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.