(NewsNation) — Less than six months after suffering a stroke, Pennsylvania’s Democratic Lt. Gov. John Fetterman took the debate stage Tuesday night against Republican Mehmet Oz to make his case for the state’s open Senate seat.

Throughout the evening, the Democratic candidate struggled to articulate his policy positions and had difficulty completing full sentences.

Earlier this month, Fetterman’s campaign released a one-page medical report from his physician, Dr. Clifford Chen, that said he had “no work restrictions” and “can work full duty in public office.”

When asked during the debate whether he would release more information regarding the stroke he suffered back in May, Fetterman cited his doctor’s note.

“My doctor believes I am fit to be serving and that’s what I believe,” he said.

Oz, as well as numerous media outlets, have asked for more detailed medical records, which Fetterman has declined to provide.

Fetterman’s visible health challenges have reignited longstanding debates about transparency when it comes to candidates’ medical history.

the case for full medical disclosures

The argument for medical transparency is fairly straightforward: Voters have a right to know if the person they are electing is up to the task.

Some, like Dr. Lawrence Altman — a physician and longtime medical correspondent for the New York Times — have made the case for full transparency and point out that politicians often benefit when they disclose their health information.

By being open and honest, candidates are able to get ahead of misinformation that might otherwise distract from their campaign, he explained in a recent opinion for The New York Times.

In some cases, candidates pay a higher price for the cover-up than the actual medical issue they’re facing, Altman argued.

“Politicians should realize that disclosing limited information about their health can make it more of an issue than full transparency,” he wrote.

As American politicians continue to get older, questions around their health and fitness to serve have become more important than ever.

In the last election cycle, medical records were a constant talking point in the Democratic primary, which had multiple septuagenarians.

Former New York Mayor Michael Bloomberg, released a one-page letter from his physician declaring he was in “outstanding health.” Then-candidate Joe Biden released a doctor’s report describing him as “healthy, vigorous.”

In the lead-up to the 2016 election, former President Donald Trump released a doctor’s note asserting that he would be “the healthiest individual ever elected to the presidency.”

So why have candidates shied away from more extensive medical disclosures in recent years?

the case against full medical disclosures

Arguments against full medical transparency often assert some version of the following: Most Americans are not doctors and thus should not be left to decide which ailments are, or are not, disqualifying.

Franklin Delano Roosevelt suffered from polio and John F. Kennedy battled Addison’s disease.

Some in the health care field contend that today’s media environment — in which news networks and social media personalities hyper-fixate on salacious talking points rather than substantive policy proposals — makes full medical disclosures a bad idea.

“Imagine the frenzy on social media if a candidate’s medical records indicated an episode of depression years before, or a sexually transmitted disease, or whether a male candidate uses Viagra, or if a candidate of either gender had been abused,” Drew Altman, the president and CEO of the Kaiser Family Foundation (KFF), wrote in a 2016 op-ed for the Wall Street Journal.

Drew Altman, who was specifically addressing health disclosures for presidential candidates, concluded that a “full disclosure” of medical records would almost certainly “cause more harm than good.”

Instead, the KFF CEO suggested an alternative — a formal system that would allow presidential candidates to submit medical records to an independent panel of professionals that could then certify statements about the candidates’ health.

That arrangement, he argued, would allow for transparency while also protecting candidates’ privacy.

Other health care experts oppose public disclosures based on their assertion that such information would likely have little impact on how people view candidates but could further stigmatize members of the public suffering from similar ailments.

“If detailed health information about candidates is unlikely to change voters’ minds, but could have adverse consequences, independent and private medical exams may be the most appropriate way forward,” Sarah Gollust, an associate professor of health policy at the University of Minnesota, wrote in a 2016 opinion for The New York Times.