Rep. Ronny Jackson, a former White House physician, is calling for President Biden to undergo drug testing before his debate with former President Donald Trump on Thursday.

The Texas Republican, who served as the presidential physician from 2013 to 2018 under Presidents Barack Obama and Donald Trump, made the request in a letter to Mr. Biden and his current physician, Dr. Kevin O’Connor.

“[D]ebates have given the American public the opportunity to gain critical insight into specific policy positions held by individual candidates, to demonstrate each candidate’s leadership qualities and style, and to observe the candidates’ ability to perform in an unscripted and high-pressure environment,” Mr. Jackson said in a three-page letter to Mr. Biden and Dr. O’Connor, Fox News reported.

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Mr. Jackson’s call comes as Republicans continue to question the president’s cognitive abilities. He said that ensuring Mr. Biden is not under the influence of performance-enhancing drugs is vital for maintaining public trust.

“American citizens must have absolute confidence in their President’s ability to perform his or her duties as Head of State and Commander in Chief,” Mr. Jackson wrote. He emphasized that the debate performance should reflect an individual’s natural capabilities, free of any drug-induced enhancements.

Mr. Jackson’s concerns were further fueled by a recent Wall Street Journal report that noted that more than 40 people have questioned Mr. Biden’s mental acuity. Additionally, special counsel Robert Hur’s report suggested that a jury might view Mr. Biden as a “sympathetic, well-meaning, elderly man with a poor memory.”

“Americans watch with great concern as the president’s cognitive performance continues to decline,” Mr. Jackson wrote.