By Abby Youran Qin
When John Fetterman returned to the Pennsylvania Senate race after his stroke in 2022, his first televised debate became a national media moment. On stage, he addressed his recovery directly and used a line that would later become a touchstone of his post-recovery rhetoric: he described himself as someone who had been “knocked down” but would “keep coming back up.”
Yet Axios’ widely circulated write-up of the debate did not include that line or engage with its political meaning. Instead, the coverage focused almost entirely on how Fetterman spoke: “Fetterman struggled at times to respond to the moderators’ questions, even with the assistance of a closed captioning device.” Even the quotes the article chose to highlight were all related to Fetterman’s stroke. The central question became: “What is happening to his body?” rather than “What political case is he making to voters?”
By contrast, a later piece from the Pennsylvania Capital-Star quoted the “knocked down but gets back up again” line and treated it as the core of the Fetterman campaign. Two outlets watched the same debate and heard the same words, but one treated speech as evidence of impairment, while the other treated speech as political communication.
Two years later, when New York Magazine examined Fetterman again, the angle shifted once more. His stroke and depression were part of the story, but the focus was on governance: Senate attendance, staff dynamics and decision-making. Health was not presented as spectacle, but as one factor in how public power was being exercised.
The same public figure.
The same health concerns.
Three very different stories.
This difference reflects a recurring ethical dilemma for journalists: How should the press cover the health of political leaders? The stakes are high — political office carries real power — but so are the risks of reinforcing ageism or ableism in the process.
Rethinking what “fitness to serve” means — and how to cover it
Much of the public conversation about whether a politician is “fit to serve” rests on mistaken assumptions about what the job actually entails. Taking the presidency as an example, Kenneth Mayer, a professor of political science at the University of Wisconsin–Madison, emphasizes that it is not — and never has been — a one-person operation.
“The responsibilities are almost endless,” Mayer said. “The idea that the president is single-handedly responsible for everything from crime rates to agricultural subsidies to national defense is simply not how modern governance works.”
The modern presidency functions through delegation, coordination and the large Executive Office of the President, which exists precisely because one person cannot manage the entire federal apparatus alone. Similar dynamics shape the work of senators and representatives, who rely on chiefs of staff, policy advisors, committee structures and caucus negotiations.
This reframing complicates the notion that physical changes or signs of aging automatically impair elected officials’ ability to govern. What matters is not whether a politician occasionally appears fatigued on camera, but whether and how decision-making systems continue to function.
This does not remove the need for journalistic scrutiny — it shifts the focus. The most important questions are not the medical diagnoses, but rather:
- How does the condition affect decision-making?
- Are responsibilities being delegated, and to whom?
- What are the incentives for a leader to hold on to power despite illness?
In these moments, journalists are not diagnosing health — they are assessing accountability.
Collateral narratives and unintended harm
Political journalism is also a profession shaped by demanding work conditions. The beat requires constant travel, long hours and rapid response to breaking developments. These pressures mean that political newsrooms tend to be staffed by people who are relatively healthy, mobile and accustomed to operating at a fast pace.
As the profession structurally selects people who have not needed to navigate disability or age-related accommodation in their own lives, even well-intentioned coverage can sometimes unconsciously reproduce stereotypes that equate health with competence and impairment with decline.
Lisa Diedrich, a professor and scholar of critical illness and disability studies at Stony Brook University, argues that public narratives about illness and aging can create a vicious cycle
“Ableism makes politicians feel it’s necessary to hide illness,” she said. “That secrecy breeds speculation, speculation gets weaponized, and that weaponization further reinforces ableism, making disclosure even less likely.”
The result is a loop that feeds distrust, stigma and sensationalism while obscuring the more meaningful questions about governance.
Julia Métraux, a disability journalist at Mother Jones, suggests a simple test:
“Ask yourself what someone with the same health condition — your grandparent, your colleague, your neighbor — would feel after reading your story about a politician’s illness.”
Coverage that treats mobility devices, speech patterns or age as symbols of decline reinforces stigma, whereas coverage that focuses on how decisions are made and how institutions adapt provides useful information. The difference is subtle but significant. It often comes down to tone, framing and what the journalist chooses to make the point of the story.
As an example, Métraux illustrates how the conversation around aging politicians can be framed differently.
“The problem is not simply that many political leaders are old — it is that they are among the small number of Americans who have the economic security to retire comfortably at any time, yet choose to remain in office. Continuing to hold power offers status, influence and material advantages that most people do not have access to.”
Reframing the aging-politician debate in these terms helps shift coverage away from biological determinism. Instead of asking whether older politicians are inherently less capable, journalists can ask why leaders choose to retain authority, how long-term incumbency affects political representation and how power is exercised when leaders age.
The focus becomes power and accountability, not frailty.
What should journalists do differently?
- Avoid medical speculation. Diagnosing from clips will only fuel rumor and reinforce ableism.
- Shift focus from symptoms to systems. Ask who is making decisions and how authority is structured.
- Interrogate power, not bodies. Aging and disability are common human experiences; what makes them politically significant is that elected officials hold power and are accountable to the public.
Covering the health of political leaders will always involve uncertainty. But the central task of journalism is not to determine medical fitness. It is to explain how leadership and power function in those circumstances.
By grounding coverage in institutional accountability rather than bodily judgment, journalists can help foster a political culture in which transparency is possible, illness is not stigmatized and democracy does not depend on projecting invincibility.
Abby Qin is a 2025 fellow at the Center for Journalism Ethics and a graduate student in the School of Journalism and Mass Communication at the University of Wisconsin–Madison.
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