However, the definition of what would constitute an inability to discharge the duties of office was left deliberately vague. Senator Birch Bayh, of Indiana, and others who drafted the clause wanted to insure that the final decision was not left to doctors. The fate of a President, Bayh wrote later, is “really a political question” that should rest on the “professional judgment of the political circumstances existing at the time. ” The Twentyfifth Amendment could therefore be employed in the case of a President who is not incapacitated but is considered mentally impaired. A study psychiatrists at Duke University, published in the Journal of Nervous and Mental Disease . in 2006, made a striking assertion: about half the Presidents they studied had suffered a mental illness at one time or another. The researchers examined biographies and medical histories of thirtyseven Presidents, from Washington to Nixon, and found that fortynine per cent met the criteria for a psychiatric disorder—mostly depression, anxiety, and substance abuse—at some point in their lives. Ten Presidents, or about one in four, had symptoms “evident during presidential office, which in most cases probably impaired job performance.
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