Leader nuclear ‘red button’ concerns

When it comes to those who have the power to push "the big red button" and start a nuclear war, it has always been hoped that cool heads will prevail.

But a University of Otago study shows there is growing concern about the leaders of nuclear-armed nations around the world, and how their health may be affecting their decision-making.

The Doomsday Clock now sits at 89 seconds to midnight — the closest it has been to catastrophe since the Cuban Missile Crisis in 1962, when the United States and Russia were brought to the brink of nuclear war.

The closer it moves to midnight, the closer humanity is to the end of the world.

University of Otago (Wellington) public health researcher Prof Nick Wilson said the world was again perilously close to the edge and, given that many former leaders of the world’s nine nuclear-armed nations were impaired by health conditions while in office, there were concerns about their decision-making abilities while they had access to nuclear weapon launch codes.

Prof Wilson, fellow researcher Associate Prof George Thomson and independent researcher Dr Matt Boyd found many of the leaders had multiple serious health issues while in office, including dementia, personality disorders, depression and drug and alcohol abuse.

Their study analysed the health information of 51 deceased leaders of China, France, India, Israel, North Korea, Pakistan, Russia, the United Kingdom and the United States.

Prof Wilson said 15 leaders had confirmed or possible health issues which impaired their performance and likely hastened their departure.

In one case, Israeli Prime Minister Menachem Begin had severe depression and spent his last year as leader isolated in his home.

"Impairment during crises was also seen in the case of Richard Nixon’s bouts of heavy drinking, including during a nuclear crisis involving the Middle East."

He said there were also cases where health information about leaders had been kept secret, including United States President John F. Kennedy, whose aides concealed that he had Addison’s disease; and Ronald Reagan, whose administration hid the extent of his injuries after he was shot in 1981, and the likely signs of his dementia near the end of his term.

Prof Wilson said Mr Kennedy’s performance was likely impaired by Addison’s disease, back pain and his use of anabolic steroids and amphetamines in 1961 when he authorised the failed CIA-backed Bay of Pigs invasion of Cuba. In turn, Soviet leader Nikita Khrushchev’s poor mental health probably contributed to him triggering both the Berlin Crisis and the Cuban Missile Crisis.

And long-serving French President Francois Mitterrand clung to power until the end of his term in 1995, despite having advanced prostate cancer and his doctor concluding in late 1994 that he was no longer capable of carrying out his duties.

A study of members of the British parliament also found they were 34% more likely to experience mental health problems than other high-income earners due to the stress of the job.

Following the rise in international instability caused by the Russian invasion of Ukraine in 2022, it had become even more important to ensure there was good leadership and governance in those countries with nuclear weapons, Prof Wilson said.

"This is particularly the case for the United States, where a leader can in principle authorise the release of nuclear weapons on their own — a situation referred to as a ‘nuclear monarchy’."

He said there was a range of measures which could reduce global security risks from leaders whose judgement was in question.

They included removing nuclear weapons from "high alert" status, adopting "no first use" policies where nations only used nuclear weapons in retaliation, ensuring any weapon launches needed authorisation by multiple people and progressing nuclear disarmament treaties.

Requirements for medical and psychological assessments could be introduced for leaders before and during their terms, and democracies could also consider introducing term limits for their leaders, as well as recall systems, so voters could petition for politicians to step down, he said.