The Goldwater Rule

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Have you ever heard of the Goldwater Rule? There is no need to be concerned if you have not, unless you happen to be a psychiatrist practising in the US, in which case you are required to understand and comply with the American Psychiatric Association’s Code of Ethics. Section 7.3 of the Code states, in terms that are wholly unambiguous, that it is unethical for a psychiatrist to offer a professional opinion about the mental health of a public figure unless he or she has conducted an examination and has been granted proper authorization to make the statement. The rule was part of the first edition of the Code introduced in 1973 and its genesis lay in a controversy during the 1964 presidential election, when a magazine sympathetic to Johnson polled psychiatrists and then published an article that questioned the mental health of the Republican nominee Senator Barry Goldwater.

It hardly seems necessary to say that opining on the mental health of a person who has not consulted the psychiatrist, and whom the psychiatrist has not examined, and whose consent therefore has not been obtained, is utterly irresponsible and without question unethical, although to put the matter beyond any doubt the Goldwater Rule was introduced and has remained part of the Code ever since. It really isn’t possible for any psychiatrist that is currently or has recently practiced in the US to say that they are not aware of the Code, or the Goldwater Rule, which can only mean that the psychiatrists among 35 authors of an open letter to the New York Times that questions the mental health of the President have quite a bit of explaining to do, possibly before a disciplinary body. The letter, which is as an insidious piece of character assassination as you are ever likely to see, does the very thing that is expressly prescribed as unethical by the Goldwater rule, and concludes with the following:

‘ … We believe that the grave emotional instability indicated by Mr. Trump’s speech and actions makes him incapable of serving safely as president.’

The letter is the latest in a constant procession of nasty swipes at the President questioning his mental stability. While we can comfortably, and even derisively, ignore the cartoonish medical opinions of the myriad and wholly unqualified journalists, social workers and other assorted political flunkies who have sunk to such contemptible conduct, the psychiatrists who have put their name to the letter should not receive the same latitude. Writing such a letter in flagrant breach of the long-established ethical boundary contained in the Goldwater Rule is conduct worthy of investigation and sanction. When the statement is made for the purpose of politically stigmatizing the person concerned, the breach is egregious and squarely calls into question whether the professionals concerned can be trusted to responsibly practice medicine.

The MSM who gleefully report the unethical musings of these psychiatrists, and the unqualified opinions of the others, are ever keen to remind us of the ethical boundaries of journalism, usually in a vainglorious assertion of their own credibility, although you would be hard pressed to find any evidence of it in their conduct. It seems highly unlikely that the New York Times was not aware of the Code or the Goldwater Rule when it received and chose to publish the letter, and it is probably safe to assume that the temptation of yet another nasty slur against the President was simply irresistible to doyens of professional journalism and their much-touted impartiality.

The attacks on the President claiming he is mentally unstable are a new low, even in the context of one of the most vitriolic elections in American history, and the vituperative defamations of people who constantly tell us they represent the moral and intellectual high ground. Heaven help us if they do.

Photo by cliff1066™

  • Deplorable Steve

    It is no wonder that ‘intellectuals’ are the first to be rounded up after a revolution. They really do themselves no favours…

    • Karen Dwyer

      While there might be a certain wishful thinking that pseudo- intellectuals might quietly disappear (via implosion or, oh perhaps coming to their senses…) in our current political climate in Australia it is the writers of substance in the public sphere (like XYZ) who would disappear. Pseudo-intellectuals write propaganda as they are directed. Intellectuals think for themselves and inspire others to resist propaganda: never popular in a totalitarian state.

    • Intellectuals…that counts me out. I’m safe !

  • Gregoryno6

    From Literally Hitler to Insane in the three months since the election. The MSM are going to run out of accusations by Christmas. Before then, however: Satanist, Pedo, Vicious Landlord, Tightfisted Boss, Alien Beast – I’ve probably missed a few…

    • I’ve experienced a few of those in my lifetime…especially being the victim of a “tightfisted boss”.

    • Bikinis not Burkas

      Fair go they can’t regurgitate pedo, that has been the flavour of the months for years!

  • If a POTUS needs a rule to shield him from public criticism, he’s already in deep do-do.

    • entropy

      If you’re going to need someone to explain every article to you, it’s going to get tiresome very quickly.

      • Dan Flynn and 1735099 are the same person….trolling.

        • entropy

          He must sure love XYZ.

  • It is now being claimed that Trump has syphilis.
    What next ?
    The claims get crazier every day.

