Dr. Clif CleavelandSix U.S. Presidents have died in office.
President William H. Harrison died of pneumonia in 1841, barely a month after his inauguration. President Warren Harding succumbed to a heart attack in 1923. Presidents Lincoln, Garfield, McKinley and Kennedy died from assassins’ bullets. President Garfield died two and a half months after he was shot. President McKinley survived for eight days after his attack.
In 1893, upon learning that he had cancer of his palate, President Grover Cleveland sailed on his yacht on a purported vacation. Two surgeries to remove the cancer were concealed from the press, Congressional leaders and the public.
President Woodrow Wilson in October 1919 suffered a severe stroke that rendered him speechless and paralyzed on his right side. His wife and personal physician concealed the illness from Congress and the public. Mrs. Wilson read documents and forged the president’s signature as needed. She blocked access to her bedfast husband. Although Wilson regained some function, his cognitive ability was questionable.
Following the assassination of President Kennedy, congressional leaders worked to clarify succession to the presidency in the event of disabling illness or injury to the chief executive. What if an attacker’s bullet left a president comatose? What if a president suffered a rapidly progressive dementia? The 25th Amendment to the Constitution addressed these issues. It was approved by Congress in 1965 and ratified by a sufficient number of states to be adopted two years later.
Article I states that the vice president becomes president upon the resignation or death of the president.
Article II deals with the filling of the vice presidency if that position is vacated. The president nominates a replacement who then must be approved by a majority vote of the Senate and House of Representatives. Gerald Ford and Nelson Rockefeller became vice presidents under this provision.
Article III allows the president to step aside temporarily by notifying the president pro tempore of the Senate and the speaker of the House. The vice president becomes acting president during the interval. This provision was employed by President George W. Bush during a brief period of anesthesia for a colonoscopy.
Article IV may be invoked if the president is deemed unable to carry out his responsibilities. If for any reason the vice president and a majority of the Cabinet determine that the president is “unable to discharge the duties and powers of his office,” they are empowered to notify the president pro tempore of the Senate (currently Sen. Orrin Hatch) and the speaker of the House that the vice president will serve as acting president. If the president disputes this action, the Senate and House must each approve the decision by a two-thirds majority.
Intimate associates of a president could conceal an injury or illness for a time. A lengthy “vacation” might be invoked. A curious press would likely find ways to determine the true status of a president’s health. A leak-proof White House would be a necessity.
The 25th Amendment would have been strengthened by the inclusion of a nonpartisan panel of relevant medical specialists to provide a more factual basis to the determination of disability. Neurological and psychiatric illnesses can pose challenges both in diagnosis and in prognosis – the forecasting of progression and outcome.
Even with the 25th Amendment in place, presidential disability poses complex uncertainties.
Contact Clif Cleaveland at ccleaveland@timesfreepress.com.