At some point, the cognitive competency of the commander in chief is a matter of constitutional as well as medical concern. The 25th Amendment establishes protocols for the transfer of power in the event a president can’t carry out the duties and powers of office. When a president becomes impaired but is unable—or unwilling—to recognize the incapacity, Section 4 is invoked. It allows the vice president and a majority of the cabinet to determine that the vice president should carry out the duties of the presidency until the president regains the ability. It has never been put to use.