Biden stepped down after questions about his health. Should he resign too?

The White House has been repeating for weeks that Biden’s high-profile debate flop was an outlier and that the president is still fit to serve. But administration officials, lawmakers from both parties and Democratic donors have raised questions about the president’s cognitive fitness, pointing to alarming moments in private when Biden appeared distant or confused, as well as his repeated gaffes in public.

Republicans on Sunday demanded that Biden resign.

“If Joe Biden is not fit to run for president, he is not fit to serve as president,” House Speaker Mike Johnson (R-La.) said in a statement. “He must resign immediately.”

Democratic leaders generally do not share that view. Lawmakers showered Biden with praise on Sunday, with several saying they had confidence in his leadership as president. Biden, who is recovering from a bout of COVID, has repeatedly said he was capable of both governing the country and campaigning for reelection.

“I’m good,” Biden said during a July 11 press conference after the NATO summit, adding that age “creates a little bit of wisdom if you pay attention.”

Andrew Bates, a White House spokesman, said Sunday that Biden would continue to focus on priorities like creating jobs and fighting abortion bans for the rest of his term. “He looks forward to finishing his term delivering more historic results for the American people,” Bates wrote in an email.

Some Democratic officials and allies have privately argued that Biden’s removal from office — and the immediate appointment of Vice President Harris to the White House — would give him additional power. political advantages in challenging Donald Trump.

Outside medical and policy experts said the campaign role — which required Biden to motivate voters, connect with donors and deliver speeches around the country — required a different set of physical and cognitive skills than the presidency, in which Biden is presented with decisions and surrounded by advisers. Some said Biden is equipped to serve out his term.

“The presidency is not a one-man show,” said Ezekiel Emanuel, a University of Pennsylvania bioethicist who advised the Biden administration on the COVID response and other health issues. “It’s an administration with the president as the boss and the ultimate decision-maker … and he has a very effective team around him that he knows, and they know him.”

David Grabowski, a professor at Harvard Medical School who specializes in aging, highlighted the difference between Biden’s ability to see out the remaining months of his presidency and his ability to continue doing so as an octogenarian.

“President Biden’s decision to end his candidacy is about his ability to serve for the next four and a half years,” Grabowski wrote in an email. “From an aging and health perspective, that is different than his fitness to serve today through the end of his current term. The two should be evaluated independently.”

Some of Biden’s aides and allies had insisted — as recently as Sunday morning — that he would not withdraw from the 2024 presidential race. But shifting political realities had complicated his re-election bid, with the president trailing Trump in polls in key states, while other Democrats were faring better in hypothetical showdowns with Trump.

While the 78-year-old Trump has had his own issues — confusing names, misrepresenting facts and delivering often-meandering speeches — voters have generally expressed more concern about Biden’s age than Trump’s. A CBS News/YouGov poll conducted last month found that 72 percent of registered voters believed Biden lacked the mental and cognitive health to serve as president, compared with 49 percent who said the same of Trump.

Biden was last examined by a team of medical specialists earlier this year, according to a summary released in February by Kevin O’Connor, Biden’s longtime physician. The doctors concluded that Biden was “a healthy, active, robust 81-year-old man who remains fit to successfully perform the duties of the presidency,” O’Connor wrote.

The specialists ruled out neurological conditions such as stroke and Parkinson’s disease, though they noted that Biden had developed an increasingly stiff gait and appeared to have peripheral neuropathy — a form of weakness or nerve damage — in both feet. Kevin Cannard, a neurologist who specializes in movement disorders such as Parkinson’s disease, was among the doctors who examined Biden as part of that evaluation.

Biden’s performance in his June 27 debate against Trump — in which the president struggled to explain some of his core policies and repeatedly stumbled over his words — raised concerns among Democrats, as well as health experts who feared a deeper medical problem. Three former members of the White House medical unit who had previously cared for Biden told The Washington Post that they believed the president should undergo a cognitive screening given his troubled debate performance.

Biden had repeatedly refused to take a cognitive test, telling reporters he is tested “every day” on his fitness to serve because of the duties of the presidency, but he showed signs of softening his stance during the July 11 press conference.

“I’m not opposed,” Biden said at the news conference. “If my doctors tell me that they — I need to have another neurological exam, I’ll do it.”

Biden’s physical and verbal stumbling has worried lawmakers, administration officials and top donors who have spoken to him privately in recent months. They said he has become visibly frail, sometimes requiring physical assistance climbing stairs or moving across a room. The lifelong politician known for his long, unforced speeches has become increasingly difficult to hear and understand.

Biden occasionally seems to freeze or veer off topic. Some said they could easily ignore those examples before the debate, but now they wonder if he can do the job for another four years.

The campaign has laid bare those weaknesses. Donors in recent weeks — including actor George Clooney — have said Biden appeared weak, tired or confused in their brief sessions, leading to calls to withdraw his reelection bid.

A Democratic donor, who met Biden in small gatherings at the White House early in his presidency and spoke on condition of anonymity to speak candidly about the president’s fitness to serve, recalled meeting Biden at a fundraising event this year.

“He was different than I had experienced him in the White House,” the donor said, adding that Biden’s behavior in a private fundraiser was similar to his performance at the debate. The president was “quieter,” his remarks trailed off and he was “staring off into space.”

“He felt like an old man,” the donor said.

White House officials who work with the president regularly and accompany him on foreign trips said that while Biden may be moving slower and looking older, they see no signs of mental decline. They say his physical aging does not affect his ability to continue as president.

“I think two things can be true: He is fully capable of serving the rest of his term as president, but it is not realistic to expect him to serve vigorously for another four years,” said Jonathan Reiner, a cardiologist and professor of medicine and surgery at the George Washington School of Medicine and Health Sciences. “I do think it would be appropriate for a formal statement from the White House medical team affirming presidential capacity.”