Since disappearing from Congress with no explanation in early March, Representative Thomas H. Kean Jr. has missed two votes on the war in Iran, one on extending a warrantless surveillance program, one on a major farm bill and another on his party’s budget blueprint, among other pressing matters.
But when asked on Thursday whether Mr. Kean, a New Jersey Republican running for re-election in a competitive district, should still be seeking another term, Speaker Mike Johnson said that “of course” there was no issue, sidestepping any questions about Mr. Kean’s health or his fitness to serve.
Mr. Kean’s largely unexplained absence — he has said only that he is dealing with a “personal medical issue” and given no timeline for his return — is the latest and most extreme example of how the health of members of Congress remains a black box.
Presidents traditionally release the results of their annual physicals and disclose what medications they are taking, although they are not legally required to do so. But members of Congress typically provide no information to the public about the state of their health or their fitness to fulfill their duties.
Some medical ethicists said public officials should receive greater scrutiny — especially at a time of growing concerns about aging lawmakers holding onto power well past the time when they are able to function in their jobs.
“Every American should expect that elected representatives are competent to do the job they were elected for,” said Arthur Caplan, a professor of medical ethics at NYU Grossman School of Medicine. “At the federal level, given the power and importance of officials, the obligation is even stronger. These are people responsible for major policy decisions that affect everyone.”
Mr. Caplan said that Mr. Kean’s extended absence and his failure to account for it was “totally unacceptable.” When you are elected to serve in Congress, he added, “the duty to be transparent about your health overwhelms any claim of privacy.”
Mr. Kean is not the only lawmaker who is missing in action from Congress these days. Representative Frederica S. Wilson, 83, a Florida Democrat, has been absent from the Capitol for over a month. Late Thursday, as pressure mounted for her to explain herself, she put out a long statement explaining that a recent surgery on her left eye prevented her from flying.
Leaders in both parties have appeared to accept these absences at face value. Mr. Johnson said in a statement that Mr. Kean was “attending to a personal health matter and expects to be back to 100 percent very soon.” That was three weeks ago.
Representative Hakeem Jeffries, Democrat of New York and the minority leader, said on Thursday that Ms. Wilson was “recovering from a procedure and I expect she’ll be back shortly.”
Mr. Kean may be stretching the bounds of how long he can go without providing any details about his health. But he is in line with a long tradition of lawmakers telling the public the bare minimum.
The bar is lower for members of Congress than it is for the president, because government can continue to function if one representative or senator is incapacitated. And in the House, where members run every two years, voters frequently have the opportunity to elect someone else if they feel they are not well represented.
Lawmakers have taken advantage of the lower bar.
Senator Mitch McConnell, Republican of Kentucky, never provided any explanation for multiple alarming incidents at the Capitol and in his state in which he appeared to suffer medical episodes in public, freezing and being escorted away by aides. His office at the time would not even say whether he had been examined by a physician afterward.
In 2023, Senator Dianne Feinstein, Democrat of California, was absent for months recovering from shingles and did not publicly disclose some of the serious complications, including encephalitis, she suffered during that time. She died later that year, her legacy tarnished by her deterioration in office and refusal to step aside even as it became clear she was too frail to serve.
When Senator John Fetterman, Democrat of Pennsylvania, disclosed that he was checking himself into Walter Reed National Military Medical Center in 2023 to receive treatment for clinical depression, it marked an unusual level of transparency. (He has since said he regrets having spoken so openly about his mental health.)
Last week, Senator Susan Collins, Republican of Maine, who is running for re-election in one of the most competitive races in the country, was forced under pressure from the left to divulge publicly for the first time that she has been diagnosed with a benign essential tremor. She said that she had lived with it for decades and that it had no impact on her ability to do her job.
Sarah Longwell, a political consultant who runs focus groups with voters, said that lawmakers’ preoccupation with maintaining their privacy is somewhat misplaced, since constituents tend to be forgiving about the health ailments of their leaders.
At the same time, she said, voters have grown hypersensitive to age as a limiting factor for serving in office, an issue that has remained at the forefront of their concerns since former President Joseph R. Biden Jr. was forced to drop his re-election campaign in 2024 amid concerns about his age, health and ability to do the job.
While Democrats have been cautious about criticizing Mr. Kean for his absence, the party campaign arm has begun making an issue of it.
After Mr. Kean’s official X account posted a message written in the first person on Wednesday, announcing that he had joined the Congressional Crypto Caucus, an official with the Democratic Congressional Campaign Committee, Nebe Betre, recirculated it, adding: “sir the question was ‘where are you?’”
Last month, amid growing concerns about President Trump’s mental acuity, Representative Jamie Raskin, Democrat of Maryland, introduced legislation that would create a commission that, if ordered by Congress, would carry out an independent medical examination of the commander in chief to determine whether he was mentally or physically unable to discharge his duties.
Mr. Raskin, who revealed his diagnoses of colon cancer and lymphoma while serving in public office, said disclosure is much more important for the president, but that he himself had been “torn between not wanting to tell anybody about it and the necessity of telling everyone about it.”
He added: “To have a life in public office is to accept that the public and private nature of your journey is really blended together. Members going through cancer or other illness can give millions of Americans on the same odyssey a real sense of hope and strength.”
In the private sector, chief executives are often required to take an independent, executive physical before assuming the job.
But there is no such vetting for lawmakers, and no real move in Congress to institute one. Dr. Brian P. Monahan, the on-site physician at the Capitol, works directly for the 535 lawmakers he treats. Given that, Mr. Caplan, the medical ethics professor, said that any medical note Dr. Monahan releases carries at least the perception of a conflict of interest.
Rachael Bedard, an internist and geriatrician, said she was sympathetic to lawmakers who found it uncomfortable to disclose information about their health. But she said that the current system needed to change.
“In a very aged Congress, where we know that many members are going to be vulnerable to serious illness, there is a need for some independent office of medical specialists who can help make dispassionate assessments about whether people are fit for office,” Ms. Bedard said. “They could stand in the breach between public speculation and people’s right to some private experience of their illness.”