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Designated survivor: What happens if the President of the United States falls ill?

Mount Rushmore
What is the protocol if the leader of the free world is taken ill? Dr Trevor McCrisken from the University of Warwick’s Department of Politics and International Studies looks at what could happen.

In the US, if the President dies, resigns or is removed from office by impeachment then constitutionally the Vice President becomes President for the rest of that presidential term. If the President becomes ill and it is judged by him or his Cabinet that he cannot continue with his duties, then the 25th Amendment to the US Constitution gives authority for the Vice President to become Acting President until the President recovers. So if Donald Trump contracts Coronavirus and becomes too unwell to work, then his Vice President Mike Pence would become Acting President. If Trump were to die in office, then Pence would become President until January 20, 2021. If Pence became President (rather than Acting President) before November 3, then he would most likely also become the Republican candidate in the presidential election.

Eight times in US history, a president has died or been killed while in office and been replaced by his Vice President, perhaps most famously when the assassinated Abraham Lincoln was succeeded by Andrew Johnson; Harry Truman became president after Franklin Roosevelt died shortly before the end of World War II; and Lyndon Johnson was sworn in as president after John F. Kennedy was killed in Dallas in 1963. Most recently, Vice President Gerald Ford became US President in August 1974 when Richard Nixon resigned before he could be impeached over the Watergate scandal.

It is possible, of course, that illness or some other tragedy or scandal could befall both the US President and their Vice President so the US Constitution gave power to the US Congress to determine the succession should both of the White House leaders become incapacitated or die in office. The 1947 Presidential Succession Act, which was last revised in 2006, established who would become President after the Vice President, provided the person holding that office is eligible to be president - they must be a "natural born citizen" of the US, been resident in the US for 14 years, and be 35 or older. Third and Fourth in line to be US President are two high ranking members of the Congress itself: Speaker of the House of Representatives, followed by the President Pro Tempore of the Senate. The list then goes through the 15 Cabinet level officers in the US Executive Branch starting with the Secretary of State and ending with the Secretary of Homeland Security.

The line of succession has caused some confusion at times. On March 30, 1981, when President Ronald Reagan was hospitalised after he was shot in an assassination attempt, Secretary of State Alexander Haig famously told the White House Press Corps that he was next in line after Vice President George H. W. Bush and that "I'm in charge here" while he waited for Bush to return to the White House. In fact, he was only 4th in line for the presidency after congressional leaders Tip O'Neill and Strom Thurmond.

In the current situation, it is unlikely that the President and the Vice President would both die at the same time as a result of Coronavirus. If Pence did become President it is likely he would appoint a new Vice President, with congressional approval, who would then become 2nd in the line of succession. If that had not happened in time and the succession passed to the Speaker of the House, however, then there could be a constitutional crisis as the Republican Party would no doubt furiously oppose their Democratic Party nemesis Nancy Pelosi, the current Speaker, becoming President even if it were in an acting capacity.

There are sometimes risks to the succession that need to be mitigated. During times of major crisis such as the September 11, 2001 terrorist attacks or at times when the whole of the US government gathers together in one place such as a Presidential Inauguration or the annual State of the Union address, at least one member of the President's Cabinet is taken to a secure location away from the main event. If the President, Vice President, Speaker of the House, Senate Pro Tempore, and all the Cabinet members were killed at once, then this so-called "designated survivor" would become President.

It seems unlikely that a designated survivor has been named from among the cabinet members currently, but if infection was to begin spreading through Trump's Cabinet it is possible that any member who tested negative for coronavirus might then be placed in complete isolation to enable them to emerge as Acting President or indeed President should everyone else in the line of succession become incapacitated or die.

Suddenly the storylines of the Kiefer Sutherland TV series Designated Survivor are seeming less far-fetched and unimaginable....



31 March 2020

Updated 2 October 2020


Dr Trevor McCriskenDr Trevor McCrisken is Associate Professor of US Politics and International Studies at Warwick. His research interests are in United States foreign policy and US politics and culture.

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