POLITICS : Quayle Case Renews Debate on Public’s Right to Know : Should candidates sacrifice privacy when it comes to their health? Some say a method for determining disability should be explored.

The hospitalization of former Vice President Dan Quayle for treatment of blood clots, followed by the removal of an apparently benign tumor on his appendix, again has raised troubling questions over how much the public is entitled to know about the health of its political leaders--especially presidential contenders.

“The public is smart enough to decide what it wants to do about a health problem, if anything, but I think we need more information than we now get,” said Arthur Caplan, a medical ethicist.

Quayle is only the latest in a long string of political figures--John F. Kennedy and Ronald Reagan notably among them--whose medical ailments have fueled the debate.

The issue became especially sensitive in Quayle’s case because speculation arose among medical experts that clots such as his sometimes signal the presence of potentially serious kinds of cancer.

But Mark Goodin, a senior adviser to the former vice president, insisted that “we were straightforward right from the start. We provided every available piece of information that we could, consistent with what was happening at the time. We were not going to participate in a process that would use any speculation or panic-ridden rhetoric from people who were outside observers.”

The tumor on the appendix, which was pinpointed as the cause of the clots, was judged by Quayle’s physicians to be benign. Goodin said the doctors “are absolutely certain” of their finding.

Dr. Jay Pasricha, a gastroenterologist and assistant professor of medicine at Johns Hopkins University, said it was clear to experts in the field that Quayle’s doctors “were obviously concerned about the possibility of a tumor, so that’s why they went in.”

Pasricha, who is not involved in Quayle’s case, said he is inclined to trust the pathologists’ conclusions because “if it had been cancerous--or if they were concerned that it was--the operation would have been far more extensive.”

Goodin, when asked, predicted that Quayle will release all his medical records when he announces his candidacy--as long as other candidates agree to do the same.

This clearly would put the pressure on other potential candidates, Republican and Democrat alike. Senate Majority Leader Bob Dole (R-Kan.), for example--who is a possible GOP presidential contender and has established an exploratory committee--has been treated for prostate cancer and has been open about having had the disease. But if Dole, 71, decides to run, his medical status will probably be the focus of much more public interest than it has been thus far.

Many political figures traditionally have resisted the notion that they must sacrifice privacy when it comes to their health. President Clinton, 48, who intends to seek reelection, consistently has refused to release his medical records to the public.

In recent years, however, medical disclosure has become more commonplace in response to specific medical disorders as they occur--such as Reagan’s colon cancer, which was diagnosed during his second term, and former President George Bush’s bout with thyroid disease.

But, at the same time, most political figures have selectively controlled the flow of information that is released to the public, as well as access to their physicians.

And physicians are bound by a longstanding medical ethic that a doctor may never discuss a patient’s circumstances without permission from the patient.

More often than not, this confidentiality ethic has resulted in a public discussion in the media and elsewhere by medical experts who are not directly connected to the individual case--but, paradoxically, are the only physicians free to talk about it.

Caplan has proposed that Congress ask the National Institutes of Health to appoint a standing panel of physicians--experts in physical and mental health--with the authority to examine candidates and their medical records and “issue reasonably forthcoming reports.”

And former President Jimmy Carter has urged that the nation come up with a “better way” to determine whether a President is disabled.

“This might be by creating a nonpartisan group of expert representatives of the medical community who are not directly involved in the care of the President,” he wrote in a recent issue of the Journal of the American Medical Assn. “They could be given the responsibility for determining disability.”

History has shown that the nation has confronted--and, in fact, survived--the ill health of its presidents: In addition to Reagan’s and Bush’s ailments, Franklin D. Roosevelt, after an earlier bout with polio, was a President in a wheelchair. Kennedy suffered from Addison’s disease--a debilitating condition characterized by weakness, weight loss and gastrointestinal problems resulting from failure of the adrenal glands--which was a well-guarded secret that was not revealed until many years after his assassination.

Perhaps the best-hidden case was that of Woodrow Wilson, whose capacity to lead the country was severely diminished by a massive stroke in 1919. The extent to which his wife and aides made critical decisions during the last year and a half of his second term was not known until decades later.