Robert Cramer: Evaluate the president’s fitness for duty | Guest Columnist


The idea of evaluating the U.S. president’s fitness for duty isn’t new. President Jimmy Carter raised the idea of having a panel of appointed doctors to regularly evaluate the president.

For many mental health professionals, being able to recognize a probable mental health issue in a public figure from a distance is a nightmare scenario. There’s often nothing we can do about it, but the knowledge that a group of clinicians could ensure the safety of that political leader, as well as the safety of those he or she serves, would provide some reassurance.

Early signs in a person struggling with a mental illness could be fatigue, forgetfulness or uncharacteristic erratic moods. Then could come impulsive behavior — possibly to the point of compromising his or her safety and the safety of those around them.

A fitness-for-duty evaluation determines whether a person has the necessary psychological or mental capacity to do a particular job. Such mental health-related exams tend to happen in professions or situations where the safety of others could be an issue. Such high-stress professions could include the military, law enforcement or firefighters.

Determination of mental fitness is a medical and legal decision. Mental health professionals conduct the exams and offer recommendations. Judges and lawyers make determinations based on those recommendations. 

In one example, a clinician would evaluate a soldier or police officer who recently faced the harrowing, emotionally challenging experience of discharging a weapon on the job, wounding or killing another person. Such a stressful experience could be associated with post-traumatic stress disorder or other issues. Since the person’s job requires him or her to carry a weapon, the safety of the person and others would be at issue.

A fitness-for-duty evaluation would include detailed interviews with the person and with his or her co-workers. Health and other records would be reviewed. Psychological testing could be conducted. In certain instances, a clinician would conduct job-related role-playing scenarios. 

Because of the nature of the examination, the issue of transparency would be critical. Evaluation of the president of the United States, for example, would lead to questions such as: What is the public’s right to know about the results of the exam?

Arguments could be made that part of the president’s job is to ensure the safety of Americans and that the president, because he or she was elected by the people, should answer to the voting public. While certain procedural safeguards — such as the checks and balances of our political system — do exist, the president wields great power and could put others’ lives at risk.

While the average voter is capable of determining who could best represent his or her political views in the office of the presidency, most people do not have the ability to assess the mental fitness of others. In the case of a police officer who is dealing with a possible case of post-traumatic stress: The average voter wouldn’t be capable of determining whether the officer is ready to return to work.

Nonpartisan fitness-for-duty evaluations, conducted by a panel of professionals according to clearly articulated policies and procedures, could provide another layer of assurance for the public. Because such an examination would be for the good of the people, the findings should be transparent.

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