Three Links on Trump, Mental Illness, and Impairment under 25th Amendment

Link #1: “Mental Health Professionals Declare Trump is Mentally Ill And Must Be Removed

From Change.org:

We, the undersigned mental health professionals (please state your degree), believe in our professional judgment that Donald Trump manifests a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States. And we respectfully request he be removed from office, according to article 3 of the 25th amendment to the Constitution, which states that the president will be replaced if he is “unable to discharge the powers and duties of his office.”

https://www.change.org/p/trump-is-mentally-ill-and-must-be-removed


Link #2: “Shrinks Battle Over Diagnosing Donald Trump

From Psychology Today:

In the several days since psychologist John Gartner posted a petition on Facebook declaring that Donald Trump must be removed from office because he has “a serious mental illness that renders him psychologically incapable of competently discharging the duties of President of the United States,” nearly 12,000 psychologists, psychiatrists, and other mental health professionals have signed their agreement.

https://www.psychologytoday.com/blog/brainstorm/201701/shrinks-battle-over-diagnosing-donald-trump


Link #3: “The Twenty-Fifth Amendment and Mental Illness

From the blog Concurring Opinions:

There is a fantasy making the rounds that the Twenty-Fifth Amendment will be invoked to remove the President from office because he is “unable” to discharge his duties.  This is just one of the many silly attempts to find a constitutional silver bullet to avoid the reality that there will be four years of this Administration (rogue electors, Emoluments Clause, impeachment, etc.).

https://concurringopinions.com/archives/2017/01/the-twenty-fifth-amendment-and-mental-illness.html

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12 thoughts on “Three Links on Trump, Mental Illness, and Impairment under 25th Amendment”

  1. I suggest a read of the following from the American Psychiatric Association:

    >> On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.” (The Goldwater Rule: Why breaking it is Unethical and Irresponsible)

    Are you advocating that we decide that in fact doing this is ethical? Or perhaps there is an “extreme measures” clause which somehow failed to be included?

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    1. As odd as this may sound, I hadn’t considered the possibility of advocating a position on that one way or the other. I’m not a mental health professional; I view the debate about whether this is ethical to be an “internal” debate for said professionals.

      With that said, as an outsider to that profession, my layman’s opinion is that an exception does seem to be warranted for the office of POTUS, especially since his condition (assuming the diagnosis is correct) is untreated.

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      1. There is nothing intrinsically unethical about rendering a tentative clinical diagnosis based on publicly available evidence. And in the case of Trump we have an abundance of publicly available evidence. I would point out that his ghost autobiographer has offered the non-professional diagnosis of psychopathy. And the mere fact that Trump’s behavior is sufficient to warrant the tentative diagnosis of psychopathy or NPD is disturbing enough.

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      2. The rule was developed precisely in response to a bunch of medical professionals anonymously diagnosing a US presidential candidate: Sen. Barry Goldwater.

        We’re in very dangerous territory, here: ethical rules that only really apply when we want them to. Otherwise, we find exceptions, exceptions which give us more power than the rules were intended to allow. It becomes the case that “Might makes right.” And yet, that’s the very complaint against Trump’s style, isn’t it? There’s a law: if you fight evil with evil, evil wins.

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  2. Let’s take Trump out of the equation and think about this generically.

    I think we need to distinguish several related questions:

    (1) Could mental illness impair a President’s ability to discharge the duties of the Presidency?
    (2) If yes, could mental illness be a sufficient reason for the VP and Cabinet to invoke the 25th Amendment and declare the President impaired?
    (3) If yes and if the President is unwilling to seek evaluation, diagnosis, and/or treatment for mental illness, who should advise the VP and the Cabinet about the risks?

    I think the answers to (1) and (2) are obviously yes. The problem is that there is no defined process today to help with (3). In the future, I can imagine Congress passing a law requiring the Surgeon General to monitor the President’s mental health and alerting the VP and Cabinet if he/she is concerned. But since nothing like that exists today, it seems not only permissible, but obligatory, for concerned mental health professionals to voice their concerns.

