During the 1984 presidential campaign, questions were raised concerning President Reagan's cognitive integrity in the televised debates. He hesitated before answering questions, appeared to lack attentiveness, and had difficulty remembering and finding words to accurately express his thoughts. These signs, sometimes indicative of early dementia, were reportedly intensified during the 1987 Reykjavik Conference, at which time the President was criticized by James Reston–admittedly an unsympathetic critic–the New York Times columnist. According to Reston, there may be “a human problem at the top of the government [that] … will have to be addressed with uttermost sympathy and care” (December 21, 1986). These questions were again raised by the Iran-Contra affair. For the President of the United States to have even a hint of cognitive dysfunction carries profound implications.

Chemical developments during the past one hundred years have filled domestic medicine cabinets as well as pharmacies. The widespread availability of medications has clearly transformed life and living in the twentieth century, with the healing benefits of antibiotics and chemotherapy countered by the destructive effects of addictive drugs both old and new. Even those medications prescribed and supervised by physicians are but one of hundreds of factors which may influence human behavior, decision making, and even international affairs. Half-way through this century even a relatively harmless drug was the scapegoat in an American book, The Aspirin Age (Leighton, 1949), whose contributors reviewed the “utterly fantastic news events of the gaudy and chaotic years that separated Versailles and Pearl Harbor.”

Leadership roles, as this study suggests, may lead to breakdowns in individuals who have performed well in more routine positions. When the demand for creativity is high, but the routes to success ambiguous and the end goals controverted, vulnerable individuals may take refuge in drink and engage in public displays which undermine their performance. Such individuals may continue to provide positive contributions to national policy formation. Their loss of control, however, even if it is only episodic, is likely to cause significant others in the environment to depreciate their entire role performance, contributing further to their loss of influence.

Only one man in American history has been elected four times to the Office of President. Despite the image of vigor and hearty good cheer that he projected, Franklin D. Roosevelt was afflicted by both disability and serious illness while in the White House. He had never recovered fully from his 1921 bout with polio, a fact concealed from the public for many years out of fear that it might be detrimental to his political career. The methods of concealment, involving both image control and media management, produced a veil of secrecy that only time has penetrated. Also, after several years in office, Roosevelt suffered from cardiovascular disease that eventually ended his life. The belief of some critics that his physical deterioration impacted negatively on his performance as president, most notably at the Yalta Conference in early 1945, is worthy of examination, with the perspective that more than forty years can provide.

In 1967 Congress passed the Twenty-fifth Amendment to rectify an apparent inadequacy in the U. S. Constitution dealing with one of the gravest dangers to executive function–disability in the presidency. For 180 years, imprecise wording had bound the public welfare beneath a constitutional sword of Damocles which threatened to sever the legal discovery of inability in our Chief Executive from its occurrence. On at least four occasions during the last 100 years alone, executive function has been paralyzed by medically defined presidential inability, while two perplexing questions restricted a satisfactory resolution to the problem. First, in such a circumstance, does the office of the presidency devolve to the vice-president, or does the vicepresident merely serve as an acting president, assuming only its powers and duties? Second, who shall determine when the president is disabled and, its corollary, when that disability has ended? In the first instance, the amendment's sponsors ultimately determined that the vice-president assumes the powers and duties, but not the office itself, when the president becomes disabled. In the second, the sponsors proposed that the vice-president and the cabinet are jointly responsible for determining the duration of inability when, for medical or other reasons, the president is unable to do so.

In the following pages, we continue our annual updating of the biopolitical literature.

Total publications (85 items) were down from last year's all-time high (116) but precisely at the average (85) for the other four of the past five years (table 1).

The most striking change in area of interest was the increase in items classified as “physiology” (table 2). More books (6) were published last year than in any previous year (table 3) and several more are in various stages of completion.

Since the Gruter Institute is interested in the mutual influence of law and behavioral science (in the broadest sense), it has evolved a policy of occasionally tackling ongoing cases as exemplars of this interaction at the “ground level” of case law. This is done partly to contrast such an approach with the more usual “philosopher king” pose adopted by scientists who wish to influence legislation. In common-law countries at least, the approach through case law merits experimental attention. To this end a working group1 of legal and scientific scholars was instituted to study the issues in the now notorious “Baby M” case, a case which was to set a precedent on the issue of surrogate mothering contracts and which would have wider implications for the legality of many of the new alternative birth technologies.