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The Presidents' Mental Health

Published online by Cambridge University Press:  06 January 2021

Kirath Raj
Kirath Raj*
Affiliation:
Boston University School of Law, Psychology, Barnard College
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Extract

Calvin Coolidge had a successful run in politics for over twenty years before ultimately becoming president of the United States in 1923. Throughout Coolidge's first term as president, he worked long, hard hours, was active in Congress, and maintained a strong relationship with the media. This changed, however, during the second term of his presidency. Less than a month after his second-term election, Coolidge's son died of blood poisoning. This traumatic event caused the President to enter into a deep depression. In his autobiography, Coolidge admitted that when his son died, the power and glory of the presidency went with him. His grief, which has since been coined pathological grief, had an effect on the President's mind, body and spirit. President Coolidge lost interest in his job and began sleeping fourteen hours a day, ultimately earning a reputation as one of the most ineffectual presidents ever to hold office. His depression rendered him incapable of making decisions, and as a result most of his duties were delegated to members of his Cabinet. Though the White House knew for four years that Coolidge's depression rendered him incompetent, he remained in office until the end of his second term.

Type
Article
Information
American Journal of Law & Medicine , Volume 31 , Issue 4 , December 2005 , pp. 509 - 524
Copyright
Copyright © American Society of Law, Medicine and Ethics and Boston University 2005

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References

1 C. Knight Aldrich, Personal Grieving and Political Defeat, in 3 PAPERS ON PRESIDENTIAL DISABILITY AND THE TWENTY-FIFTH AMENDMENT, 81, 82 (Kenneth W. Thompson ed., 1996); Calvin Coolidge, http://www.whitehouse.gov/history/presidents (last visited Oct. 14, 2005).

2 Aldrich, supra note 1, at 85.

3 Id.

4 Id. at 85-86.

5 Id. at 86 (internal citation omitted).

6 As Aldrich notes:

The President withdrew almost completely from inter-action [sic] with Congress and showed little inclination even to participate in the activities of the departments of his own government. His workdays began to shrink in length and his naps grew considerably longer and more frequent. His shrewdness turned to disinterest; his involvement turned to indifference, and his well-developed leadership skills were abandoned. Id.

7 Robert E. Gilbert, Presidential Disability: The Case of John F. Kennedy, in 3 PAPERS ON PRESIDENTIAL DISABILITY AND THE TWENTY-FIFTH AMENDMENT, supra note 1, at 102.

8 Aldrich, supra note 1, at 94.

9 Gilbert, supra note 7, at 101.

10 Id. at 102; Johnson, Jessica L., The Americans With Disabilities Act of 1990: The Incredible Shrinking Legislation? A Closer Look at Chevron v. Echazabal and the Expansion of the Direct Threat Defense, 32 CAP. U. L. REV. 761, 765 (2004)Google Scholar (noting that Roosevelt's staff, family, and Secret Service detail went to great lengths to help him conceal the effects of polio from the public during his political career, and largely they succeeded.).

11 Gilbert, supra note 7, at 101.

12 Medical History of American Presidents, George Bush, http://www.doctorzebra.com/prez/g41.htm (last visited Nov. 16, 2005).

13 The President's News Conference With Prime Minister Kiichi Miyazawa of Japan in Tokyo on January 9, 1993, http://www.doctorzebra.com/prez/z_x41puke_g.htm (last visited Nov. 16, 2005) (President Bush proclaimed there was no political downside to the vomiting incident or his other recent public health episodes).

14 Gilbert, supra note 7, at 101.

15 Id.

16 Kesselheim, Aaron Seth, Privacy Versus the Public's Right to Know, 23 J. LEGAL MED. 523, 526 (2002).CrossRefGoogle ScholarPubMed

17 Id.

18 Id.

19 As Kesselheim notes:

For the remaining 15 months of his presidency, Wilson was physically and mentally debilitated exhibiting a short attention span, forgetfulness, and emotional liability but brief public appearances helped keep the American public confident in the President's health. During this time, 28 different laws were passed, laws that arguably were enacted without a President. Many have questioned whether Wilson actually made any remaining policy decisions, or whether the First Lady filled in for him. Id. at 527.

20 Id. at 526-27.

21 Cramm, Tim, The Designated Nonpublic Forum: Remedying the Forbes Mistake, 67 ALB. L. REV. 89, 97 (2003).Google Scholar

22 Id. at 97-98.

23 Gilbert, supra note 7, at 111; Goodman, Jay S., Book Review, The Kennedy Presidency: A Refocus on Governance, 43 R.I. B.J. 23, 24 (1994).Google Scholar

24 Gilbert, supra note 7, at 108.

25 Id. at 107-10.

26 MEDICAL DICTIONARY, at http://medical-dictionary.com/dictionaryresults.php (last visited Oct. 25, 2005); Fact Sheet: Addison's Disease, at http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Addison's_disease?open (last reviewed Feb. 2005).

