Photograph Source: Office of Speaker Mike Johnson – Public Domain

Our concern with the politics, policies, and propaganda of Donald Trump underplays the central question of his presidency: Is Donald Trump psychologically fit to be president of the United States? In Trump’s first term, psychiatrists and psychologists warned that our dangerously disordered president was a threat to domestic and international security. The erratic behavior of Trump as a candidate in 2015-2016 and as a president in 2017-2021 led to the ethical principle known as the “duty to warn” of the danger he represented.

Trump’s malignant narcissism was well established in his first term as he claimed that he knew more than anyone else and that only he could fix our problems. Trump’s demonization of the press and his opponents as well as his treatment of minorities and his handling of immigration issues pointed to paranoia. His separation of immigrant families demonstrated the lack of empathy that accompanies narcissism. His lack of impulse control was particularly worrisome in a nuclear age that presents no real checks and balances on a commander-in-chief’s role regarding the use of nuclear weapons. It is the combination of paranoia and impulse control that is most worrisome because it can lead to destructive acts.

As a result of his performance as president, Trump faced an unusual level of public criticism from his own appointees, including chief of staff John Kelly, secretary of state Rex Tillerson, national security adviser H.R McMaster, and even director of national intelligence Dan Coats. The criticism by Tillerson, McMaster, and........

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