Abstract
In this viewpoint we consider brief case studies of four former Aotearoa New Zealand prime ministers whose poor health impaired their decision making. Two of them died in office-Michael Joseph Savage (leader for 1935-1940) and Norman Kirk (1972-1974)-while a third, Joseph Ward (1928-1930), died shortly after his resignation from his position. The fourth, Robert Muldoon (1975-1984), drank heavily at critical times during his prime ministership. We suggest that further New Zealand research on health-impaired leaders is justified, and discuss possible system improvements that can help to recognise when leaders become incapable or even need, if possible, to be removed from any position of authority.