In a NY Times op-ed, two psychiatrists — one from Brown University, the other from the American Enterprise Institute — tackle their profession's proper relationship to Section 4 of the 25th Amendment:
"Whenever the Vice President and a majority of either the principal officers of the executive departments or of such other body as Congress may by law provide, transmit to the President pro tempore of the Senate and the Speaker of the House of Representatives their written declaration that the President is [out of his everloving mind], the Vice President shall immediately assume the powers and duties of the office as Acting President."
What the co-authors ask is simple: Since only mental health professionals could affirm the clinical existence of presidential madness, should the decision to remove such a lunatic substantially be left to these professionals, rather than to a political process? The answer is complicated, but in its shortest form, no.
The answer exposes the uselessness of psychiatric diagnoses in politics — but even worse it exposes the legitimacy of any utterly diseased democracy. "[A]s psychiatrists and citizens," write the authors, "we agree on this point: The medical profession and democracy would be ill served if a political determination at this level were ever disguised as clinical judgment."
In other words, the body politic has every right to elect a madman, to keep and protect the madman in office, and to endanger the nation's existence as a democracy. Every psychiatrist drawing breath might agree that Donald Trump is clinically bonkers and a violent peril to all that is virtuous, but submission to democratic considerations must outweigh competent opinion. For mental health professionals to declare Trump unfit for office "would strike those who elected him as elitist and anti-democratic," observe the authors. "Don’t the people have the right to choose an exceedingly narcissistic leader?"
The hard, brutal truth is yes.