The Owen/Russell thesis on the impact of mental illness on political leaders is considered. The importance of the issue is acknowledged. Using the examples of President Kennedy and the Shah of Iran it is argued that what constitutes good decision-making is contingent on circumstances and evaluated by outcomes. There are often alternative explanations to mental impairment for poor decision-making, and that hubris is not the only possible failing. Last, democratic systems have better mechanisms than authoritarian regimes to address the problems posed by leaders who are physically or mentally ill.
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