No one who watched the presidential debate last month can seriously think that President Biden is at the top of his game. It would be a deeply unfair expectation — he will turn 82 two weeks after Election Day, and he has been in elected office almost continuously for more than half a century.

Even so, the president looked unsteady. He is the same age as Carole King and Martin Scorsese, who both seem much more vibrant. Several times, Biden lost his train of thought and jumbled his words. The arguments made by his defenders, that it was an isolated incident or that he was jet-lagged or overprepared, are simply not credible. Unsurprisingly for a man in his eighties, Biden is obviously suffering from some degree of cognitive impairment.

The American Psychiatric Association’s “Goldwater Rule” rightly states that it is “unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.” It is wrong, on that basis, for a clinician, or anyone else really, to diagnose the nature and degree of Biden’s affliction.

That said, something is wrong. And while the president’s supporters may deny it, it is now widely rumored that foreign........

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