Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T13:28:29.569Z Has data issue: false hasContentIssue false
  • English
  • Français

Goldwater After Trump

Published online by Cambridge University Press:  27 October 2021

Jacob M. Appel  and
Akaela Michels-Gualtieri
Jacob M. Appel*
Affiliation:
Department of Psychiatry, Icahn School of Medicine Ichan School of Medicine, New York, USA
Akaela Michels-Gualtieri
Affiliation:
Brown University, Providence, Rhode Island, USA
*
*Corresponding author. Email: jacobmappel@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

The “Goldwater rule,” a policy adopted by the American Psychiatry Association (APA) in 1973, prohibits organization members from diagnosing or offering professional opinions regarding the mental health of public figures without both first-hand evaluation and authorization. Initially developed in response to a controversial survey of APA members during the 1964 Presidential election campaign, the ethics rule faced few large scale challenges until the election of Donald Trump in 2016. Since that time, a significant number of psychiatrists have either violated or criticized the rule openly. This paper argues that whatever the initial merits of the rule, the prohibition has since been rendered obsolete by the combined lack of professional consensus supporting the policy, absence of a meaningful enforcement mechanism, and the credible statements of non-APA members in the mental health professions regarding public figures.

Keywords

Goldwater rulepsychiatrypublic figures mental healthAmerican Psychiatric AssociationDonald Trumpmental health professionalismpsychiatric ethics
Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 30 , Issue 4 , October 2021 , pp. 651 - 661
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. American Psychiatric Association. The Principles of Medical Ethics: With Annotations Especially Applicable to Psychiatry. Washington, DC: American Psychiatric Association; 1993.

2. Borenstein S. Amateurs analyze Trump’s mind, but should the pros do it? Associated Press; 2016 August 11; available at https://apnews.com/article/cc8abb2128ef4497adffdab00481d2d7 (last accessed 24 Nov 2020).

3. Stone, AA. The ethical boundaries of forensic psychiatry: A view from the Ivory Tower. Journal of the American Academy of Psychiatry and the Law 2008;36(2):167–74Google Scholar.

4. Appelbaum, PS. Reflections on the Goldwater rule. Journal of the American Academy of Psychiatry and the Law 2017;45(2):228–32Google Scholar.

5. Trump, Procknow G., proto-presidency, and the rise of sane supremacy. Disability & Society 2017;32(6):913–7CrossRefGoogle Scholar.

6. Kroll, J, Pouncey, C. The ethics of APA’s Goldwater rule. Journal of the American Academy of Psychiatry and the Law 2016;44(2):226–35Google Scholar.

7. Heller S. Ralph Ginzburg, 76, publisher in obscenity case, dies. New York Times; 2006 Jul 7.

8. Writ to block Goldwater denied in California court. The Baltimore Sun; 1964 Sept 11.

9. Ginzburg R. Goldwater: The man and the menace. Fact; 1964 Sept/Oct;1(5).

10. See note 9, Ginzburg 1964.

11. See note 9, Ginzburg 1964.

12. Boroson W. What psychiatrists say about Goldwater. Fact; 1964 Sept/Oct;1(5).

13. See note 12, Boroson 1964.

14. See note 12, Boroson 1964.

15. See note 12, Boroson 1964.

16. See note 12, Boroson 1964.

17. Appel, JM. Prohibiting psychiatrist–patient sex: Roy v. Hartogs (1976). In: Ash P, ed. From Courtroom to Clinic: Legal Cases that Changed Mental Health Treatment. Cambridge: Cambridge University Press; 2019, at102–13 Google Scholar.

18. Goldwater v. Ginzburg 414 F.2d 324 (1969).

19. Post, JM. Ethical considerations in psychiatric profiling of political figures. Psychiatric Clinics of North America 2002;25(3):635-46CrossRefGoogle Scholar.

20. See note 12, Boroson 1964.

21. Northern Securities Co. v. United States, 193 U.S. 197 (1904).

22. Stone A. The Psychiatrist’s Goldwater Rule in the Trump Era. Lawfare [Internet]; 2018 Apr 19; available at https://www.lawfareblog.com/psychiatrists-goldwater-rule-trump-era (last accessed 23 Nov 2020).

