WASHINGTON -- A commission headed by former top government officials called today for a greater role for presidential physicians in determining whether a chief executive should be replaced temporarily by a vice president.
The commission said in a 32-page report that such a need was shown by the failure of White House aides to consult adequately with the presidential physician during President Reagan's emergency surgery after the March 30, 1981, attempt on his life and at the time of his July 1985 cancer surgery.
The 13-member panel, established in 1985 by the Miller Center of Public Affairs at the University of Virginia, was chaired by former Attorney General Herbert Brownell and former Sen. Birch Bayh, D-Ind., the two primary authors of the Constitution's 25th Amendment on presidential disability.
The commission, which included retired Chief Justice Warren Burger, found the White House ill-prepared to deal with the question of presidential disability when the assassination attempt took place two months into Reagan's first term.
Though Reagan underwent surgery, he did not officially transfer powers and duties temporarily to Vice President George Bush. Such delegation is allowed by the 25th Amendment, ratified in 1967, which provides for a president to notify the Senate president pro tem and the House speaker that he is unable to perform his duties.
'The White House physician was not consulted by the White House staff before the emergency surgery following the attempted assassination, although he was inside the hospital,' the commission reported.
Dr. Daniel Ruge, Reagan's personal doctor at the time of the assasssination attempt, testified before the commission that consideration of using the 25th Amendment 'never occurred to me.'
Likewise, Fred Fielding, the White House counsel at the time of the shooting, said he had his staff working on an emergency book covering steps to be taken in the event of the president's disability but, 'I state to you in all candor that it was not completed (when Reagan was shot).'
Fielding added that when he met later in the day with Cabinet members, 'To be very frank with you ... when I mentioned the 25th Amendment, I could see eyes glazing over in some parts of the Cabinet. They didn't even know about the 25th Amendment.'
Before Reagan's 1985 colon cancer surgery, the commission said, 'The White House staff received inadequate medical information or chose to ignore the information it did receive.'
Though Reagan claimed he was not invoking the 25th Amendment when he turned over temporary control to Bush at the time of the surgery, the commission concluded that this did constitute use of the provision.
The panel recommended that during the transition period between this year's election and the presidential inauguration, the new president, vice president, presidential physician, chief of staff and president's spouse get familiar with the amendment and determine what procedures would be followed in the event of an emergency, a planned procedure or routine medical treatment.
'Most certainly,' the report said, '(the amendment) should be invoked for any surgical procedure involving the use of anesthesia, narcotics and other drugs which alter cerebral function.'
In determining whether a president is fit to resume office, 'consideration must be given to anything that impairs mental capacities,' it advised.