There is a surprising amount of pushback on the idea that the President should hand over his powers to the Vice President while on Dexamethasone. Many physicians would argue that the risk of an adverse reaction is low and therefore do not routinely take any precautions with ordinary people who are discharged on these medications.
But they neglect to consider the difference in magnitude of the risks between an ordinary person having an adverse reaction and the POTUS having a reaction.
It is rational to increase one's efforts to avoid low probability bad events as the bad events become more catastrophic. For example, you may routinely drive 10 miles per hour over the speed limit knowing that the risk of an accident is low and if you do have an accident you are most likely to sustain only minor injuries. But if your car were wired to explode in the event of even a minor fender bender, you would probably change the way you drive--and you may not drive except under the most exceptionally pressing situations.
It turns out that medicine recognizes this. There are a whole host of medical therapies which are considered no big deal for ordinary people, but which should not be given to commercial pilots. Why? If a commercial pilot has a problem, the consequences are much more grave than if an ordinary person has a problem. Physicians who work in aviation medicine understand that the level of caution that should be exercised with pilots exceeds, by a rather large degree, the level of caution that should be exercised with the general public.
The FAA has actually issued guidelines about commercial pilots and steroids. They recommend no more than 20mg per day of Prednisone, and state that airmen should be advised not to fly on doses higher than this : https://www.faa.gov/about/office_org/headquarters_offices/avs/offices/aam/ame/guide/pharm/dni_dnf
That raises the question: should doctors be more or less risk averse with the President of the United States (a man with his hands on the nuclear codes) than they would be with a commercial pilot. Is the number of people who can be harmed by a poor decision made by POTUS greater or lesser than that which can be harmed by a commercial pilot?
The answer is clear to me: With the POTUS, the magnitude of risk is far greater than the risk is in a commercial pilot. If one cannot fly a plane because of the potential neuropsychiatric side effects of a medication, one should not hold or exercise the powers of the presidency.
The President of the United States is on a medication that would ground a commercial pilot because physicians think the risks of psychiatric disturbances are too great for the pilot. This is unacceptable.