I have previously criticized psychiatrists who have regularly appeared on the air to identify a variety of mental illness that they have observed in President Donald Trump from afar. As I discussed in a prior column on the demise of the Goldwater rule, this is diagnosis without examination and often seems mixed with strong political judgments about Trump’s political positions. Bandy X. Lee, a professor of psychiatry at the Yale University School of Medicine, has been one of the most outspoken and last week urged House Speaker Nancy Pelosi to demand some ill-defined “hold” on the president pending psychiatric examination. Her position latest position is utterly bizarre but has been treated as a serious discussion point by some media like Salon magazine.
Lee previously served as the editor of the book “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President” and has continually argued for removal on the basis for mental illness. I previously discussed the difficulties in pursuing such loose analysis as the basis for removal under the 25th Amendment.
Lee’s most recent call for some form of intervention by Pelosi seems utterly disconnected from the constitutional process. She bizarrely treated this as an office intervention. Lee told Salon that “As a co-worker, she has the right to have him submit to an involuntary evaluation, but she has not. I am beginning to believe that a mental health hold, which we have tried to avoid, will become inevitable.”
I am at a loss on this one. Does Lee think that Pelosi can “as a co-worker” force the President into an involuntary evaluation? The only provision from incapacity of a president is found in the 25th Amendment and it omits such a workplace evaluation process. As I previously discussed, Section 4 has, essentially, two avenues for dragging a president from the Oval Office. First, there is the mutiny option. A vice president and a majority of the Cabinet can agree that the president is “unable to discharge the powers and duties of his office” and notify Congress that the vice president intends to take over. If Vice President Pence could get eight Cabinet officers to sign a letter to that effect, he would immediately become the “Acting President.” But if the president then declares to Congress that “no inability exists,” Trump could resume his powers.
Pence and the rebellious Cabinet would then have to send another declaration within four days to the President pro tempore of the Senate and the Speaker of the House that says, more or less, don’t believe a word, he’s unfit. Once Congress had the second declaration, if not already in session, it would have 48 hours to assemble to debate the issue. It would then have 21 days to vote on the president’s fitness. To remove the president, two-thirds of both houses would have to agree. If Congress did not vote within 21 days, the president would get his power back.
Notably, Lee again seems triggered by policies or actions with which she disagrees. This latest call for co-worker intervention was due to the killing of Iranian Maj. Gen. Qassem Soleimani. I also raised concerns over this action as a possible assassination in violation of U.S. law and an act of war under international law. However, Trump is not the first president to attack individuals on foreign soil whether it was Osama Bin Laden or the attempt on former Libyan President Muammar el-Qaddafi.
Lee’s medical diagnosis is hard to untangle from her political judgment. She insists that this is “exactly what someone who lacks mental capacity would do.”:
“This is exactly the kind of dangerous event we foresaw as Donald Trump’s response to the impeachment proceedings, just as his pulling troops from northern Syria was a direct response to the announcement of an impeachment inquiry . . . In other words, he is extremely drawn to actions that would help him appear as if he has mental capacity, such as a ‘presidential strike’ against an enemy, while avoiding the proper procedures, such as briefing with Congress, that might expose his lack of capacity . . . What we do not expect from someone who lacks mental capacity is rational, reality-based decision making that is non-impulsive, non-reckless, and cognizant of consequences.”
She adds that his attacks on President Obama must also be treated as a reflection of his mental illness: “Since he is incapable of putting himself in another person’s shoes, he projects his own thoughts entirely onto others. Hence, we can deduce that what he has said about Mr. Obama has nothing to do with the former president but has only to do with the way he himself thinks.”
At points, Lee seems herself a bit adrift. When asked about the widespread criticism of her claims of mental illness, Lee responded “My critics do not have an argument. There are many situations where I hoped that my formulation would be wrong — but now that my hypotheses have been tested so many times to 100 percent precision.”
Really? She is 100 percent right without ever actually personally examining the subject.
Then the interview gets downright batty when the 25th Amendment is raised:
“Yes. In this country, no one is above the law, and as far as mental health laws and the president are concerned, there is no Office of Legal Counsel memo, no exceptions and at this time not even confidentiality, since he has yet to be a patient. Before it is a political matter involving impeachment or the 25th Amendment, it is a medical matter. The physical danger due to psychological impairment needs to be removed, and we are bound by our own professional code not to abandon persons or the public in danger. We are even legally bound to take steps to protect potential victims if warning is insufficient and security staff will not act. If the personal physician is unavailable or too conflicted to do so, any physician can.
A 72-hour hold does not require court intervention and is enough for a solid evaluation. There is no shortage of mental health professionals willing to put their names to commitment papers, and multiple legal groups have offered to file for a court order for security staff to cooperate. All we need are auspices so as to show it is not a coup or something nefarious — although, at this point, we may need to proceed anyway because the populace is growing too sick to see any intervention as legitimate unless it is illegitimate. This is common in mental health settings, and we apply the proper treatment according to standard anyway with the hope that patients will improve enough to see that you have helped them — which happens most of the time. It is this nature of mental disease that has allowed for civil commitment laws to be possible in a country that protects civil liberties.”
Could you imagine the future of our system if a Speaker of the House could have a president civilly committed for involuntary examination? Some Republicans would no doubt have asked Pelosi’s GOP predecessor for the same civil confinement of President Obama. We would need a regular presidential suite at St. Elizabeth’s. Lee herself shows the potential for securing favorable rulings from doctors who believe no sane person could hold certain political views or take certain actions.
It would be, in a word, madness.