President Donald Trump’s COVID-19 illness, and the treatments he received, raise serious concerns about the adequacy of the Twenty-Fifth Amendment to handle cases of transient presidential incapacity. This is particularly challenging when the president refuses to acknowledge any impairment and resists any attempt to constrain his powers, even temporarily.

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.