Butler is a husband, father, grandfather, business executive, entrepreneur and political observer.
I have said it before, and I will say it again: We deserve better.
It is bad enough that our only real choices for president come November will be old, white, polarizing men tainted by scandal. After nearly four years in what is arguably the most demanding and stressful job in the universe, Joe Biden, whose cognitive capabilities were subject to question even in the last campaign, now appears even to ardent supporters to be too old for the job. Whether they question his ability to do the job or his ability to win the election is unclear.
And while it may be less obvious, Trump provides his own evidence that he is not the man he used to be, neurologically.
If he is up to the job physically, mentally, and neurologically, Biden could easily persuade most of America of this fact, and in doing so, would likely ensure his re-election. The solution? An exhaustive medical, cognitive and neurological exam with the results published in complete and transparent form to the American people. One has to question why he has not done so already. The obvious conclusion is that he and his team are convinced the results of such an exam would not be helpful to the campaign — if not devastating.
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If he were to take the exam, he should do it in the context of accepting Trump’s recent challenge that they both undergo a cognitive evaluation. Presumably, Trump refers to the relatively simple and short cognitive test he took when still in office. But the American people deserve more than just that. These two are old and the examinations should be complete and thorough, including age-affected physical parameters, cognition evaluations and in-depth neurological exams.
Should both candidates agree to this, to make it “fair,” each candidate could specify a general practitioner and a neurological expert to conduct the test. Those four could jointly select a third neurologist to ensure an independent expert is involved. Ideally, they would issue a single consensus report on each candidate. If necessary, each doctor could provide a separate write-up dissenting on any given result or including observations the larger group chose not to include in the report.
Of course, each candidate would need to sign HIPAA waivers to allow the information to be published.
The American presidency is arguably the most important executive position in the world. No public corporation would hire either of these candidates as their CEO without an exhaustive medical evaluation. Why should we be forced to do so?
What age should a president be? When inaugurated, George Washington was 57 years old. The youngest was Theodore Roosevelt, just 42 when taking office. Nine presidents were in their 40s including Jimmy Carter, Bill Clinton and Barack Obama. The first person inaugurated at the age of 70 was Donald Trump, while Joe Biden was 78. If he takes office again, in January 2025, Donald Trump will be the oldest inaugurated president in history, about five months older than Biden was in 2021.
For various reasons, modern men and women, especially those in developed countries, live significantly longer than people did 200 years ago. It is therefore natural that some public servants, including presidents, will be older than the historical norm. But how old is too old? The answer is, we do not know. But we do know that as we age, we have a higher and higher risk of debilitating medical conditions, including neurological and cognitive problems.
Beyond this election cycle, Congress should enact legislation that requires a similar in-depth exam and transparent public report for any presidential candidate who will reach the age of 70 during the term for which they seek election. This exam should be performed not more than one year before the first presidential caucuses or primaries, and the results released before those primaries. A similar requirement should be established for vice presidential candidates within 30 days of being selected for the ballot. Presumably, the results of an earlier examination would be part of the vetting process for selecting an older vice presidential candidate.
The results of the tests would not be disqualifying for any candidate. They should simply be required to have the exam and release the report. But the exam may inform their decision on whether to run, and the report would be part of the information available to the American people during the election cycle. Of course, there are no guarantees. Even a candidate with a perfect report could drop dead or become severely disabled shortly after taking office. But for older candidates, where the risk is higher and higher, we deserve to know the status of a candidate's current physical, neurological and cognitive health.
