Questions of Mental Competence

The President of the United States, whoever that might be at any given time, gets regular and thorough physical examinations. This is as it should be. By analogy, and because of the incredible and almost overwhelming burden of the office, the President should also have regular examinations to determine the state of his–and/or it might soon be, “her”?–mental health.

Because of inadequate screening, it is possible that someone suffering from some type and some degree of mental illness might be chosen as the chief executive of a nation. Of course, in those instances where a nation has no say in who attains that high office, it becomes even more likely that they will be ruled by someone who is or borders on psychosis.

In nations where the people have some say, they should be–and sometimes are–aware of this possibility. Certain types and degrees of mental illness should not be a barrier to high office, but we should be, and in a few cases have been, aware. We try to be aware of physical health problems before voting: serious heart problems, terminal cancer, lack of physical stamina, early stage Alzheimer’s are among things that should give us pause before electing a person.

On the other hand, we have been served about as well from a wheel-chair as from a touch football field. Physical handicaps do not necessarily disqualify one for competent leadership and statesmanship. Similarly, mental illnesses of several types can be managed quite well with appropriate medicine and/or competent counseling. Many of us believe we were better served by a president who probably suffered from major depression–Abraham Lincoln–than by a man of apparently good mental health–Herbert Hoover.

On still the other hand (life, like the octopus, has numerous “other hands”), if we place in office a person in good health, but see their health decline to the point that they are incompetent (the unexpected onset of rapidly escalating Alzheimer’s or the surprising appearance of psychotic paranoia), we should have appropriate ways to replace them.

Perhaps we have such ways. I am quite limited in my knowledge of the particulars of how our government works. Surely we have in place ways other than impeachment to remove one who has become incompetent.

Were a nation to have a Chief who suffers serious mental illness, some sort of action should be taken to remedy the situation before disaster occurs. Particularly in the case where we see disaster happening, we should take action to change the situation. If executive leadership is disastrous–as is presently the case globally in too many instances–and if psychosis is ruled out, then that Chief still should be removed from office.

In the United States, impeachment would be the appropriate action if mental illness is not what is causing the problem. Other nations have differing procedures. Unlike Bush and Blair in the case of Saddam Hussein, and in the case of military coups, I believe that violent removal from office only changes the color, flavor, and style of the problem, and more often than not exacerbates the situation.

Is any of this relevant to the state of affairs in the United States of America in these opening years of the 21st Century?