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    1. It would be interesting to see the party affiliations of all those mental health professionals who decided to either disregard the APA’s ethical guidelines, or were merely ignorant of what their profession has considered ‘ethical’. BTW, according to the NYT “In infectious disease medicine, psychiatry and pediatrics, more than two-thirds are Democrats.”

      As to monitoring the President’s mental health, I’m sure there’s precedent for thinking about that, given Ronald Reagan’s Alzheimer’s. I’m also aware that we as a nation are notoriously bad about thinking about mental health. It’s just not clear that flaunting guidelines put in place specifically for presidential elections is the way to do it. It smacks of ethics giving way to power.

      This whole phenomenon smacks of an attempt to do an end-run around democracy. Instead of facing ourselves and the fact that We the People chose this, we want to escape the consequences of our actions (and inactions). It’s not like those who choose to be informed on issues which matter are unaware of stuff like the Harvard Business Review‘s Why Do So Many Incompetent Men Become Leaders?.

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  3. Sorry, Luke, but I’m just not seeing it. I don’t understand how this could be construed as an “end-run around democracy,” since invoking the 25th Amendment makes Pence, not Hillary Clinton, the Acting President.

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    1. Who decides who is fit to be President? The elite, or the masses? If the former, it isn’t a democracy but in name. Barring some psychological change, We the People are getting what we saw prior to November 8, 2016.

      Now, ostensibly the Electoral College was designed to prevent Trump from becoming President. But the dominant mood from liberals seems to be that the EC should be done away with. And now we have a request for an authoritarian dismissal of Trump. The contradictions are amazing.

      What I don’t see, in all of this, is Americans taking a deep look at themselves, repenting of the foolishness that led to all this happening, and then doing the hard work of reinvigorating the institutions which have been neglected for so long, with consequent growing distrust by the masses. What is going to come of this declaration by mental health professionals, other than increased alienation between Americans?

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      1. Not really. I highly doubt that those with the power—

        Section 4. 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,

        —would enact it unless something significant changes about Trump’s behavior. I mean c’mon, Mike Pence got to know Trump plenty well before November 8. Do you really think that all of a sudden he’s going to cock his head, realize that Trump is is several standard deviations worse on the psychopathy and NPD scales than your average President, and thus take part in seizing power from Trump? Perhaps it would help to realize just how much Trump’s personality is reflected in the advisors he has chosen. Do you really expect them to throw the man who gave them incredible power to the wolves?

        Again, this is all a ridiculous charade which attempts to avoid dealing with the consequences of actions and inactions. It is likely to further diminish citizens’ trust in a key American institution: the mental health profession.

        P.S. My own guess is that everyone listed in Section 4. will want Trump in-place to run interference. As far as I can tell, Trump et al are playing a very different game than many realize. They are playing off the massive amount of entropy that has accumulated in American society and have been massively successful. I doubt that anything but more civic virtue among more citizens will solve this problem, and yet I virtually never see that argued. So it’s one set of authorities vs. another—authoritarianism itself is simply taken for granted.

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  4. “Not really. I highly doubt that those with the power—[snip]—would enact it unless something significant changes about Trump’s behavior.”

    I feel like we are talking past one another. I have never claimed or thought it is likely that Pence and the cabinet would declare Trump impaired. To put it bluntly, I don’t think it will happen. Rather, I claim the following:

    (1) Mental illness can impair a President’s ability to discharge the duties of the Presidency.
    (2) Mental illness can be a sufficient reason for the VP and Cabinet to invoke the 25th Amendment and declare the President impaired.
    (3) If the President is unwilling to seek evaluation, diagnosis, and/or treatment for mental illness which has impaired his ability to discharge his duties, it is appropriate for mental health professionals to publicly voice their concerns so that the VP and the Cabinet can become aware.

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    1. I just find it extraordinarily hard to believe that those who could execute Section 4 of the 25th Amendment don’t know exactly what kind of person Trump is. And I find it extraordinarily hard to believe that the mental health professionals who signed that document aren’t aware of this. (If they aren’t, that would demonstrate a profound lack of competence, or inability to stay within one’s area of competence.) So, I’m forced to conclude that either they are acting irrationally, or their purpose is very different from your (3). My guess is that they’re not acting irrationally, understanding ‘rationality’ here to be merely “intelligibility with respect to a purpose”.

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