As a psychologist, I couldn't agree with you more. There are great incentives for folks to hide any problems with mental capacity, and often those nearest them are complicit. I have long thought a process such as the one you suggest would be helpful. At the very least, this should be a prominent part of our national dialogue. As you note, people are living longer, which means more of us get dementia. Mental health issues, sequelae of stroke or other illness, all can affect the ability to do the very difficult job of representing Americans. We deserve to have some process in place to ensure those who are in these positions are capable of doing the work.
Per my remark above, I think "complicit" is too strong a word (although it might not be for those who are adjacent to power). I genuinely did not realize at any given time just how bad off my elderly relative was. It had to become completely and unavoidably obvious before I fully grasped her condition.
Biden's had a speech problem all his life. As he ages, his usual efforts to suppress it, which were never 100% effective anyway (hence his lifelong reputation for gaffes), have been failing more often. But if you saw the recent BBC interview, you would know he's not senile.
Here's a good article from 2019 on his speech issues:
Good ideas, as always. Throughout Biden's presidency, but especially the last year or so, it was obvious he was declining. But I kept thinking back to my experience with a close relative who also suffered from dementia. If one is really close to someone, it is amazingly easy to overlook her decline. A friend, whose mother died from Alzheimer's, told me when I was in the middle of this struggle that she found, at each stage of her mother's decline, when she would look back, she would realize her mother was worse off than she realized at the time. In other words, we are constantly behind the curve in evaluating the condition of those whom we love. It took a conversation with the director of the senior living facility--in other words, an outsider--to make me see how much my relative had declined. So I was always sympathetic to at least Jill Biden (now not so much). An external, independent board of mental health physicians could be incredibly valuable.
Joe Biden’s mind is fine. His lifelong stutter suppression efforts (sensationalized by the Trump-loving press, whose readers and viewers dropped off once Trump was gone and people weren't reading or watching news out of sheer fear) are what you've been conned into calling "cognitive decline", a smear started by the Bernie Bros and picked up by Republicans.
Before A.G. Sulzberger declared war on Biden, the NYT accurately described his speech impediment problems and pointed out that they masked a sharp mind:
I think we, as a society have stigmatized mental health struggles and, to Kim Green's point below, this societal stigma is what pushes people to ignore or hide their illnesses. For a politician, this is doubly so as mental illness and the associated stigma can be the kiss of political death in some districts and states.
Yes, we definitely need a law or constitutional amendment for a nonpartisan medical commission to assess the competence of the President or any member of Congress and if nededed to remove the impaired individual.
Thanks for this Gabe. Always asking the good questions
Next one, as you behave hinted at already, is will we learn from Trump. What does the Democratic Party stand for? I have no idea. The Party is being given a political gift with this administration but I have my doubts they will take advantage
Great topic, well-presented. Thank you, Gabe. I found it strange that you left out the judiciary…. Perhaps it is because members of the Supreme Court are explicitly appointed for life? What recourse does our Constitution provide if a Justice suffers mental decline?
The whole topic also begs the question: what degree of private life is a top-level public servant (Congressmen, Senators, President, Justices, Generals) entitled to? Perhaps you have some perspective on how the Press has traditionally handled this issue?
The question of just how much private life any publicly elected official is entitled to is an excellent one Deborah! Gabe, I’d love it if you could do some research and address this for us.
I am in agreement with most of the commenters that we need some way to assess the mental and physical capacities of legislators and key Executive officers, including the President, to do their jobs, I think that there is a fundamental Constitutional problem that even an Amendment would be hard to address. Namely, there are only three branches of government according to the Constitution.
If you place this "commission" within Congress, you have the same conflict of interest that you have with respect to the current medical service. If you place it within the Executive, you have the very real risk of it being politicized ("weaponized") by the party in power. I don't see any sense in locating it within the Judiciary, nor do I think that they would want it in any case.
So, where do you put this commission? I don't think you want to create a fourth branch of government who job is to determine whether the other three are capable of doing their jobs. In fact, that already exists, as you point out, in the Fourth Estate - the press is that non-Constitutional fourth branch. If the press doesn't do it very well, then thank goodness we have you!
Listen carefully. My late husband died after what, in retrospect, was 20 years with Alzheimer's, eventually in a Northwestern University Neurology Department study. A year ago, I found Trump's speech patterns very similar to my husband's as he descended into demential. Very similar. Once a writer, my husband and had a limited vocabulary, repeated himself, went into silly tangents, became angrily easily although once an easygoing man. I have no doubt at all in my in my mind that Trump is suffering from demential/Alzheimer's.
Trump has no “limited vocabulary”, does not repeat himself, silly tangents, or easily angered. Unless you have a PHD in diagnosing dementia/Alzheimers, I’d say you have a very bad case of TDS.
Of course Jamie Raskin and the liberals would love this to be enacted now, not when Biden couldn’t string two sentences together.
Such hypocrisy and all of you should be ashamed of yourselves
The essential problem is that the people who have to decide these things are the very people who will be possibly impacted by them. It is one thing to remove someone everyone agrees needs a time out, it is quite another when it is realized that person could be themselves.
I worry about this becoming yet another method of voter disenfranchisement. Do you really want the government to decide who is "mentally competent" enough to vote?
As a psychologist, I couldn't agree with you more. There are great incentives for folks to hide any problems with mental capacity, and often those nearest them are complicit. I have long thought a process such as the one you suggest would be helpful. At the very least, this should be a prominent part of our national dialogue. As you note, people are living longer, which means more of us get dementia. Mental health issues, sequelae of stroke or other illness, all can affect the ability to do the very difficult job of representing Americans. We deserve to have some process in place to ensure those who are in these positions are capable of doing the work.