23. Osnos E. How Trump could get fired. The New Yorker; 2017 May 8.

24. Post, JM. Ethical considerations in psychiatric profiling of political figures. Psychiatric Clinics of North America 2002;25(3):635–46CrossRefGoogle Scholar.

25. Friedman, RA. Role of physicians and mental health professionals in discussions of public figures. JAMA 2008;300(11):1348–50CrossRefGoogle Scholar.

26. See note 25, Friedman 2008.

27. Friedman RA. How a telescopic lens muddles psychiatric insights. The New York Times; 2011 May 23.

28. See note 25, Friedman 2008.

29. See note 27, Friedman 2011.

30. See note 19, Post 2002.

31. Alford H. Is Donald Trump actually a narcissist? Therapists weigh in! Vanity Fair; 2015 Nov 11.

32. See note 31, Alford 2015.

33. Blake A. The American Psychiatric Association issues a warning: No psychoanalyzing Donald Trump. Washington Post; 2016 Aug 7.

34. Transcript of the Duty to Warn Conference Yale School of Medicine [Internet]; 2017 Apr 20; available at https://static.macmillan.com/static/duty-to-warn-conference-transcript.pdf (last accessed 23 Nov 2020).

35. See note 34.

36. Lee BX, Glass LL. We’re psychiatrists. It’s our duty to question the president’s mental state. Politico; 2018 Jan 8; available at https://www.politico.com/magazine/story/2018/01/10/were-psychiatrists-its-perfectly-healthy-to-question-the-presidents-mental-state-216266 (last accessed 24 Nov 2020).

37. See note 36, Lee, Glass, 2018.

38. American Psychiatric Association Ethics Committee Opinion; 2017 Mar 15.

39. APA reaffirms support for Goldwater rule. American Psychiatric Association [Internet]; 2017 Mar 16; available at https://www.psychiatry.org/newsroom/news-releases/apa-reaffirms-support-for-goldwater-rule (last accessed 23 Nov 2020).

40. Report of the Council on Ethical and Judicial Affairs. American Medical Association; available at https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/hod/i17-refcomm-conby.pdf#page=41 (last accessed 24 Nov 2020).

41. See note 4, Appelbaum 2017.

42. Frances A. We must not confuse Trump’s bad behavior with mental illness. The BMJ Opinion; 2017 Aug 25; available at https://blogs.bmj.com/bmj/2017/08/25/allen-frances-we-must-not-confuse-trumps-bad-behavior-with-mental-illness/ (last accessed 24 Nov 2020).

43. Lieberman, JA. Psychiatrists diagnosing the President—Moral imperative or ethical violation? New England Journal of Medicine 2018;378(5):483–4CrossRefGoogle Scholar.

44. Martin-Joy, J. Introduction to the special section on the Goldwater rule. Journal of the American Academy of Psychiatry and the Law 2017;45(2):223–7Google Scholar.

45. Redinger MJ, Gibb TS, Longstreet PL. Journal of the American Academy of Psychiatry and the Law 2016;44(3):407–8.

46. See note 6, Kroll, Pouncey 2016.

47. Kroll, J, Pouncey, C. Prudence, not silence. Journal of the American Academy of Psychiatry and the Law 2016;44(3):408–9Google Scholar.

48. Begley S. Psychiatrists call for rollback of policy banning discussion of public figures’ mental health. Scientific American; 2018 Jun 28; available at https://www.scientificamerican.com/article/psychiatrists-call-for-rollback-of-policy-banning-discussion-of-public-figures-mental-health/ (last accessed 24 Nov 2020).

49. Glass LL. Dealing with American psychiatry’s gag rule. Psychiatric Times; 2017 Jul 20; available at https://www.psychiatrictimes.com/view/dealing-american-psychiatrys-gag-rule (last accessed 24 Nov 2020).