27 Id.; Kenneth R. Crispell, Presidential Disability, in 1 PAPERS ON PRESIDENTIAL DISABILITY AND THE TWENTY-FIFTH AMENDMENT 43, 49 (Kenneth W. Thompson ed., 1996).

28 Gilbert, supra note 7, at 109.

29 Medical History of American Presidents, supra note 12.

30 Thomas G. Wicker, The Public's Right to Know, in PRESIDENTIAL DISABILITY 118, 119 (James F. Toole and Robert J. Joynt eds., Univ. of Rochester Press 2001); Gilbert, supra note 7, at 114-15.

31 Medical History of American Presidents, supra note 12.

32 Id.

33 Gilbert, supra note 7, at 114.

34 Crispell, supra note 27, at 50-51.

35 Whitehouse.gov, John Kennedy, http://www.whitehouse.gov/history/presidents/jk35.html (last visited Nov. 12, 2005).

36 Wicker, supra note 30, at 119.

37 Gilbert, supra note 7, at 116.

38 Id.

39 Id. at 115-16 (suggesting that Kennedy's military advisors, Joint Chiefs of Staff, and executive committee did not think he acted aggressively enough during the Cuban Missile Crisis).

40 Crispell, supra note 27, at 50 (Kennedy's physician, Dr. Janet Travell, issued a public statement that read, John F. Kennedy does not now nor has he ever had an illness described as Addison's disease… [a]ny statement to the contrary is malicious and false.).

41 Wicker, supra note 30, at 119.

42 Bushisms, http://politicalhumor.about.com/library/blbushisms.htm (last visited Sept. 18, 2005).

43 Id.

44 Alex Beam, A Medical Cause for Bushisms?, BOSTON.COM NEWS, http://www.boston.com/news/globe/living/articles/2004/09/14/a_medical_cause_for_bushisms/ (Sept. 14, 2004).

45 Id. (Dr. Joseph Price of Carsonville, Michigan describes himself as a country doctor.).

46 Id.; Dementia, http://antiessays.bigwonk.com/show.php?cat=psychology&eid=1170 (Nov. 15, 2004).

47 Edward B. MacMahon and Leonard Curry, MEDICAL COVER-UPS IN THE WHITE HOUSE 3 (Farragut Publishing Co. 1987).

48 See The Reagan Information Page, President Reagan Courageously Announces His Illness (Nov. 5, 1994), http://www.presidentreagan.info/alz.cfm (last visited Nov. 15, 2004).

49 Allen, Anita L., Lying to Protect Privacy, 44 VILL. L. REV. 161, 185 (1999).Google Scholar

50 Id.

51 Kesselheim, supra note 16, at 526-27.

52 Borgna Brunner, A Short History of Impeachment: High Crimes and Misdemeanors, http://www.infoplease.com/spot/impeach.html (last visited Nov. 27, 2004).

53 U.S. CONST. amend. XXV; Bellamy, Calvin, Presidential Disability: The Twenty-Fifth Amendment Still an Untried Tool, 9 B.U. PUB. INT. L.J. 373, 374-75 (2000).Google Scholar

54 U.S. CONST. art. II, 1.

55 Election Process, http://library.thinkquest.org/11492/convention/election.html (last visited Nov. 27, 2004).

56 Fact Sheet: Addison's Disease, supra note 26.

57 Gilbert, supra note 7, at 115-16.

58 U.S. CONST. art. II, 1.

59 National Bureau of Economic Relief, How Health Declines with Age, http://www.nber.org/aginghealth/summer03/w9821.html (Nov. 11, 2005).

60 Ronald Reagan, http://www.whitehouse.gov/history/presidents/rr40.html (last visited Nov. 10, 2005). Compare retirement age of 60 for airline pilots (The Age 60 Rule, Pilot Medical Solutions, http://www.leftseat.com/age60.htm (viewed on Oct. 26, 2005)), between the ages of 50 and 60 for firemen and policemen (U.S.C.A. Const. Amend. XIV, 1, ch. 3406 (2004)), and between the ages of 65 and 70 for lawyers (Jaimie Pessin, Retiring Young: Few Big Law Firms Work Past 60, CHICAGO LAWYER, http://www.sachnoff.com/media/media_detail.aspx?type=354&archive=&id=860 (July 2005)).

