Psychological Illness in Presidents: A Medical Advisory Commission and Disability Determinations

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Abstract

Although the 25th Amendment is intended to provide for instances of presidential disability, critics claim that it is impractical since it requires vice presidents and cabinet members to move overtly against the president—which they are unlikely to do. Also, they warn that medical information about the president is likely to be concealed. To overcome these problems, they recommend that a Medical Advisory Commission be established at the outset of every presidential administration to examine the president annually and then provide formal medical input so that the vice president and cabinet would be “compelled” to act in the presence of medically determined “inability,” whether physiological or psychological. This paper argues, however, that such a proposal is badly flawed and quite unworkable, particularly in the case of psychological illness where accurate diagnosis typically depends on long-term, continuous doctor-patient interaction rather than through sporadic and superficial interchange. It concludes that less draconian measures in implementing the Amendment are far more sensible, such as those proposed by the Working Group on Presidential Disability which are discussed here.

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