Per my remark above, I think "complicit" is too strong a word (although it might not be for those who are adjacent to power). I genuinely did not realize at any given time just how bad off my elderly relative was. It had to become completely and unavoidably obvious before I fully grasped her condition.
Biden's had a speech problem all his life. As he ages, his usual efforts to suppress it, which were never 100% effective anyway (hence his lifelong reputation for gaffes), have been failing more often. But if you saw the recent BBC interview, you would know he's not senile.
Here's a good article from 2019 on his speech issues:
https://www.nytimes.com/2019/10/30/us/politics/joe-biden-debate-gaffes.html
as long as we are talking about mental health, what about narcissistic personality disorder? or pathological liar?
Good ideas, as always. Throughout Biden's presidency, but especially the last year or so, it was obvious he was declining. But I kept thinking back to my experience with a close relative who also suffered from dementia. If one is really close to someone, it is amazingly easy to overlook her decline. A friend, whose mother died from Alzheimer's, told me when I was in the middle of this struggle that she found, at each stage of her mother's decline, when she would look back, she would realize her mother was worse off than she realized at the time. In other words, we are constantly behind the curve in evaluating the condition of those whom we love. It took a conversation with the director of the senior living facility--in other words, an outsider--to make me see how much my relative had declined. So I was always sympathetic to at least Jill Biden (now not so much). An external, independent board of mental health physicians could be incredibly valuable.
Oh come off it!
Joe Biden’s mind is fine. His lifelong stutter suppression efforts (sensationalized by the Trump-loving press, whose readers and viewers dropped off once Trump was gone and people weren't reading or watching news out of sheer fear) are what you've been conned into calling "cognitive decline", a smear started by the Bernie Bros and picked up by Republicans.
Before A.G. Sulzberger declared war on Biden, the NYT accurately described his speech impediment problems and pointed out that they masked a sharp mind:
https://www.nytimes.com/2019/10/30/us/politics/joe-biden-debate-gaffes.html
Note that Fetterman, prior to his stroke already suffered from depression.
https://www.nbcnews.com/politics/congress/sen-john-fetterman-opens-mental-health-struggles-rcna131147
I think we, as a society have stigmatized mental health struggles and, to Kim Green's point below, this societal stigma is what pushes people to ignore or hide their illnesses. For a politician, this is doubly so as mental illness and the associated stigma can be the kiss of political death in some districts and states.
Yes to all of this! Our country should have high performing leaders who are healthy mentally and physically.
Yes, we definitely need a law or constitutional amendment for a nonpartisan medical commission to assess the competence of the President or any member of Congress and if nededed to remove the impaired individual.
Agreed. Difficult to create the panel.
Thanks for this Gabe. Always asking the good questions
Next one, as you behave hinted at already, is will we learn from Trump. What does the Democratic Party stand for? I have no idea. The Party is being given a political gift with this administration but I have my doubts they will take advantage
Great topic, well-presented. Thank you, Gabe. I found it strange that you left out the judiciary…. Perhaps it is because members of the Supreme Court are explicitly appointed for life? What recourse does our Constitution provide if a Justice suffers mental decline?
The whole topic also begs the question: what degree of private life is a top-level public servant (Congressmen, Senators, President, Justices, Generals) entitled to? Perhaps you have some perspective on how the Press has traditionally handled this issue?
The question of just how much private life any publicly elected official is entitled to is an excellent one Deborah! Gabe, I’d love it if you could do some research and address this for us.
I am in agreement with most of the commenters that we need some way to assess the mental and physical capacities of legislators and key Executive officers, including the President, to do their jobs, I think that there is a fundamental Constitutional problem that even an Amendment would be hard to address. Namely, there are only three branches of government according to the Constitution.
If you place this "commission" within Congress, you have the same conflict of interest that you have with respect to the current medical service. If you place it within the Executive, you have the very real risk of it being politicized ("weaponized") by the party in power. I don't see any sense in locating it within the Judiciary, nor do I think that they would want it in any case.
So, where do you put this commission? I don't think you want to create a fourth branch of government who job is to determine whether the other three are capable of doing their jobs. In fact, that already exists, as you point out, in the Fourth Estate - the press is that non-Constitutional fourth branch. If the press doesn't do it very well, then thank goodness we have you!
At the very least these politicians need to be more transparent about their physical and mental condition
Listen carefully. My late husband died after what, in retrospect, was 20 years with Alzheimer's, eventually in a Northwestern University Neurology Department study. A year ago, I found Trump's speech patterns very similar to my husband's as he descended into demential. Very similar. Once a writer, my husband and had a limited vocabulary, repeated himself, went into silly tangents, became angrily easily although once an easygoing man. I have no doubt at all in my in my mind that Trump is suffering from demential/Alzheimer's.
This is a ridiculous comment!
Trump has no “limited vocabulary”, does not repeat himself, silly tangents, or easily angered. Unless you have a PHD in diagnosing dementia/Alzheimers, I’d say you have a very bad case of TDS.
Of course Jamie Raskin and the liberals would love this to be enacted now, not when Biden couldn’t string two sentences together.
Such hypocrisy and all of you should be ashamed of yourselves
The essential problem is that the people who have to decide these things are the very people who will be possibly impacted by them. It is one thing to remove someone everyone agrees needs a time out, it is quite another when it is realized that person could be themselves.
Perhaps we should have mental competency standards for voters as well.
I worry about this becoming yet another method of voter disenfranchisement. Do you really want the government to decide who is "mentally competent" enough to vote?
True enough. Anything can be mis-used.
Excellent article, Gabe. Keep all of us up-to-date on this issue.
Timely and appropriate. Please keep on this track - and keep it on the front burner.
Great column One of your best ever