# Presidential cognitive exams. To whom do they report?
**URL:** https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844
**Category:** Factual Questions
**Created:** [March 28, 2026, 7:06pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844 "2026-03-28T19:06:04Z")
**Posts on this page:** 20
**Page:** 1
### Author:  [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)
#### Post date: [March 28, 2026, 7:06pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/1 "2026-03-28T19:06:04Z")
Should a President fail such an exam, to whom do those giving the exam report? I know there is a constitutional amendment providing a way for the cabinet? Congress? to remove the President if he is incompetent, but I doubt the current people in those posts would be willing to do so.
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### Author:  [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)
#### Post date: [March 28, 2026, 7:55pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/2 "2026-03-28T19:55:43Z")
To the President. It would violate HIPAA laws to give them to anyone else, without his consent.
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### Author:  [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)
#### Post date: [March 28, 2026, 8:02pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/3 "2026-03-28T20:02:22Z")
> [@Fear\_Itself](#):
>
> It would violate HIPAA laws to give them to anyone else, without his consent.
Exactly. Despite the fact that the President is a public official, he is also a private individual, and AIUI, being the President does not trump (apologies for the pun) his right to privacy regarding his medical information, as guaranteed by HIPAA.
The fact that previous presidents have been more forthcoming about their health (both the good and the bad, such as cancer treatments and illnesses) is a matter of custom and a choice to be (relatively) transparent to the public, rather than a law mandating that they do so.
Similarly, previous presidents made a tradition of publicly releasing their annual Federal income tax filings, in the spirit of transparency, but there is no law requiring it, and the current occupant of the White House has chosen to ignore that informal precedent.
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### Author:  [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)
#### Post date: [March 28, 2026, 8:37pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/4 "2026-03-28T20:37:33Z")
An insane President must realize he is insane and resign or call for himself to be removed. That may be problematic.
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### Author:  [@Roderick\_Femm](https://boards.straightdope.com/u/Roderick_Femm)
#### Post date: [March 28, 2026, 8:49pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/5 "2026-03-28T20:49:03Z")
Having cognitive problems does not make one insane. It means one has difficulties with mental processes such as memory, attention, decision-making, and problem-solving. One may be insane without having these problems, or have these problems without being insane, or have both.
Besides, if you call the President insane, it may give him a legal defense against any crimes he may have committed, i.e. not guilty by reason of insanity.
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### Author:  [@md-2000](https://boards.straightdope.com/u/md-2000)
#### Post date: [March 28, 2026, 8:58pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/6 "2026-03-28T20:58:28Z")
If the physician deemed a president sufficiently incompetent, I assume he would pass it on to next of kin, it would fall to next of kin (Melania?) to deal with whether the matter should be made public; and resultant fallout like whether she then, for example, becomes power of attorney for all his financials. đ At the very least, filing such a request for declaration of power of attorney would effectively make the news public. I assume in that situation the doctor would be obliged to testify, although presumably being a military doctor there would be chain of command issues too?
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### Author:  [@thelurkinghorror](https://boards.straightdope.com/u/thelurkinghorror)
#### Post date: [March 28, 2026, 8:59pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/7 "2026-03-28T20:59:24Z")
> [@Roderick\_Femm](#):
>
> Besides, if you call the President insane, it may give him a legal defense against any crimes he may have committed, i.e. not guilty by reason of insanity.
This is a very specific legal defense, which requires the defendant to be unaware they were committing a crime due to impairment at the time of the event. Having cognitive or psychological disorders is not in itself a good defense. Itâs rarely pursued in cases where it may apply as it can be weakened by e.g. evidence of planning behaviors, and when it is attempted fails some 75% of the time.
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### Author:  [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)
#### Post date: [March 28, 2026, 9:03pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/8 "2026-03-28T21:03:09Z")
> [@md-2000](#):
>
> I assume in that situation the doctor would be obliged to testify, although presumably being a military doctor there would be chain of command issues too?
TIL that the last Physician to the President who was _not_ a military doctor was Dr. Burton Lee, who served George H.W. Bush and (briefly) Bill Clinton.
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### Author:  [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)
#### Post date: [March 28, 2026, 9:18pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/9 "2026-03-28T21:18:51Z")
My pint being that if âaâ President were insane.
