The Contemporary Presidency: The Twenty‐Fifth Amendment: Recommendations and Deliberations of the Working Group on Presidential Disability

Abstract

The Twenty‐fifth Amendment was added to the Constitution in 1967 as a response to long‐festering issues of presidential disability and succession. Jimmy Carter and other critics have argued, however, that the amendment is badly flawed. In response to Carter's suggestion, the Working Group on Presidential Disability was established in 1994 and, in late 1996, presented nine recommendations for strengthening the amendment to President Clinton at the White House. These are cited here and a number are explained and defended. Also, the suggestion made by some Working Group members that a Standing Medical Commission be created by law to monitor the president's health and issue periodic reports to the country is critiqued, using, in part, a case study derived from the presidency of John F. Kennedy.

The politics of presidential medical care: The case of John F. Kennedy

“…In each case, the competition for access and political power can work to compromise the quality of care that the President receives. 33 The case of John F. Kennedy is simply rife with examples of individuals who put their personal preferences or ambitions above the proper care of the patient, the patient himself included. Obviously, no one else may be able to make the President do something he does not want to do, but curtailing exposure to multiple actors who all feel they deserve primary authority might be one good place to start.…”

“…• FALL 2014 • VOL. 33,NO. 2 Taylor writes to Burkley on January 18, 1963, that: "The clinical impression is that he has a definite lingual tonsillitis ...…”

Presidents’ Health and Medical Confidentiality

“…7 This working group concluded that the 25th Amendment did not require revision, but that "guidelines are needed to ensure its effective implementation," and that while "determination of presidential impairment is a medical judgement…determination of presidential inability is a political judgement." 7 The group also concluded that while the president's physician is the "best source of information" about the president's health, the president or designees have the responsibility "to make accurate disclosures to the public." 7 Over the past quarter-century since this report, however, political and legal landscapes have changed.…”

“…7 The group also concluded that while the president's physician is the "best source of information" about the president's health, the president or designees have the responsibility "to make accurate disclosures to the public." 7 Over the past quarter-century since this report, however, political and legal landscapes have changed. In the past, for instance, a norm existed by which candidates voluntarily submitted their private tax returns and their medical information, but this norm of openness has now eroded.…”

“…The group also dismissed as "unwarranted" potential criticism that the vice president and cabinet might be "unlikely to seek to remove the president…when they clearly should." 7 Yet, especially given current political polarization, these officials would have significant COIs in removing their party's elected president and might not do so. Arguably, situations could arise in which the president's physician should, in the name of national security, override the president's decision to keep certain medical information confidential.…”