America might be led by its first octogenarian, and risk of incapacitating illness rises as people age.
In January 1965, Congress began moving toward passing a constitutional amendment in case poor health caused a president or vice president to leave office or need to be removed. The impetus for adding to the Constitution arose from concern about the fragility of the health of most recent presidents. President Dwight Eisenhower had spent six weeks in the hospital because of his heart attack in 1955. Then, President John Kennedy was assassinated in November 1963, resulting in heart-attack-survivor Lyndon Johnson taking over the White House. Recognizing the issue’s urgency, the House and Senate soon passed the 25th Amendment, and the states completed the ratification process in February 1967.
The 25th Amendment has four sections. The first three are straightforward. The last one is not. First, presidential succession: If the president dies or resigns, his vice president takes over. Second, vice presidential vacancy: If the vice president leaves office, the president nominates a successor, who must be approved by a majority of the House and Senate. Third, presidential declaration: If the president notifies House and Senate leaders that he can’t do his job for a while, (like when he’s about to undergo surgery), the vice president takes over until the president tells Congress he’s ready to resume his duties. All three sections have been invoked in the last 53 years.
Then comes the fourth section that has never been used, and is the trickiest. It covers the situation when a president can no longer fulfill his duties, but is unable or unwilling to admit it. In that instance, the vice president and a majority of the Cabinet must agree on the need for removal, and notify Congress that they believe the president is unable to do his job. In that case, the vice president becomes the acting president.
The president has the right to contest the issue of his capacity, and if the vice president and Cabinet majority refuse to yield to the president’s position, then the issue of who will ultimately occupy the Oval Office goes to Congress immediately. Only if two-thirds of both houses agree with the vice president and Cabinet majority will there be a change in executive branch leadership.
If Section Four had been in place in October 1919, it might have resulted in the replacement of President Woodrow Wilson after he went down with a stroke that largely disabled him for the remainder of his second term; though that result is not certain because Vice President Thomas Marshall made it clear he did not want to become president.
Because there was no law at the time on a process for dealing with a president’s disability, Wilson’s leading biographer Scott Berg says that what transpired in the aftermath of the stroke was “the greatest conspiracy that had ever engulfed the White House.” Until March 1921 when Wilson’s second term ended, his wife Edith essentially functioned as the nation’s first female president, and “was definitely the person in charge of the White House for 17 months.”
Section Four almost came into play in March 1987 when newly appointed White House Chief of Staff Howard Baker and his aides became so concerned about 76-year-old President Ronald Reagan’s disengagement from his duties that they set up a meeting, the sole purpose of which was to observe whether their boss was firing on all cylinders. Though he knew nothing about the meeting’s purpose, Reagan avoided a challenge to his job that morning by coming across as alert, attentive and even witty, ending the conversation about invoking the 25th Amendment.
In January 2017, Donald Trump became the oldest person ever to be sworn in for his first term, at 70 years old. If his opponent Hillary Clinton had won the 2016 election, she would have been 69-and-a-half at her inauguration, though both of them would have been younger than Ronald Reagan, who was almost 74 when he started his second term.
This coming fall, President Donald Trump will likely run against Joe Biden. On the Jan. 20 inauguration date, Trump will be 74 years old and Biden 78, which means that if Biden gets elected, and survives 22 months in office, he will become the country’s first octogenarian president.
What’s the importance of a presidential election between two guys in their 70s who are their parties’ oldest presidential nominees in American history? According to the Mayo Clinic’s website, “the risk of dementia rises as you age, especially after age 65.” Many know the challenges of dealing with a dementia-diminished elder. Carol Thatcher, daughter of former British Prime Minister Margaret Thatcher, described her mother’s declining condition in her final 12 years (beginning when Lady Thatcher was 75): “Sufferers look and act the same, but beneath the familiar exterior, something quite different is going on. They’re in another world and you cannot enter.”
Given the Mayo Clinic’s assessment of dementia risk rising at age 65, and the age of the presidential candidates, has the time come to require a complete physical for candidates age 61 or older? Many corporations require as much from their top leaders. If the tests reveal that a candidate shows signs of physical or mental incapacity, does any voter believe it’s in the nation’s best interests for that person to be in charge of the United States for the next four years? Shouldn’t voters know if a candidate is ill at the time of the election?
This is not an attempt to screen out candidates with disabilities, physical or mental, who are capable of doing the job. This test would purely screen for incapacitating illnesses.
There is no law that requires a presidential candidate to make public the results of a physical or cognitive examination before running. But at this point, the nation may soon put its fate in the hands of an octogenarian. Now is the time for pre-election physical and cognitive testing of candidates over the age of 61, given the dangerous scenarios that may arise if Section 4 of the 25th Amendment needs to be invoked.
To use Carol Thatcher’s words, we simply cannot afford to have the President of the United States “in another world” we cannot enter.
Talmage Boston is a lawyer and presidential historian in Dallas. He wrote this column for The Dallas Morning News.
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