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Updated July 2, 2024
The Twenty-Fifth Amendment: Sections 3 and 4-Presidential
Disability

The Twenty-Fifth Amendment, proposed by Congress in
1965 and ratified by the states in 1967, provides for
presidential succession, vice presidential vacancies, and
presidential disability. Presidential inability or disability is
specifically covered in Section 3, whereby the President
may declare a disability, and Section 4, whereby a
presidential disability is declared by the Vice President and
a majority of the Cabinet or such other body as may be
established by law.
Section 3: Presidental Declaration of
Dsabilty
Section 3 of the amendment covers circumstances in which
a President is able to declare himself or herself unable to
discharge the powers and duties of the office. When the
disability is removed, the President reclaims the office by a
declaration to that effect. Disabilities may include a sudden
injury or illness or scheduled medical treatment that might
leave the President less than fully aware or cognizant for
some period of time. It may potentially cover other
situations, such as absence from the country or a period of
intense grief, for example, related to the loss of a loved one.
Opinion as to whether a President could invoke Section 3 to
concentrate on defense in a case of impeachment is divided.
The President activates Section 3 by transmitting a written
declaration to the President pro tempore of the Senate
(President pro tem) and the Speaker of the House of
Representatives (Speaker). For the duration of the
disability, the Vice President discharges the President's
powers and duties as Acting President. When the President
transmits a written declaration to the contrary to the
President pro tem and the Speaker, he or she resumes the
powers and duties of the office.
When Has Section 3 Been Activated?
This section has been activated several times under
circumstances in which the President underwent general
anesthesia for medical treatment. In 1985, President Ronald
Reagan informally invoked the amendment when he was
anesthetized during cancer surgery. President George W.
Bush formally implemented Section 3 twice, in 2002 and
2007, and President Joseph Biden used it once, in 2021,
while they were anesthetized for routine medical
procedures.
Section 4: Contingent Disabilty
Section 4 of the Twenty-Fifth Amendment provides for
instances of contingent presidential disability. It covers
instances of presidential disability or inability that differ
from, and arguably are more potentially complex and
problematic than, those addressed in Section 3.

Some of the differences between the two sections are
notable. Section 3 can be activated only by the President,
whereas the disability initiation element of Section 4 can be
implemented only by the Vice President and either (1) a
majority of the Cabinet, or (2) a majority of such other
body as Congress may by law provide. This envisioned
body will be identified in this publication as the Disability
Review Body (DRB). Section 3 was designed to be invoked
either in anticipation of presidential inability, or as a
response to a disability, whereas Section 4 was intended by
the amendment's sponsors to be activated only in response
to a presidential disability. Section 3 assumes that the
President is fully aware and competent, and capable of
declaring his disability, whereas Section 4 assumes that the
President, for whatever reason, is unable or unwilling to
declare an obvious disability, and that he or she cannot or
will not step aside for its duration.
Section 4's complexity and concern about its potential for
misuse have raised questions among some observers that it
could be implemented for political purposes. During debate
on the amendment, its authors and proponents largely
rejected such claims. They insisted the section was not
intended to facilitate the removal of an unpopular or failed
President, in support of which they cited checks and
balances incorporated in the amendment that were designed
to prevent abuse of the procedure. To date, Section 4 has
not been implemented.
Section 4: Actions
Section 4 authorizes four potential procedures:
(1) a joint declaration of presidential disability by the Vice
President and a majority of the Cabinet or such other body
(i.e., DRB) as Congress has established by law. When they
transmit a written message to this effect to the President pro
tem and the Speaker, the Vice President immediately
assumes the powers and duties of the office as Acting
President;
(2) a declaration by the President that the disability invoked
under the provisions set out above no longer exists. If the
President's declaration is not contested by the Vice
President and the Cabinet or DRB within four days, then
the President resumes the powers and duties of the office;
(3) the Vice President and a majority of the Cabinet or
DRB, acting jointly, may, however, contest this finding by
a written declaration to the contrary to the aforementioned
officers. As noted previously, this declaration must be
issued within four days of the President's declaration;
otherwise, the President resumes the powers and duties of
the office;