The cover-up of President Urho Kekkonen's dementia and its impact on the political life of Finland - a personal account

Urho Kekkonen, born in 1900, was elected President of Finland in 1956. He s tayed in office for 25 years, the longest term for any democratically elect ed chief of state, until his resignation in 1981. Since he was always a mod el of good health, news of his cognitive decline while still in office came as it surprise to the whole nation. The impact was aggravated by an attemp ted cover-up of his dementia. The attempt failed and the health of presiden tial candidates became, suddenly, a topic of intense public discussion. No special team of presidential doctors was established but Kekkonen's success or initiated a practice of reporting annually on his health. The ethical di lemma involving mass media was, and still is, its duty to inform people ver sus its right to self-censorship, which was practised in Kekkonen's case. T he physicians face the question of when, how and whom to inform when they n otice that the president or some other powerful leader suffers from cogniti ve decline or other neuropsychological or mental disability. These are univ ersal problems whose solution depends on the degree of democracy and freedo m of expression in each country. Kekkonen died in complete privacy in 1986. Until now, no scientific report of his cognitive decline has been publishe d. Eur J Neuror 6:137-140 (C) 1999 Lippincott Williams & Wilkins.