Purely playing devil's advocate.

It's down to those above in management to deal with this, up to and including firing them. Unfortunately, for an elected official, that boss is technically the voters. Until an election comes up, it's difficult to do anything about it.

In a functional system, there would be procedures in place for situations like this. America apparently doesn't have any, on the books, and the social based ones have long been discarded.

It's also worth noting the pressure should be the other way. We should all have more flexibility and safety, not taking it away from someone, no matter how much of an arsehole they are, as a person.

E.g. at a previous company I worked for, one of the guys got cancer. He intended to work as much as he could, and take unpaid leave when he couldn't. The CEO (previously the CFO) put him in his place. He was expected to take as much time as he needed to fight it. He was welcome to come in and work, but it wasn't expected. He was also kept on full pay. Unfortunately, the cancer won. Even then, they gave his widow 6 months of his pay, so she didn't have to panic about finances. This is the behaviour we should be expecting to anyone, not just the elite, or the lucky.