On June 29, 2002, President George W. Bush invoked the United States Constitution's Twenty-Fifth Amendment, ratified in 1967. By so doing, he helped focus attention on the amendment's two disability provisions, Sections 3 and 4. Section 3 provides for voluntary transfer of power from the president to the vice president and is wholly dependent on the president's wishes. Section 4 provides for involuntary transfers of power, possibly over the president's objection. This controversial provision allows a vice president, with the assent of a majority of the cabinet, to become acting president. Critics have long argued that the vice president and cabinet officers, since they all owe their positions to the president, may be excessively reluctant to act even when action clearly is warranted. Therefore, some of these critics have proposed that a presidential disability commission be established at the beginning of every administration either to act under Section 4 in place of the cabinet or to provide formal and regular medical assessments so as to press for action in the event of presidential inability. I argue that such proposals are unwise and that their implementation would be counterproductive and even dangerous, both to the presidency and to the nation.

During his first term as President of the United States, Dwight D. Eisenhower suffered several serious illnesses. Particularly important was the massive heart attack he experienced in the fall of 1955. Drawing on primary sources as well as prior scholarship, this article analyzes varying interpretations of Eisenhower's 1955 medical treatment in light of his previous illnesses and their management. It explores the handling of public disclosure by the White House, by Eisenhower himself, and by his medical team. And it reconsiders Republican strategists' efforts to allay public concerns about the President's health. Current understanding is called into question in several respects. Although it sharpened speculation about his fitness and willingness to run in the 1956 presidential campaign, the 1955 heart attack made Eisenhower more likely, rather than less likely, to run. Although often sick, and in several instances critically so, Eisenhower was clearly the dominant player — intentionally “behind the scenes” — both in the management of his illnesses and in the health-perceptual aspects of his drive toward a second term. These findings should lead us to a better reading of Eisenhower as a president and to a better appreciation of health's linkage to legacy in presidential politics.

Only one man in American history has been elected four times to the Office of President. Despite the image of vigor and hearty good cheer that he projected, Franklin D. Roosevelt was afflicted by both disability and serious illness while in the White House. He had never recovered fully from his 1921 bout with polio, a fact concealed from the public for many years out of fear that it might be detrimental to his political career. The methods of concealment, involving both image control and media management, produced a veil of secrecy that only time has penetrated. Also, after several years in office, Roosevelt suffered from cardiovascular disease that eventually ended his life. The belief of some critics that his physical deterioration impacted negatively on his performance as president, most notably at the Yalta Conference in early 1945, is worthy of examination, with the perspective that more than forty years can provide.

In March 2008, I published an article in this journal that examined the ways in which the White House managed the news—and minimized the political impact—of Dwight D. Eisenhower's massive 1955 heart attack. In addition, the analysis explored the manner in which Eisenhower himself, in handling this issue, had brilliantly “manipulated his medical team, safeguarded his image, cajoled his staff, confused the press, managed his advisers, dominated his party, and ran a campaign that was virtually impossible for the opposition to counteract” (p. 18).1 This article expands on my previous work by considering the ways in which Eisenhower's ill health had significant public policy repercussions that went beyond the immediate political effects evaluated in 2008. These included the drawbacks associated with Eisenhower's concept of “Team Government,” a tragic war in the Middle East, a serious deterioration of the U.S. relationship with three very close allies and, finally, the beginnings of a presidentially led effort to add a much needed “presidential disability” amendment to the United States Constitution. These latter effects have been studied here through use of primary source materials located at the Dwight D. Eisenhower Presidential Library, commentaries written by Eisenhower himself, members of his family and other close associates and the voluminous secondary literature that has appeared over the years focusing on the Eisenhower presidency.

This introduction to the special issue on presidential disability and succession focuses on the distinctly positive contributions that invocations of the Twenty-Fifth Amendment have made to American political life since the Amendment's ratification in 1967. It also underlines the importance for Presidents, their family members and aides to understand the necessity for putting the welfare of the country first, above all else—even at times above the wishes of a disabled Chief Executive. As the articles in this special issue make clear, the Twenty-Fifth Amendment provides an effective constitutional mechanism by which the country's well-being can be maintained while simultaneously showing compassion and respect for a disabled leader. The idea for this issue emerged from a conference organized by Professor Robert E. Gilbert focusing on presidential disability and succession held on the campus of Northeastern University in April 2014. Papers from the conference assembled here clarify and add to the historical record about presidential inability while illuminating the many political, legal, and constitutional contingencies that future presidential administrators may face. Contributors to this issue have varied disciplinary and professional backgrounds, including expertise in American politics, constitutional law, the presidency and vice presidency, presidential impairment, and, of course, the Twenty-Fifth Amendment to the Constitution.

This paper assesses the likelihood that the Iran-Contra scandal was shaped heavily by the effects of Ronald Reagan's cancer surgery in summer, 1985. During the President's hospitalization and in the period soon after, he took several actions—which he apparently did not remember—that launched a policy that was unwise, counterproductive, and a failure. These damaged both his Administration and his standing in history. The 25th Amendment afforded Reagan the means by which his involvement in these events could easily have been avoided. However, the President and his aides determined that he would resume the powers and duties of the presidency only hours after undergoing extensive cancer surgery. This decision contributed materially to the most damaging episode of Reagan's eight-year presidency.

Nutrigenomics is the study of how constituents of the diet interact with genes, and their products, to alter phenotype and, conversely, how genes and their products metabolise these constituents into nutrients, antinutrients, and bioactive compounds. Results from molecular and genetic epidemiological studies indicate that dietary unbalance can alter gene–nutrient interactions in ways that increase the risk of developing chronic disease. The interplay of human genetic variation and environmental factors will make identifying causative genes and nutrients a formidable, but not intractable, challenge. We provide specific recommendations for how to best meet this challenge and discuss the need for new methodologies and the use of comprehensive analyses of nutrient–genotype interactions involving large and diverse populations. The objective of the present paper is to stimulate discourse and collaboration among nutrigenomic researchers and stakeholders, a process that will lead to an increase in global health and wellness by reducing health disparities in developed and developing countries.

Biographers commonly describe Calvin Coolidge as having had a sound, comfortable, supportive upbringing. Fuess writes, for example, that Coolidge's early life was “simple, wholesome and unfurtive.” White and McCoy point out that the Coolidges were “aristocrats” and that Calvin was “a young prince” who was “brought up in as much luxury as could be expected in Plymouth township.”. However, a close analysis suggests strongly that the childhood years of Calvin Coolidge were marked by great sadness and dislocation. He was an extraordinarily shy boy who had few friends and often was lonely. His father, John Coolidge, was frequently absent from the household, either because of his service in the Vermont state legislature or his various business activities. As Lynch and Kilmartin point out, a father who is physically or emotionally missing from his son's life leaves scars on the boy's psychological development.

Molecular analyses based on plasmid profile typing and pulsed-field gel electrophoresis have defined a strain of Salmonella enterica serotype Anatum associated with the consumption of a particular brand of formula-dried milk responsible for an outbreak in late 1996/early 1997 involving 15 infants and 2 relatives in the UK, and 2 infants in France. The study has demonstrated the value of laboratory-based surveillance involving identification of the outbreak strain at the molecular level coupled with food microbiology and targeted epidemiological investigations, and has highlighted the importance of rapid communication and subsequent international collaboration through the European Union-funded Salm-Net salmonella surveillance network.