Goldwater Rule Is Challenged But Still Active

It’s recently been reported (Stat News) that members of a “psychiatry group” were informed via email that the Goldwater Rule may not have to stand firm in these troubling times: “We don’t want to prohibit our members from using their knowledge responsibly.” In other words, if so inclined, go ahead and speak openly about your views regarding the president’s state of mind.

The group in question, however, was not the creator of the Rule, the American Psychiatric Association (APA), but the American Psychoanalytic Association (APsaA), a much smaller body (3500 members versus 37,000) who represent all mental health disciplines, not just psychiatry.

A clarification from APsaA (per Mark Joyella, Forbes) included the following:

…(O)ur leadership did not encourage members to defy the ‘Goldwater Rule’ which is a part of the ethics code of a different mental health organization, the American Psychiatric Association (APA).

Rather, it articulated a distinct ethics position that represents the viewpoint of psychoanalysts…(W)e feel that our concepts and understanding are applicable and valuable to understanding a wide range of human behaviors and cultural phenomenon.

Whether or not this leads to hearing from more mental health professionals about Trump remains to be seen. But it’s not as though the Goldwater Rule hasn’t been bent or broken by many already, and as Jesse Singal, The Cut, notes, it seems no one’s ever been punished for doing so.

This has led to an unfortunate situation in which the only psychiatrists truly gagged by the rule are those who are conscientious enough to follow it in the first place. This probably skews the sample of psychiatrists willing to comment on Trump’s mental health so that it’s mostly those with relatively extreme opinions — that Trump is a clear and present danger to the republic, or that even bringing up the potential that he has mental-health problems is staggeringly out of bounds — taking part in the conversation.

“A more diverse range of voices would make that conversation more intelligent and less hysterical,” Singal argues. Perhaps the Goldwater Rule is a detriment. “Overall, given how emotionally charged the debate over Donald Trump’s strange, frequently abusive behavior is, it would be useful to have more expert voices participating — the benefits clearly outweigh the costs. The psychiatric establishment should follow the American Psychoanalytic Association’s defiant lead and retire the Goldwater Rule altogether.”

On the other hand, rebuts Susan MatthewsSlate“The Goldwater Rule Is Irrelevant”:

Singal is right about revoking the rule, but he’s wrong about why. Whether or not psychiatrists agree that Trump is a bad fit for the position of president of the United States is totally irrelevant to whether Trump gets to be president. The question around whether a diagnosis means anything now centers not on whether it will sway voters but on whether it could be used to implement the 25th Amendment, which asserts that the president can be removed from his position if he is deemed ‘unable to discharge the powers and duties of his office.’ Goldwater Rule or no, it is extremely unlikely that the 25th Amendment will be invoked, with or without a ‘real’ diagnosis, because it is not whether Trump has NPD that matters—it is whether those in power will stand up to him, and the answer to this is a resounding no

But nix the Goldwater Rule anyway, she adds, in order to improve general discourse regarding mental health. Mental illness alone, after all, doesn’t necessarily prevent good leadership. “And as many psychiatrists have in fact already argued, Trump’s true deficiencies center not around his possible mental impairments but around his potential and capacity for evil. To blame that on a mental disorder lets Trump off easy and does a disservice to those actually struggling with mental illness.”

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