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### Author:  [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)
#### Post date: [March 28, 2026, 10:00pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/10 "2026-03-28T22:00:12Z")
Crazy, narcissists donât ordinarily own up or maybe even know they are like that.
Realization you have a problem is part of the battle. So a person with dementia wouldnât necessarily be able to know.
Either way, Trump wonât be saying it.
If heâs insane, who knows what the insane think? Really.
(Until they write the manifesto)
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### Author:  [@Si\_Amigo](https://boards.straightdope.com/u/Si_Amigo)
#### Post date: [March 28, 2026, 10:22pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/11 "2026-03-28T22:22:11Z")
> [@Roderick\_Femm](#):
>
> Besides, if you call the President insane, it may give him a legal defense against any crimes he may have committed, i.e. not guilty by reason of insanity.
As we have seen , an insane POTUS doesnât need an insanity defense in order to get away with crimes against the American people and the world. There is not legal defense required for a King.
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### Author:  [@Sherrerd](https://boards.straightdope.com/u/Sherrerd)
#### Post date: [March 28, 2026, 10:30pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/12 "2026-03-28T22:30:00Z")
> [@Beckdawrek](#):
>
> Realization you have a problem is part of the battle. So a person with dementia wouldnât necessarily be able to know.
This is quite true, and combined with HIPAA, seems to ensure that a President with full-on dementia could stay in office until the end of his or her term. The only thing that could intervene would be an invocation of the 25th Amendment by that Presidentâs VP and others authorized in Section 4 to initiate the Presidentâs removal:
> [@](#):
>
> 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 unable to discharge the powers and duties of his office** , the Vice President shall immediately assume the powers and duties of the office as Acting President.
If those people choose not to act, a dementia-riddled President can go on doing as much harm as heâs able.
(My bolding)
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### Author:  [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)
#### Post date: [March 29, 2026, 12:04am UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/13 "2026-03-29T00:04:56Z")
The right people, family included, can do a lot. They did it to Biden.
I believe Eleanor wanted FDR to give it up.
Wilsonâs wife and Doctor kept his condition secret, for something like 2 years.
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### Author:  [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)
#### Post date: [March 29, 2026, 11:30am UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/14 "2026-03-29T11:30:40Z")
Which President was incapacitated to the point that only his wife could understand him? She would speak to him and report, âThe Presidentâs will is..â?
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### Author:  [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)
#### Post date: [March 29, 2026, 3:36pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/15 "2026-03-29T15:36:10Z")
> [@carnivorousplant](#):
>
> Which President was incapacitated to the point that only his wife could understand him?
Wilson, probably, as mentioned by @Beckdawrek in the post above yours.
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### Author:  [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)
#### Post date: [March 31, 2026, 3:17pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/16 "2026-03-31T15:17:39Z")
Thanks.
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### Author:  [@Schnitte](https://boards.straightdope.com/u/Schnitte)
#### Post date: [April 5, 2026, 8:13pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/17 "2026-04-05T20:13:34Z")
The 25th Amendment defines a process whereby the Vice President and the majority of the fifteen cabinet secretaries (or some other body designated by Congress, but no such designation has been made so far) can declare the President unable to discharge the powers and duties of his office; the Vice President will then assume the presidency. No participation of the old President required.
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### Author:  [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)
#### Post date: [April 5, 2026, 8:55pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/18 "2026-04-05T20:55:16Z")
Thanks.
That depends upon the cabinet being honest, and not wanting to keep their jobs badly enough to vote to keep him.
The Founding Fathers seem to have designed things to work only if all the participants just, honest and forthright. Wilson, for example, should have been removed by that method.
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### Author:  [@Beckdawrek](https://boards.straightdope.com/u/Beckdawrek)
#### Post date: [April 5, 2026, 9:16pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/19 "2026-04-05T21:16:20Z")
The 25th amendment wasnât in place when Wilson was president.
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### Author:  [@carnivorousplant](https://boards.straightdope.com/u/carnivorousplant)
#### Post date: [April 5, 2026, 9:30pm UTC](https://boards.straightdope.com/t/presidential-cognitive-exams-to-whom-do-they-report/1028844/20 "2026-04-05T21:30:14Z")
Ah.
I should have paid more attention to History 1100 and 1101. Thanks. Just as I wanted to point out to someone who was screaming about FDR taking four terms. Both amendments are better late than never.
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