Which presidents have used Section 3 of the 25th Amendment and in what circumstances?
Executive summary
Section 3 of the 25th Amendment — the president’s power to declare a temporary inability and hand authority to the vice president — has been used in modern practice for planned medical procedures by three presidents: Ronald Reagan in 1985, George W. Bush (twice during his terms), and Joe Biden in 2021, with debate in the record about whether Reagan’s action was formal or procedural [1] [2] [3] [4].
1. Ronald Reagan — the 1985 colonoscopy episode and a debate over formality
President Ronald Reagan underwent a colonoscopy under anesthesia on July 12, 1985, and the administration used the template of Section 3 to transfer duties to Vice President George H. W. Bush while Reagan was incapacitated by anesthesia, though some official accounts and later commentary differ on whether Reagan’s letters constituted a formal invocation or an informal use of the Section 3 procedure (Reagan Library posts describe the intent and use of the form but note Reagan “decided not to officially invoke Section 3” while still following its steps) [1] [3] [5].
2. George W. Bush — two acknowledged transfers for routine procedures
George W. Bush invoked Section 3 twice to temporarily transfer presidential powers and duties to Vice President Dick Cheney while Bush underwent routine medical procedures requiring anesthesia, with public notifications and formal letters transmitting the president’s inability and later his resumption of duties; these actions are recorded by the presidential libraries and constitutional overviews as clear examples of Section 3’s intended use for planned incapacity [2] [1] [4].
3. Joe Biden — a modern instance during a brief procedure in 2021
President Joe Biden invoked Section 3 to enable Vice President Kamala Harris to serve as Acting President while Biden underwent a brief medical procedure in November 2021, a formal transmission documented in public reporting and summarized by constitutional explainer resources as an ordinary, procedural use of Section 3 for temporary medical incapacity [2] [3] [4].
4. Who else considered Section 3 (or 4) but did not use it
Several presidents and White Houses have contemplated invoking Section 3 or its more fraught sibling Section 4 without completing the formal steps — historians and the Constitution Annotated note that Dwight D. Eisenhower’s precedent informed later practices, and that administrations including those of George H. W. Bush, Bill Clinton, Barack Obama and Donald Trump considered the mechanism at various times without formal invocation; Section 4, which allows the vice president and Cabinet to declare a president incapacitated, has never been invoked [5] [4] [6].
5. Counting instances, legal context and conflicting tallies
Authoritative sources agree that Section 3 exists to cover voluntary, anticipated, or short-term incapacity and that it has been used around medical procedures, but they differ slightly on counting: some official lists and the American Presidency Project enumerate every formal transmission and list all vice presidents who served as acting president under the amendment, while explanatory outlets sometimes summarize “three presidents” or “three uses” depending on whether Reagan’s 1985 maneuver is classified as formal or informal and whether George W. Bush’s two uses are counted as separate invocations [7] [3] [4] [2].
6. The practical pattern and the unanswered questions
The demonstrable pattern is narrow and routine: modern presidents have invoked Section 3 to cover brief, planned medical incapacities so the vice president is the acting president during anesthesia; the record relies on White House transmissions and presidential libraries for verification, and where sources disagree — notably on the formality of Reagan’s 1985 letters — reporting flags that ambiguity rather than invent certainty [1] [3] [4].