Should doctors speak of their concerns about the mental health of a president?

Heads of state have a right to confidentiality about their personal health affairs.But decisions made by a head of state sometimes have life or death consequences for millions of people.Professional standards prohibit doctors from commenting on the health of a public figure.But recent events around the world raise the question: should that prohibition be absolute?In 2017, a group of mental health clinicians, led by John Gartner, a clinical psychologist, accused Donald Trump, president of the United States, of being "paranoid and delusional" and having "malignant narcissism." 1 They requested that the 25th Amendment to the US Constitution be invoked to remove him from office, adding: "We have an ethical responsibility to warn the public about Donald Trump's dangerous mental illness."