61 Wiernicki, Peter J., Pilot Medical Certification: Current Standards and Procedures, 64 J. AIR L. & COM. 477, 478 (1999).Google Scholar

62 Id. at 479-80 (noting that, Under the new medical standards, there are fifteen medical conditions that will disqualify a pilot from all classes of medical certification: (1) diabetes mellitus requiring hypoglycemic medication; (2) angina pectoris; (3) coronary heart disease that has been treated or, if untreated, that has been symptomatic or clinically significant; (4) myocardial infarction; (5) cardiac valve replacement; (6) permanent cardiac pacemaker; (7) heart replacement; (8) psychosis; (9) bipolar disorder; (10) personality disorder manifested by overt acts; (11) substance dependence; (12) substance abuse; (13) epilepsy; (14) disturbance of consciousness without satisfactory explanation of cause; and (15) transient loss of control over nervous system functions without satisfactory explanation of cause. In addition to the fifteen enumerated conditions, there exists a catch-all regulation: FAA will deny medical certification if the pilot suffers from an: organic, functional, or structural disease, defect, or limitation that the Federal Air Surgeon, based on the case history and appropriate, qualified medical judgment relating to the condition involved, finds--(1) [m]akes the person unable to safely perform the duties of the airman certificate applied for or held; or (2) [m]ay reasonably be expected to make the person unable to perform those duties or exercise those privileges.).

63 Id.

64 Id. at 489.

65 Id.; Hoover v. National Transportation Safety Board, 43 F.3d 712 (D.C. Cir. 1994).

66 Wiernicki, supra note 61, at 489.

67 See e.g., Breitigan v. New Castle County, 350 F. Supp.2d 571 (D. Del. 2004).

68 Mass. Bd. of Ret. v. Murgia, 427 U.S. 307, 309 (1976).

69 Id. at 314.

70 Id. at 311-313.

71 Id. at 311 (emphasis added).

72 See Wicker, supra note 30, at 119.

73 See Gilbert, supra note 7, at 113; Goodman, supra note 23.

74 Lawrence C. Mohr, The White House Physician, in PRESIDENTIAL DISABILITY 105, 105 (James F. Toole and Robert J. Joynt eds., 2001).

75 Id.

76 Id. at 107.

77 Id.

78 Id.

79 Id.

80 See CNN.com, Connie Mariano: Doctor to the President,, http://www.cnn.com/2004/HEALTH/09/23/cnna.mariano/index.html (Sept. 24, 2004).

81 CNN.com, White House Doctors: The President's Shadow, http://www.cnn.com/2004/HEALTH/09/23/wh.doctors/ (Sept. 24, 2004).

82 See id.; Daniel Ruge, The President's Physician, in PRESIDENTIAL DISABILITY 112, 114 (James F. Toole and Robert J. Joynt eds., 2001).

83 See Abrams, Herbet L., The Vulnerable President and the Twenty-Fifth Amendment, With Observations on Guidelines, a Health Commission, and the Role of the President's Physician, 30 WAKE FOREST L. REV. 453, 476 (1995).Google Scholar

84 Kesselheim, supra note 16, at 533.

85 Ruge, supra note 82, at 114.

86 Id.

87 Id.

88 See id. at 114-15.

89 Kesselheim, supra note 16, at 533-34.

90 Wicker, supra note 30, at 122; Kesselheim, supra note 16, at 533.

91 Abrams, supra note 83, at 476.

92 Jo Anne Czecowski Bruce, PRIVACY AND CONFIDENTIALITY OF HEALTH CARE INFORMATION 2 (American Hospital Publishing, Inc. 1984).

93 Berry, Roberta M., The Genetic Revolution and the Physician's Duty of Confidentiality: The Role of the Old Hippocratic Virtues in the Regulation of the New Genetic Intimacy, 18 J. LEGAL MED. 401, 412-13 (1997).CrossRefGoogle ScholarPubMed

94 Id.

95 Id. at 414; see also Standards for Privacy of Individually Identifiable Health Information, 65 FR 82462-01 (Dec. 28, 2000) (one of HIPAA's stated purposes is [t]o protect and enhance the rights of consumers by providing them access to their health information and controlling the inappropriate use of that information.).

