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From a legal point of view, if Giffords is unable to resume her duties in congress, what happens to her seat?
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The only direction in the Constitution is in Article 1, Section 2, Clause 4: "When vacancies happen in the Representation from any State, the Executive Authority thereof shall issue Writs of Election to fill such Vacancies."
There is no provision in the Constitution for removing members of Congress for being unable to perform their duties. Member of Congress remain such until the end of their elected terms unless they die, resign, accept an incompatible office, or are expelled.