The Best Analysis of a Presidential Candidate

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FROM OUR READERS

This article is a response to the articles, “A Call for Immediate Medical Evaluations of Presidential Candidates” by H. Steven Moffic, MD, and “POTUS, Politics, & Neuropsychiatric Assessment: What Do We Need to Know and When Do We Need to Know It?” by Jeffrey A. Lieberman, MD.

H. Steven Moffic, MD, called for an independent medical evaluation of presidential candidates in his July Psychiatric Times article. He pointed out that the Goldwater Rule prohibited diagnosing a candidate without consent, but expressed his belief that candidates for important leadership positions have an objective and independent complete medication examination including neuropsychiatric aspects and that the summary be released to the public.¹

Jeffrey A. Lieberman, MD, voiced a similar recommendation for elected government leaders to undergo an annual independent medical evaluation to include neuropsychologic, mental status, and brain scan to be shared with the public.²

Both Moffic and Lieberman’s proposals sound reasonable enough. However, in this highly charged political environment, is it possible for any candidate, especially a “disrupter” such as Trump to get a psychiatric assessment that is indeed independent and without bias?

Bandy X. Lee, MD’s book, The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President, made us exquisitely aware of the dangerous murky waters inherent in brandishing a psychiatric assessment without consent.³

But what if Moffic and Lieberman’s wish was granted and Congress passed a law requiring presidential candidates to be given a full neuropsychiatric assessment? The delineation of character flaws, ego weaknesses, and less than optimal personality traits would be ripe for biases inherent in the examiner. Psychiatric history is also best left between a candidate and his physician. What value would an MRI of the brain have other than ruling out a tumor without clinical signs or look for signs of shrinkage? What would be done with signs of shrinkage given a presidential candidate who is articulate and able to handle press conferences and tough questions? Fitness for duty exams may work for certain professions and age requirements may also have some value; however, the American public is still the best judge of character and fitness for the job of president, but only in an environment where the media is given frequent access to candidates in the form of debates and press conferences and the questions asked by the media are relevant and balanced.

To be without bias, the neuropsychiatric exam would have to be limited to a simple, easily administered neurocognitive study such as the Mini‐Mental State Examination, which is concrete, easily documented, and without bias. Use of psychoanalytic analysis and personality assessments interpreted by psychiatrists who are trained in political psychiatry such as used in leadership or intelligence analysis presents an inherent danger of bias. Too much information from a neuropsychiatric assessment of a candidate can be used by foreign countries, opponents or a hostile press in negative ways.

To summarize, the best analysis of a presidential candidate requires a healthy unbiased media and the eyes and ears of the American people. A full neuropsychiatric analysis, however, may be indicated if the 25th amendment is invoked.

Dr Varas is a psychiatrist in Westwood, New Jersey.

References
1. Moffic HS. A call for immediate medical evaluations of presidential candidates. Psychiatric Times. July 8, 2024. https://www.psychiatrictimes.com/view/a-call-for-immediate-medical-evaluations-of-presidential-candidates
2. Lieberman JA. POTUS, politics, & neuropsychiatric assessment: what do we need to know and when do we need to know it? Psychiatric Times. September 30, 2024. https://www.psychiatrictimes.com/view/potus-politics-neuropsychiatric-assessment

3. Lee BX, ed. The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President. Thomas Dunne Books; 2017.