96 Berry, supra note 93, at 418.

97 Id.

98 Tarasoff v. Regents of the University of California, 551 P.2d 334 (Cal. Sup. Ct. 1976) (wherein a disturbed man named Prosenjit Poddar told his therapist he wanted to kill a woman he had become obsessed with over the year named Tatiana Tarasoff. When Poddar later killed Tarasoff, her parents brought suit against the therapist for failing to warn Tatiana or them of Poddar, given that he knew Poddar posed a danger. In finding the therapist liable, California's Supreme Court held, When a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. The discharge of this duty may require the therapist to take one or more of various steps, depending upon the nature of the case. Thus it may call for him to warn the intended victim or others likely to apprise the victim of the danger, to notify the police, or to take whatever other steps are reasonably necessary under the circumstances. 551 P.2d 334, 340 (Cal. Sup. Ct. 1976); James C. Beck, Confidentiality Versus the Duty to Protect: Foreseeable Harm in the Practice of Psychiatry 3 (James C. Beck, ed., American Psychiatric Press, Inc. 1990).

99 Tarasoff, 551 P.2d at 340.

100 Id.

101 Bruce, supra note 92, at 54.

102 Robinson, David A. , Discovery of the Plaintiff's Mental Health History in an Employment Discrimination Case, 16 W. NEW ENG. L. REV. 55, 70-71 (1994).Google Scholar

103 Id.; Craig Henry, Lead and Gold: On Leaks, Bias, and Truth, http://www.leadandgold.blogspot.com/2004_12_01_leadandgold_archive.html (Dec. 30, 2004).

104 Robinson, supra note 102, at 70-71; Henry, supra note 103.

105 Henry, supra note 103.

106 See generally Tarasoff, 551 P.2d 334.

107 See Bruce, supra note 92, at 54.

108 See Aldrich, supra note 1 at 85-86.

109 Tarasoff, 551 P.2d at 340.

110 See Time, Inc. v. Hill, 385 U.S. 374, 384 n.7 (1967) (citing a number of cases holding that, in certain circumstance, the right to privacy is outweighed by the right of the press to publish matters of public interest). See also Afro-American Pub. Co. v. Jaffe, 366 F.2d 649 (D.D.C. 1966); Wagner v. Fawcett Pubs., 307 F.2d 409 (7th Cir. 1962); Jenkins v. Dell Pub. Co., 251 F.2d 447 (3d Cir. 1958).

111 Bartnicki v. Vopper, 532 U.S. 514, 534 (2001) (in which plaintiffs filed suit when their cell phones were wiretapped and their recorded conversation broadcast on the radio).

112 U.S. CONST. amend. XXV (Section 3. Whenever the President transmits to the President pro tempore of the Senate and the Speaker of the House of Representatives his written declaration that he is unable to discharge the powers and duties of his office, and until he transmits to them a written declaration to the contrary, such powers and duties shall be discharged by the Vice President as Acting President. 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, 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.).

113 Id.

114 Id.

115 Id.; Gant, Scott, Presidential Inability and the Twenty-Fifth Amendment's Unexplored Removal Provisions, 1999 L. REV. MICH. ST. U. DET. C.L. 791, 796 (1999).Google Scholar

116 Kesselheim, supra note 16, at 539.

117 Id.

118 Id. at 540.

119 Bellamy, supra note 53, at 374-75.

120 Subcommittee Report: Criteria for Disability and Impairment, in PRESIDENTIAL DISABILITY 276, 276 (James F. Toole & Robert J. Joynt eds., 2001).

121 Id.

122 Id.

123 Kesselheim, supra note 16, at 542.

124 The importance of allowing a president to choose at least one of his physicians is illustrated by the confession of Daniel Ruge, President Reagan's White House physician, that it bothered [him] a great deal that he did not have a doctor-patient relationship with Reagan when he came on the job because he did not know Reagan's medical history. Ruge, supra note 82, at 114.

125 Kesselheim, supra note 16, at 542.

126 Abrams, supra note 83, at 464 (circumstances that call for invocation of section 4 of the 25th Amendment should include, Loss of consciousness, a comatose state, or general anesthesia, whenever the transfer of power under Section 3 has not already occurred; Significant alterations of the President's cognitive faculties or inability to communicate. If the President suffers a massive coronary occlusion or a stroke, and is incapable of signing Section 3, power should be transferred at least for the duration of hospitalization; Serious injury to the President associated with accidents or attacks on his person. Depending on his competence or level of consciousness, he may be able to sign the letter of transfer. If the President is unconscious, Section 4 should be considered; Serious, apparently terminal illness, from which the President will not recover in the judgment of his physicians; Alzheimer's disease, brain tumor, or any other progressive, mentally disabling condition in a President who is incapacitated, but cannot or will not step aside voluntarily.)

127 Kesselheim, supra note 16, at 542.

128 Id.

129 Bayh, Birch, The Twenty-Fifth Amendment: Dealing With Presidential Disability, 30 WAKE FOREST L. REV. 437, 443 (1995)Google Scholar; Subcommittee Report: Criteria for Disability and Impairment, supra note 120, at 276.