50. Psychiatrists denounce poll on Goldwater. Los Angeles Time; 1964 Oct 2.

51. Foolish and unethical. Chicago Tribune; 1964 Oct 16.

52. Doctors deplore Goldwater poll: Denounce Fact Magazine’s survey of psychiatrists. The New York Times; 1964 Oct 2, at 20.

53. @DrJlieberman. Twitter; 2019 Jan 4 1:25 AM; available at https://twitter.com/DrJlieberman/status/1081074093334691840

54. @AllenFrancesMD. Twitter; 2020 Sept 6 9:13 PM; available at https://twitter.com/AllenFrancesMD/status/1302777013372035072

55. Lee BX. Mental health experts urge revision of the Goldwater rule. Psychology Today; 2018 Jun 28; available at https://www.psychologytoday.com/intl/blog/psychiatry-in-society/201806/mental-health-experts-urge-revision-the-goldwater-rule?amp

56. See note 55, Lee 2018.

57. Stone A. The Psychiatrist’s Goldwater rule in the Trump era. Lawfare [Internet]; 2018 Apr 19; available at https://www.lawfareblog.com/psychiatrists-goldwater-rule-trump-era (last accessed 23 Nov 2020).

58. Lieberman JA. Trump’s Brain and the 25th Amendment. Vice; 2017 Sept 8; available at https://www.vice.com/en/article/wjjv3x/trumps-brain-and-the-25th-amendment (last accessed 24 Nov 2020).

59. Friedman RA. How a telescopic lens muddles psychiatric insights. New York Times; 2011 May 24, at Sect D:5.

60. Lake CR. This issue: Justification for breaking the Goldwater rule: Mass murderers’ diagnoses. Psychiatric Annals 2014;44(5):211–2.

61. Gerson JS. Will Trump be the death of the Goldwater rule? The New Yorker; 2017 Aug 23.

62. Fingar C. The silencing of psychiatry: Is the Goldwater rule doing more harm than good ahead of the US 2020 election? The New Statesman; 2020 Sept 22; available at https://www.newstatesman.com/world/2020/09/silencing-psychiatry-goldwater-rule-doing-more-harm-good-ahead-us-2020-election (last accessed 24 Nov 2020).

63. See note 6, Kroll, Pouncey, 2016.

64. Mitgang H. How a psychiatrist ‘analyzed’ Nixon. New York Times; 1977 Apr 7.

65. Martin-Joy, J. Diagnosing from a Distance. Cambridge: Cambridge University Press; 2020, at 166 CrossRefGoogle Scholar.

66. See note 65, Martin-Joy, 2020.

67. Kimball R. Time to scrap the Goldwater rule. The Spectator; 2020 Mar 10; available at https://spectator.us/time-scrap-goldwater-rule/ (last accessed 24 Nov 2020).

68. Trump M. Psychiatrists know what’s wrong with my uncle. Let them tell voters. Washington Post; 2020 Oct 22; available at https://www.washingtonpost.com/outlook/psychiatrists-mary-trump-goldwater/2020/10/22/ebf5e2b6-13c0-11eb-ba42-ec6a580836ed_story.html

69. American Psychological Association. Ethical principles of psychologists and code of conduct; 2017; available at http://www.apa.org/ethics/code/index.html

70. Grohol J. What the Media Get Wrong About the Goldwater Rule [Internet]; 2019 Apr 15; available at https://psychcentral.com/blog/what-the-media-get-wrong-about-the-goldwater-rule/ (last accessed 23 Nov 2020).

71. Romig R. What do we mean by ‘evil’? The New Yorker; 2012 Jul 25.

72. Martin N. Psycho with a ‘killer smile’. New York Post. 2011 Jan 11; available at https://nypost.com/2011/01/11/psycho-with-a-killer-smile/ (last accessed 24 Nov 2020).

73. Peyser A. Kill? She just ‘interrupted’ 5 tiny lives. New York Post; 2002 Feb 19; available at https://nypost.com/2002/02/19/kill-she-just-interrupted-5-tiny-lives/ (last accessed 24 Nov 2020).