The Presidency and Health: A HealthCentral Explainer

CRegal Editor
  • July 13, 1972: Democratic presidential nominee George McGovern selects Thomas Eagleton, a senator from Missouri, as his running mate. 


    August 1, 1972: Eagleton withdraws from the ticket.   


    According to the St. Louis Post-Dispatch, Eagleton had been hospitalized for mental health issues, including depression, three times between 1960 and 1966, and had undergone electro-convulsive therapy – also known as electroshock therapy – for "exhaustion and fatigue." Eagleton was also taking Thorazine, a powerful anti-psychotic drug, information that had not been  disclosed to McGovern prior to his selection of Eagleton.

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    In a Time magazine poll conducted that summer,  76.7% of respondents said that Eagleton's mental health record would not influence their votes.  But there clearly was concern that given the pressures that come with being vice president and, potentially, the president, Eagleton was at risk for a recurrence of mental health problems. So, despite initially expressing “1000 percent” confidence in his running mate, McGovern soon decided to drop Eagleton from the ticket.


    So what role does the health of a president play in his electability? 


    Historical precedent certainly exists. President Franklin Roosevelt, fearing that his political life may be in jeopardy if his disability became public, hid the fact that he was confined to a wheelchair due to the effects of polio.  FDR also was quite ill during the 1944 presidential campaign, and died of a stroke just a few months after beginning his fourth term.


    "President Roosevelt had real concerns that the public might not think that he was up for the job of being president," said Dr. John Kenneth White, professor of politics at the Catholic University of America and an expert on the U.S. presidency. 


    "There has always been concern about the president and his health," White added, citing FDR, John F. Kennedy and Dick Cheney as others in high office who concealed their health status.  "Only in the last 30 or 40 years have we had presidents release health information to the public as a matter of routine."  Just last week, Republican presidential candidate Mitt Romney and his running mate, Rep. Paul Ryan, released their health records.


    However, as White noted, Roosevelt and Kennedy held office during a very different era.  "In the cable and YouTube age, a president wouldn't be able to hide anything,” he said. “There is a sense of wanting presidents to be the model of physical fitness."  White provided examples from the more recent past, including a Parade magazine featuring President Reagan lifting weights, Ted Kennedy losing a significant amount of weight before a presumed run at the presidency in 1980 and George W. Bush's penchant for bicycling.  "Especially in the television age, the president must present an image of physical fitness – we certainly have two very healthy candidates in this cycle."


    When asked about the impact of a president having a physical ailment, White explained that the 25th Amendment created guidelines for a president to temporarily step away from his position, including in the case of a medical emergency.  This has come into play during 1985 colon cancer surgery for Reagan and when George W. Bush underwent colonoscopies in both 2002 and 2007.  Each time, the president wrote a letter to both the vice president and Speaker of the House, relieving himself from duty during surgery. He then submitted another letter to reclaim authority after the procedures were finished. 


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    However, according to White, the amendment doesn’t provide clear guidance on what would need to be done in the event of an unplanned medical emergency, such as a stroke or heart attack.  "The 25th Amendment is also not very thorough on a declaration of 'disability,'” White noted. “This creates the potential for political intrigue, as the vice president and Speaker of the House are responsible for declaring a president to be out of commission. The intent was to have continuity in governance in the nuclear age, but it isn't perfect." 


    What’s not clear is what level of disability would become an issue today.  Sen. Joe Biden's health was extensively researched during the 2008 campaign before he was selected as Barack Obama’s running mate, and it was decided that a brain aneurism he had suffered two decades earlier should not prevent him from running for vice president.


    "The only time that the process didn't work, it seems, was with Dick Cheney," White noted. Cheney originally headed the selection process to pick a running mate for George W. Bush's, but ultimately threw his own hat in the ring, despite having a history of heart attacks.


    White did present an interesting question regarding the definition of disability under the 25th Amendment: What if President Kennedy had lived after being shot?  If he had survived, he would have been severely incapacitated, and even if he had suffered only the initial shot through his throat, he might have been unable to speak.  In 1957, President Dwight Eisenhower suffered a stroke and temporarily lost his ability to speak; Dr. Jerrold Post, director of the political psychology program at George Washington University, was quoted in a 2008 piece on The Daily Beast suggesting that this "raised the specter of a president who was unable to communicate." 


    This question remains, as no president has been in such a situation in many decades.  That said, the health of the president and disability could become a touchy issue, although, as White pointed out, "FDR was proof that being bound to a wheelchair did not impede his ability to govern." More likely, some form of cognitive decline would qualify as a reason to question whether a person could continue to serve as president.


    This issue of cognitive decline came to prominence in 1984, while President Ronald Reagan was campaigning for his second term.  During the first debate with his opponent, Walter Mondale, Reagan was reported to look "completely out of it," according to White.  Reagan's advisors feared that age might become more of an issue, but in the second debate, Reagan tackled the issue head-on, joking about Mondale's "youth and inexperience" while deflecting concerns about his rising age


    Adds White: "The public was inclined to re-elect Reagan all along, but wanted some assurance that age wasn't an issue." 


    Reagan's quip in the second debate did just that; the public was quick to forgive an aging president so long as his wits remained sharp.


Published On: October 02, 2012