Let’s Not Wait for a Constitutional Crisis : A better way to replace an incapacitated president is needed

The recent spate of violent incidents near the White House underscores the need for better constitutional means of replacing a president who is permanently or temporarily incapacitated. Five U.S. presidents have been shot, four of them fatally. Of the 18 presidents of this century, about half were targets of physical assaults, successful or unsuccessful. Several 20th-Century Presidents suffered from heart disease, hypertension or stroke or underwent serious surgery requiring anesthesia.

Yet the procedure for removing a chief executive unable to function for medical reasons remains cloudy. Congress attempted to resolve the issue in 1967 when it passed the 25th Amendment to the Constitution. That amendment authorizes a mentally alert president to designate the vice president as acting president when he is unable to discharge his duties, by informing Congress in writing, and then to resume his powers when he considers himself ready.

However, the amendment created a hopeless mess when it came to a president disabled mentally--by old age, stroke, disease, medication or other causes--who is unable or unwilling to cede authority.

In such cases, the amendment provides that the vice president and the majority of the Cabinet, “or such other body as Congress may by law provide,” shall determine when the president is unable to function. Thereupon, the vice president immediately assumes power. The president can resume duties by written declaration, unless the same majority of the Cabinet and a two-thirds majority of both houses of Congress disagree.

All this puts the vice president and Cabinet, all essentially appointees of the president and presumably none of them doctors, in an impossible political position. The failure of the 25th Amendment was apparent in the confusion over who was in charge at the White House after the shooting of President Ronald Reagan in 1981. That was obviously a time to invoke the 25th Amendment, but it was not used. The amendment was ignored again in 1985 when Reagan had surgery for a malignant colon tumor.

Modern American history shows why a better procedure is needed. President Woodrow Wilson suffered a stroke in 1919 and was partially disabled until he died in 1924. The stroke seriously damaged his cognition, a fact concealed by his doctors and his wife, who acted as a kind of de facto president. Historians say this contributed to the Senate’s defeat of the League of Nations treaty. Two subsequent presidents suffered serious mental impairment, Franklin D. Roosevelt from hypertension and Dwight D. Eisenhower from the aftereffects of a heart attack.

Today’s world of instant communication and lightning-fast world developments makes it ever more imperative that the nation have a president and commander in chief in full possession of his faculties. Writing recently in the Journal of the American Medical Assn., former President Jimmy Carter suggested creating a nonpartisan body of medical experts not directly involved in the care of the president to help determine whether a president is incapacitated.

This is an attractive concept. It would not appear to require another constitutional amendment to implement. Though poorly crafted and vague, the 25th Amendment does allow Congress to create panels other than the Cabinet to determine presidential incapacity. When it convenes this month, the new Congress should put this issue high on its agenda--before it is forced to by a constitutional crisis.