By Andrea Estrada

When the President of the United States becomes physically or mentally ill or incapacitated, his condition impacts not only his immediate family and circle of advisors, but the country as a whole. His inability to act as an effective commander-in-chief can result in poor decision-making on his part or lead to other people within his administration—many of whom are appointed to their positions—making important decisions on his behalf.

In her new book “Presidential Leadership, Illness, and Decision Making,” Rose McDermott, professor of political science, examines the ways in which processes related to aging, physical and psychological illness, and addiction influence executive decision-making. She provides detailed case studies of four American presidents—Woodrow Wilson, Franklin Delano Roosevelt, John F. Kennedy, and Richard M. Nixon—and discusses how their physical conditions may have influenced foreign policy decisions and altered the course of history.

“Before Woodrow Wilson suffered a stroke in 1919 he had agreed to compromises regarding the League of Nations,” said McDermott. The League of Nations was an international organization founded as a result of the Treaty of Versailles. Its goals were to encourage disarmament and prevent war by means of collective security, settling disputes between countries through negotiation and diplomacy, and improving global welfare.

“Then he suddenly and inexplicably changed his mind. That meant the League of Nations Treaty was never passed in the United States Senate and the League of Nations never became the forum it was intended to be through which contentious issues could be taken up and discussed,” she said.

She was inspired to write about presidential leadership and illness after reading a similar book by political psychology experts Robert Robbins and Jerrold Post. While Robbins and Post concentrated on how illness and the associated changes in leadership affected domestic policy, McDermott wanted to examine their ramifications on international policy.

In addition to Wilson’s stroke and subsequent psychological and neurological limitations, McDermott examines FDR’s severe cardiac disease, including how it might have impacted his decisions and actions during the last two and a half years of World War II, more specifically regarding his decisions surrounding the conduct of war in the Pacific. His choice to follow a strategic plan developed by General Douglas MacArthur rather than the initial one he endorsed, by Admiral Chester W. Nimitz, led to a bloody series of island campaigns in the Pacific.

McDermott also discusses how John F. Kennedy’s various drug treatments, including the use of steroids to treat his Addison’s disease as well as narcotics and amphetamines for his chronic back pain, might have altered his behavior at the 1961 Vienna conference with Soviet premier Nikita Khrushchev. She also examines how Richard Nixon’s psychological impairments influenced his conduct in the Vietnam War, particularly his decisions regarding the covert bombing of Cambodia in 1969-70.

Finally, the book, published by Cambridge University Press, considers the 25th Amendment to the U.S. Constitution, which establishes procedures by which the vice president becomes acting president in the event of presidential impairment or disability.

McDermott is a specialist in political psychology as it relates to international relations. She is the author of “Political Psychology in International Relations” and “Risk Taking in International Relations: Prospect Theory in American Foreign Policy.”