When Mortality Is a Matter of State: Medicine, Power, and Truth

This article shows how “reasons of state” can sometimes influence end-of-life care decisions made by top politicians. Drawing on Ivan Illich’s concept of “medical nemesis” and the myth of Tithonus and Eos, it argues that the success of medicine in prolonging life can, paradoxically, increase suffering and raise ethical dilemmas, particularly when medicine is used to ensure the continuity of power. Through the analysis of four historical cases—Franklin D. Roosevelt, Francisco Franco, Josip Broz Tito, and François Mitterrand—the article highlights some issues related to the concealment or deliberate manipulation of information about the health of political leaders, invasive and disproportionate medical interventions, and various conflicts that can arise between clinical goals and political objectives. The article then adopts the doctrine of the “king’s two bodies”, revived in contemporary times by Ernst Kantorowicz, to interpret these dynamics as attempts to merge the leader’s mortal body with an eternal political body, generating a dangerous identification that fuels therapeutic excess. By decoupling the natural body from the political body, the study calls for transparent and ethically grounded frameworks capable of balancing privacy, continuity of government, and limits on the use of medical care.