As readers of this blog know only too well, I think that Trump has psychiatric and personality problems that make him unfit for the office that he holds. But reaching that conclusion is the easy bit. The really problematic part is what to do about it. There are at least three questions. 1. Who decides that the President has to be relieved of power? 2. What kind of process is required? And 3. How is all this to be squared with democracy?

There’s a thoughtful piece by Peter Kramer and Sally Satel (two psychiatrists with opposing political affiliations) about these questions in today’s New York Times.

The peg for their opinion piece is the fact that 28 Democrats in Congress have put forward a Bill which could lead to a formal assessment of Trump’s mental fitness.

The bill seeks to set in motion a part of the 25th Amendment that empowers Congress to establish a body to assess the president’s ability to govern. The commission created by the bill would have 11 members, at least eight of whom would be doctors, including four psychiatrists. If the commission doctors found Mr. Trump unfit to govern and the vice president agreed, the vice president would become acting president. Since the 25th Amendment was written to address temporary disability, it allows the president to announce that he has recovered — presumably Mr. Trump would do so immediately — and force a congressional vote on the finding of unfitness.

Their view is that the role of professional psychiatrists in all this is problematic. That’s a polite way of saying that it’s bonkers. Having a majority of professionals on the commission is totally inappropriate. Removing a president in a democracy is a political, not a medical, matter.

Kramer and Satel conclude, sensibly:

If the time comes that Congress finds Mr. Trump unable to discharge his duties, its members should appoint a bipartisan commission dominated by respected statesmen to set the removal process in motion. Obviously, if a president’s health deteriorates drastically, medical consultants should be called in. But when the problem is longstanding personality traits, a doctor-dominated commission simply provides cover for Congress — allowing legislators, presumably including those in the majority, to arrange for the replacement of the president while minimizing their responsibility for doing so.

Spot on. Medics should be on tap, not on top.

Peter Wehner, writing in the New York Times:

A new Washington Post-ABC News poll illustrates the dilemma Republican politicians face. It found that 28 percent of polled voters say they approved of Mr. Trump’s response to Charlottesville. But among Republican voters, the figure was 62 percent, while 72 percent of conservative Republicans approved.

The more offensive Mr. Trump is to the rest of America, the more popular he becomes with his core supporters. One policy example: At a recent rally in Phoenix, the president said he was willing to shut down the government over the question of funding for a border wall, which most of his base favors but only about a third of all Americans want.

Implication: anyone hoping for impeachment from a Republican Congress is engaging in magical thinking.

As ever, Jack Shafer’s ‘Swamp Diary’ has useful insights into the tangled web in Washington. This for example:

If the Russian operations don’t add up to a single rational number, that’s to be expected. The Russian playbook teaches its operatives to “create so much confusion and uncertainty and mystery that no one knows what the truth is,” British journalist Ben Macintyre told novelist John le Carré in a recent conversation. “It’s called maskirovka—little masquerade.”

Peering into the wilderness of mirrors, Macintyre offered this about the Russians:

“They set up an ex-MI6 guy, Chris Steele, who is a patsy, effectively, and they feed him some stuff that’s true, and some stuff that isn’t true, and some stuff that is demonstrably wrong. Which means that Trump can then stand up and deny it, while knowing that the essence of it is true. And then he has a stone in his shoe for the rest of his administration.”

Nice metaphor, that.

Basically, at the moment, nothing — even though the guy has his finger on the nuclear button.

The New Yorker has a piece by Jeannie Suk Gersen, a Harvard law professor, asking the question “Will Trump be the death of the Goldwater rule?”

“The class of professionals best equipped to answer these questions”, she writes,

has largely abstained from speaking publicly about the President’s mental health. The principle known as the “Goldwater rule” prohibits psychiatrists from giving professional opinions about public figures without personally conducting an examination, as Jane Mayer wrote in this magazine in May. After losing the 1964 Presidential election, Senator Barry Goldwater successfully sued Fact magazine for defamation after it published a special issue in which psychiatrists declared him “severely paranoid” and “unfit” for the Presidency. For a public figure to prevail in a defamation suit, he must demonstrate that the defendant acted with “actual malice”; a key piece of evidence in the Goldwater case was Fact’s disregard of a letter from the American Psychiatric Association warning that any survey of psychiatrists who hadn’t clinically examined Goldwater was invalid.

There’s something comical about this, in the sense that if any of these august professionals did indeed conduct an examination of the president, then they would be bound by patient confidentiality and so would be unable to contribute to a public discussion on his mental state.

Not being a psychiatrist, I am unfettered by these considerations and indeed performed my own examination of the question some time ago. I dug out the Mayo Clinic’s list of the symptoms and causes of ‘Antisocial Personality Disorder’ (aka sociopathy) and concluded that Trump ticked most of the boxes. I also quoted the only commentator I could find who openly approached the question of whether Trump is unhinged — Andrew Sullivan — and who had also concluded in the affirmative.