Scrutiny grows over Trump competence – but can an unfit president be removed?

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Donald Trump looked out across the White House ballroom at his audience of wealthy donors and business figures – people who had given millions of dollars to his extravagant plan to build a vast ballroom attached to the building’s East Wing.

The president, 79, told the crowd he had enjoyed a “really historic trip” to the Middle East, and indulged in some of his familiar patter: saying his tariffs were successful, and claiming that under Joe Biden, countries were “literally emptying out insane asylums into our country”.

As his speech, given last Wednesday, labored on, Trump turned to ballroom specifics.

He said: “So I just wanna say, thank you all. Uh, simply, behind me, so, is a knockout panel. This panel, the next time you come here, will be opened up and gone. No – uh, no problem with any of the surrounding areas. These, this room will be fixed. This will be like a cocktail – the whole floor will be cocktails or pre-briefings or whatever it may be, lots of different things. So the entire floor. So you come in, the entire floor sets up. We didn’t have to do any of that. Usually, you have to do that. You need different rooms to go along with a ballroom.”

The speech, with its confusing false starts and repeated tangent-veering, was typical of many addresses Trump, the oldest person to be inaugurated president, has given recently. The president frequently appears to lose his train of thought, before retreating to the verbal safe ground of repeating frequently incorrect claims about the current success of the US.

Republicans seem happy to ignore Trump’s odd speeches and claims. But his performances in public settings, whether a lengthy soliloquy about how former president Barack Obama walks down the stairs – “Da da da da da da, bop, bop, bop,” Trump told a room full of generals in September – or his treaties about water pressure – “The water’s dripping out and that’s no good for me. I like this hair lace and [sic] – I like that hair nice and wet,” the president said at a roundtable discussion about immigration in July – has slowly begun to raise questions from experts, Democrats, and the general public.

Among those: what guardrails exist to remove an impeded commander-in-chief from office?

“The system is really set up to protect the president. It’s really hard to get rid of a president between elections,” said Brian Kalt, a professor at Michigan State University College of Law and author of Unable: The Law, Politics, and Limits of Section 4 of the Twenty-Fifth Amendment.

There are essentially two ways a US president could be removed from office: through impeachment and conviction by the Senate, and through the aforementioned section 4. No president has ever been removed by either measure – although three presidents have been impeached: including Trump, twice.

A simple majority of the House of Representatives has to vote to impeach a president for “treason, bribery, or other high crimes and misdemeanors”, and the president is then tried in the Senate, where a two-thirds majority is required to convict. In 2021, 57 of the 100 senators voted to impeach Trump – 10 short of the 67 votes required.

Given there are 53 Republican senators, it is hard to imagine Trump being convicted and removing office.

That leaves section 4 of the 25th amendment, designed to be used when a president is “unable to discharge the powers and duties of his office”. This month, JB Pritzker, the governor of Chicago, who has repeatedly clashed with Trump, called for the amendment to be invoked against the president, claiming “there is something genuinely wrong with this man”.

It came as Trump bizarrely reposted to Truth Social an AI-generated fake video which featured himself making an announcement about “med-bed hospitals”, and after he spoke confusingly of “certain elements of genius that can be given to a baby” during a speech at the White House.

Speaking about grants awarded to investigate autism, Trump added: “They have to move quickly. They, they – when the alternative is that nothing bad can happen, let’s do it now. I was just saying to Bobby [health secretary Robert F Kennedy Jr] and the group, let’s do it now. Nothing bad can happen, it can only good happen.”

The examples keep coming. At a press conference last week Trump repeated himself several times when talking about immigration, in one case appearing to become confused on the issue of so-called legal immigration.

“We’ve got the strongest border of anybody – nobody has a border. We have a border where the numbers just came out again, you saw zero people came in illegally. Now we do take people into our country legally, but zero people,” Trump said. Approximately 7 million people entered the US from abroad during the first three months of 2025 alone.

Section 4 of the 25th amendment is designed for when a president is “not just doing a bad job, but not doing anything at all – like can’t function”, Kalt said. For it to be invoked, JD Vance and a majority of Trump’s cabinet would have to agree that Trump is unable to perform the duties of president. But even then, Trump could disagree, which would force a vote in the House and the Senate. A two-thirds majority in both would be required to remove the president – a higher bar than impeachment. Kalt said it’s a deliberately high bar.

“It’s not just about protecting the president, although that is the most direct manifestation of it. It’s really about protecting the system of elections. So once the people elect a president, it’s supposed to be four years before they get to say anything again – their choice is respected, is put in place,” Kalt said.

Despite the White House claiming earlier this year that Trump’s “mental sharpness is second to none”, the examples of unusual behavior keep stacking up. There was an incident this summer where Trump invented an entire story about his deceased uncle having met the Unabomber. The time in July when he went on a sudden rant about windmills driving whales “loco”, during a meeting with the European Commission president. The occasion when he derailed a cabinet meeting by talking, unprompted, for 13-minutes about the decor of the room.

Last month, Democratic congresswoman Madeleine Dean made national news after she confronted Republican House speaker Mike Johnson in an exchange about Trump’s health recorded by MSNBC.

“The president is unhinged. He is unwell,” Dean told an uncomfortable-looking Johnson. His reply was a strong indicator that there is zero appetite among Republicans to subject their leader to scrutiny.

“A lot of folks on your side are too,” Johnson said.

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