results of his physical exam in February, but neither he nor Trump have released the results of cognitive exams they say they have taken.
But nothing has overwhelmed the news, social media and even dinner table conversations more lately than the health and well-being of Catherine, Princess of Wales, whose last official public appearance was Christmas. On Jan. 17, Kensington Palace issued a statement explaining that the princess had a “planned abdominal surgery” that week and said she wouldn’t “return to public duties until after Easter.”
But that didn’t stop speculation from growing online and evolving into wild conspiracy theories that reached a fever pitch on March 10, when multiple photo agencies pulled an image of Catherine and her three children from use. According to The Associated Press, the photo — taken by Catherine’s husband, Prince William, and released by Kensington Palace — appeared to have been “manipulated.” The next day, Catherine apologized on the palace’s X account “for any confusion” the photograph had caused. “Like many amateur photographers, I do occasionally experiment with editing,” she wrote.
However, the incident — much like a recent blurry video of her out shopping — seemed to only create more confusion and misinformation about her health. As journalists navigate the layers of this story, they must ask themselves: When, if ever, is it appropriate to report on speculation? And where is the line between the public’s right to know and a person’s right to privacy?
To understand how to sort through an onslaught of unverified claims, how to give important context in health reporting and how to inform the public about health issues, I spoke with NBC health reporter Erika Edwards. Our conversation has been edited and condensed for clarity.
Stick to the facts and stay away from speculation
What do you see as a journalist’s responsibility in covering a public figure’s health?
Edwards: I think that health journalists have a tremendous responsibility. When a celebrity, a politician or some other public figure is open about his or her health conditions, it gives us a great opportunity to educate the public. We’ve had a few celebrities, for example, who recently talked about their skin cancer or their breast cancer. A lot of times they share their stories to raise awareness.
But the biggest thing I think that we have to keep in mind, as health journalists, is that public figures are, in fact, human. And we need to treat their stories with as much respect and dignity as anybody’s.
What is your advice for journalists on getting the most accurate information when it comes to a public figure’s health?
Edwards: Above all, stay away from speculation. Report only on what the public figure says or a person who has been appointed to represent the person or the person’s medical team. Unfortunately, as we all know, that doesn’t always happen. And you will inevitably have to cover a story where no one’s talking and there’s really no information coming forth.
Let’s say a person collapses onstage during a live televised event, for example, and there’s no information coming out of that person’s team or the hospital. Stick with only what you know to be true. Be honest about what you do or don’t know. It’s OK to remind viewers and readers that you’re not going to engage in any guesswork.
Educate, don’t entertain
Let’s say evidence points to a politician having health issues — they are rushed to the hospital or have had multiple memory lapses. What are the steps you take to report that story? Is it a story?
Edwards: Yes, it’s definitely a story. Memory lapses are tricky because perfectly healthy people forget names and dates all the time. It can even be difficult for doctors to figure out how to diagnose memory lapses and what that really means in terms of dementia or other related issues. Without a diagnosis that we can actually report on, I wouldn’t speculate. In some cases, I may propose to my editors a story about the differences between normal memory decline versus possible signs of a real problem and educate the public as a way of telling the story, but it would come with a lot of caveats about what we do and do not know about the person that ignited the story. I always try to make sure that as health journalists, we are staying in our health lane. And that’s kind of why we propose that education approach.
How do you balance the public’s right to know with the politician’s right to privacy about their health?
Edwards: No law says public figures, even politicians, have to give out their health information. Regardless, this is going to be a major story leading up to the presidential election in November. We have two of the oldest candidates. … Many people are going to focus on their mental acuity, right? But their ages alone put them at much higher risk of heart attack, stroke and other normal age-related conditions. I believe it’s reasonable for journalists to ask people who are seeking public office about their health. It’s information that voters often find useful. Politicians don’t have to answer the questions, but it’s our duty as health journalists to ask them.
On the other hand, what is the danger of assuming someone of a certain age has health issues? Do journalists have to be careful not to conflate increased age with bad health?
Edwards: We absolutely should remember that a person’s age, young or old, is not necessarily a reflection of their health, good or bad. We can report that people over age 65 have a higher risk of heart disease or complications of Covid, for example, but we’d never say that a person is automatically primed for a heart attack based on his or her age.
Relatedly, when Defense Secretary Lloyd Austin was rushed to the hospital in January, the story was bigger than his diagnosis — it was that he hadn’t disclosed his health issues to the White House. It becomes a politics story and a health story. How do you as a health reporter approach that?
Edwards: I did not personally work on this story, but in cases like this, the politics and medical units work closely together. We help find the right doctors and experts and then often write up a few graphs to make sure the health side of such stories is accurate.
What context should reporters be adding to stories about public figures’ health?
Edwards: I think that reporters should offer a reminder that one public figure’s health story may not apply to everyone. Let me give you an example. So 10 years ago, Angelina Jolie went public about her decision to have a preventative double mastectomy after learning that she was genetically predisposed to breast cancer. What followed was called the “Angelina Jolie effect,” a huge, massive increase in the number of women opting for this major, life-changing procedure. And breast cancer doctors will tell you that it’s not necessarily something that’s right for everyone, and it could sometimes lead to misinformation. For example, I heard other celebrities say a double mastectomy reduces a person’s risk of breast cancer to zero, and that’s simply not true.
Words matter
When it comes to a celebrity or royal family member’s health, sometimes the public jumps to conclusions and comes up with wild conspiracy theories, as people are doing right now with Catherine, the Princess of Wales. How do you handle speculative information like that?
Edwards: It’s tricky, especially with the millions of people on the internet weighing in with their own opinions, their own diagnoses and judgments about the health of people like the Princess of Wales, other celebrities and other public health figures. I will boil it down to this: The thing to remember is that responsibly reporting on a person’s health is not meant as entertainment. Stick to the facts.
At the same time, cultural conversations are also stories in themselves. How do you report on the cultural conversations around the speculation without giving those speculations too much weight?
Edwards: To me, that is when a story stops being a health story. That’s when it turns into an entertainment story or a culture story. Now, if she divulged that she has Crohn’s disease, for example, I would jump right in with an explainer.
How can journalists ensure that their reporting doesn’t contribute to stigma or discrimination related to health conditions?
Edwards: Words matter. Language about health conditions evolves over time, and it’s important to stay on top of that. We don’t use the phrase “commit suicide” because dying by suicide is not a crime. Reporting on addiction issues is also another potentially stigmatizing subject. Instead of calling someone an addict or an alcoholic, it’s better to use phrases like a patient or a person with a substance use disorder.
Any other advice for journalists who are reporting on the health of public figures? If they’re just getting started in the field, how should they approach these types of stories?
Edwards: Especially if you’re starting out, don’t be afraid to ask questions for context. There’s usually some history there when it comes to a certain procedure, a drug or medication out there. Just don’t be afraid to ask as many doctors as you possibly can about it to get that extra context. Because inevitably, there’s always another layer of context behind someone’s personal health story that will only help your own reporting.
