The “Goldwater Rule” is a gentleman’s agreement between members of the American Psychiatric Association which “prohibits psychiatrists from offering opinions on someone they have not personally evaluated.” It was put in place during the 1964 candidacy of Barry Goldwater after Fact magazine surveyed more than twelve thousand mental-health professionals and found that nearly half of those who responded said the candidate was mentally unfit of office.

On Monday, after several interviews published by Bloomberg, Face the Nation, and the SiriusXM radio network — including one in which he questioned the need for the Civil War and suggested Andrew Jackson could have prevented it — a senior GOP aide offered his own evaluation of the president: “He just seemed to go crazy today.”

Impeachment is the formal way out of this mess, but there’s another loophole that doesn’t require an act of Congress: The 25th amendment, in which insanity, incompetence, or really any inability to do the job are all reasons to remove the president. It’s an amendment that could be put in motion by Trump’s own administration, if they so chose.

Evan Osnos, in his latest article for The New Yorker, “How Trump Could Get Fired,” lifts a curtain on the history of presidential incapacity. Franklin Pierce, grieving after the death of his son in a train accident,  was “morose and often drunk” in his final year in office, “unable to defuse the tensions that precipitated the Civil War.” Lyndon B. Johnson showed signs of “profound paranoia” during the Vietnam War, when he “imagined conspiracies involving the Times or the United Nations or élites whom he called ‘those Harvards.’ He took to carrying, in his jacket pocket, faulty statistics that he recited about ‘victory’ and troop commitments in Vietnam.”

But there was only one administration that considered invoking the amendment, when a beloved Republican idol, then the oldest person to hold the office, began to forget simple words, stopped reading memos, and preferred to watch television than work.

In 1987, at the age of seventy-six, Ronald Reagan was showing the strain of the Iran-Contra scandal. Aides observed that he was increasingly inattentive and inept. Howard H. Baker, Jr., a former senator who became Reagan’s chief of staff in February, 1987, found the White House in disarray. “He seemed to be despondent but not depressed,” Baker said later, of the President.

Baker assigned an aide named Jim Cannon to interview White House officials about the Administration’s dysfunction, and Cannon learned that Reagan was not reading even short documents. “They said he wouldn’t come over to work—all he wanted to do was watch movies and television at the residence,” Cannon recalled, in “Landslide,” a 1988 account of Reagan’s second term, by Jane Mayer and Doyle McManus. One night, Baker summoned a small group of aides to his home. One of them, Thomas Griscom, told me recently that Cannon, who died in 2011, “floats this idea that maybe we’d invoke the Constitution.” Baker was skeptical, but, the next day, he proposed a diagnostic process of sorts: they would observe the President’s behavior at lunch.

In the event, Reagan was funny and alert, and Baker considered the debate closed. “We finish the lunch and Senator Baker says, ‘You know, boys, I think we’ve all seen this President is fully capable of doing the job,’ ” Griscom said. They never raised the issue again. In 1993, four years after leaving office, Reagan received a diagnosis of Alzheimer’s. His White House physicians said that they saw no symptoms during his Presidency. In 2015, researchers at Arizona State University published a study in the Journal of Alzheimer’s Disease, in which they examined transcripts of news conferences in the course of Reagan’s Presidency and discovered changes in his speech that are linked to the onset of dementia. Reagan had taken to repeating words and using “thing” in the place of specific nouns, but they could not prove that, while he was in office, his judgment and decision-making were affected.

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