Nov 2000

Health and Mental Competency of Presidents

Audiey Kao, MD, PhD
Virtual Mentor. 2000;2(11):122-123. doi: 10.1001/virtualmentor.2000.2.11.dykn1-0011.


  • Until 1967 there was no procedure in place for assessing the physical or mental capability of the President to carry out the duties of office? Indeed, when President Woodrow Wilson suffered a paralytic stroke in 1919, his inner circle, consisting of personal physician, private secretary, the first lady, and the Secretary of State, kept the President's condition a secret until his presidency ended in 1921.
  • The possibility that such a presidential secret could be kept again diminished with the adoption of the 25th Amendment to the US Constitution in 1967. The Amendment states that "whenever the Vice President and a majority of either the principal officers of the executive departments or of such other body as Congress may by law provide, transmit to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President." The Amendment, however, did not explicitly define the relevant types and degrees of "disability," nor did it designate who should make the medical determination that might ultimately lead to a political decision to relieve the President of his Constitutional authority.
  • Lt. Colonel Richard Tubb, Air Force Academy Class of 1981 and a graduate of the University of Wisconsin Medical School specializing in family practice, currently serves as a White House physician. It would seem that the White House physician would be the person best equipped to make an informed medical determination concerning the President's ability to dispense the duties of his office. But many argue that an independent panel should make this critical medical determination.
  • Maintaining the proper balance between medical privacy and the public's right to know can be tricky when the patient is the President. Over time, privacy has given ground to right-to-know, and the expectation has evolved for more and fuller disclosure concerning the health of both the President and those running for the office. Some claim, though, that there must be limits on medical disclosure, arguing that the President and candidates for president deserve a reasonable degree of privacy when it comes to their medical records [1].


  1. Annas G. The health of the President and presidential candidates: the public's right to know. NEJM. 1995;333(14):945-949.


Virtual Mentor. 2000;2(11):122-123.



The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.