Diagnosis at a distance: is it ever appropriate?

[EddyTeddyFreddy]

From today’s Boston Globe newspaper:

It is an article of faith with millions of Americans, most of them on the left, that George W. Bush is stupid. Many reasonable people think his policies are ill-advised, but millions more insist Bush must be a moron because he sounds stupid.

The president’s tortured “Bushisms” are chronicled daily and have been collected in books. Two of the more notorious are “I know how hard it is for you to put food on your family” and “Families is where our nation finds hope, where wings take dream.”

But something doesn’t compute. Fred Smith, the founder of Federal Express and a Yale pal of both Bush and John Kerry, says Bush is five times smarter than people think he is. Cynics deride what passes for scholarship at the Harvard Business School, but the course work for the two-year MBA isn’t easy. A grading curve forces a small number of students to fail, and Bush didn’t fail.

So why does Bush sound stupid? One doctor thinks he shows signs of “presenile dementia,” or an early onset of Alzheimer’s disease.

The columnist goes on to discuss the underpinnings for this doctor’s theory. He looks back at Reagan and questions that have been raised about that president’s competency while in office. He also notes this dissenting view:

Yes, I asked for a second opinion. University of Massachusetts neurology professor Dr. Daniel Pollen thinks it is bootless to speculate about Bush’s condition without a formal neuropsychological assessment. “I think it’s unfair to say somebody has or does not have a dementia as an analysis based on his public utterances,” says Pollen, who is not a Bush supporter. Noting that Bush spoke well in his debates with both Richards and Al Gore, Pollen adds that Bush’s “peak performances are not in the range I would consider for anybody to have Alzheimer’s disease in the near future.”

I’m not asking for opinions on the (in)validity of this armchair diagnosis. What I’d like to discuss is:

When, if ever, is it appropriate for medical and/or psychological experts to express public doubts about a president’s mental competency? How clearly off the rails must a president be in order to justify public debate on such a sensitive topic, perhaps even demands for a competency examination? Given the awesome powers inherent in the office, and the obvious incentives for an administration to conceal such a disability, can it be argued that the welfare of the country should trump the professional ethos against engaging in such speculation?

[roger_thornhill]

@EddyTeddyFreddy

How clearly off the rails must a president be in order to justify public debate on such a sensitive topic, perhaps even demands for a competency examination?

Just to consider this question, the two Bushisms that you quote are more slip of the tongues than anything else. They are not uncommon when people are speaking publicly and need to think on their feet.

A number of apparently highly intelligent dopers have similarly complained about the fact that there mind is working faster than their fingers when explaining mistakes in their writing.

[EddyTeddyFreddy]

Being subject to similar gaffes and Spoonerisms myself, I agree with you, Roger. What I’m wondering is, does there come a point where signs of incapacity are clear-cut enough that questioning presidential competency is appropriate? I’m thinking about evidence of disordered thinking that goes beyond everyday misspeaking into the realm of pathology.

I say again, this isn’t a “let’s bash Bush as an early-Alzheimer dolt” thread. If I’d wanted to engage in that, I’d have opened a thread in the Pit. I’ve employed this column as a springboard for Dopers to dive into the underlying question: when, if ever, should a medico say: “My professional opinion is that our president is incapacitated based on such-and-such evidence”?

[CrazyCatLady]

when, if ever, should a medico say: “My professional opinion is that our president is incapacitated based on such-and-such evidence”?

When they have performed an examination and suitable testing on the president. Without that, they’re just making a WAG.

It’s one thing to say, “I think he ought be evaluated because of x, y, and z.” That’s fine. That’s like your doctor returning your late-night phone call to say it sounds like you probably ought to go to the emergency room because of this, that, and the other thing. It’s something else again to say, “I think he’s incapacitated” without ever actually evaluating the patient. That’s like your doctor returning your late-night call to say you have appendicitis and will die without surgery. You might have appendicitis, true, but you also might have ruptured ovarian cysts, or gallbladder stones, or any number of other conditions.

[wonky]

@EddyTeddyFreddy

I’ve employed this column as a springboard for Dopers to dive into the underlying question: when, if ever, should a medico say: “My professional opinion is that our president is incapacitated based on such-and-such evidence”?

I wouldn’t trust a diagnosis of anyone under such circumstances, so I’m certainly not going to trust a diagnosis that could be politically motivated under such circumstances.