    • Gregoryno6

      According to the symptoms listed here, so have I.
      Questions were raised about Hillary’s health during the campaign, but there was something blatantly wrong with her head bobbing about and her collapse as she got into the limo. And she seems to be keeping a low profile presently…

  • Dan Flynn

    Hi BJ, I liked Psychiatrist Allen Frances’ response to the open letter that you refer to:
    To the Editor:

    Fevered media speculation about Donald Trump’s psychological motivations and psychiatric diagnosis has recently encouraged mental health professionals to disregard the usual ethical constraints against diagnosing public figures at a distance. They have sponsored several petitions and a Feb. 14 letter to The New York Times suggesting that Mr. Trump is incapable, on psychiatric grounds, of serving as president.

    Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder. I wrote the criteria that define this disorder, and Mr. Trump doesn’t meet them. He may be a world-class narcissist, but this doesn’t make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder.

    Mr. Trump causes severe distress rather than experiencing it and has been richly rewarded, rather than punished, for his grandiosity, self-absorption and lack of empathy. It is a stigmatizing insult to the mentally ill (who are mostly well behaved and well meaning) to be lumped with Mr. Trump (who is neither).

    Bad behavior is rarely a sign of mental illness, and the mentally ill behave badly only rarely. Psychiatric name-calling is a misguided way of countering Mr. Trump’s attack on democracy. He can, and should, be appropriately denounced for his ignorance, incompetence, impulsivity and pursuit of dictatorial powers.

    His psychological motivations are too obvious to be interesting, and analyzing them will not halt his headlong power grab. The antidote to a dystopic Trumpean dark age is political, not psychological.

    ALLEN FRANCES

    Coronado, Calif.

    The writer, professor emeritus of psychiatry and behavioral sciences at Duke University Medical College, was chairman of the task force that wrote the Diagnostic and Statistical Manual of Mental Disorders IV (D.S.M.-IV).

    • entropy

      You like defamatory accusations made in the absence of an argument, let alone evidence?

      Your motivation for pasting this is too obvious to be interesting (but I won’t tell you what it is), and analysing it will not halt your regressive behaviours (about which I will go into no further detail).

      • Dan Flynn

        ‘Most amateur diagnosticians have mislabeled President Trump with the diagnosis of narcissistic personality disorder’

        You remember our first conversation I suspect? I was one of those ‘amateur diagnosticians’ which you pointed out. So I guess you and Mr Frances agree on something.

        As you might have read, Mr Frances’ letter was in opposition to the original open letter from psychiatrists about Trump – which is agreeing, in part at least, with BJ. This was the main reason I posted this.

        Sure, Mr Frances does go on to express his displeasure about with Mr Trump which you clearly see as ‘defamatory accusations made in the absence of an argument, let alone evidence’.
        In my world though, all I have to do is use my eyes and ears which provide an abundance of evidence to prove Mr Frances’ point.
        We will never agree on this I’m sure.
        Happy Monday.

        • entropy

          Yes, I thoroughly approved of the way the letter began, but then we shouldn’t have to be thankful when professionals deign to follow the rules of their own professions.

          He then ruined all that good work by indulging in an unsubstantiated editorial, and not even giving the reasons for his judgements much less citations. ‘My eyes and ears’ is neither of those. Some people’s eyes and ears have them believing they’ll get virgins in heaven for exploding infidels in the name of Allah. That’s why we have things like science, and referencing, and standards of evidence.

          I cannot agree with your position when you don’t have an argument to support it.

    • Wide Awake

      Allen Frances is also behaving in an unethical manner by saying what he has said. BTW if you think the DSM does not have flaws, you must be naive.

      • Dan Flynn

        Perhaps you and I have different ideas of what constitutes unethical behavior, and yes of course the DSM is extremely flawed. I have worked in mental health for the past eight years.

        • BJ

          Why not use the standard set by the rule; after all, that is why we have rules. In this context, ideas don’t come into it.

          • Dan Flynn

            You sure are a stickler for the rules BJ. I should know better than to take you on, unfortunately I’m too much of a Radical!

          • BJ

            I am not necessarily a stickler’ for rules; some are good and others are unnecessary or bad, or both. In this instance, the profession established an ethical boundary, and has retained it for a very long time; and frankly it records nothing more than common sense. These people have put themselves on the wrong side of it, and they may or may not be called to account. For all of the debates that might occur if that happens, I just don’t see how there could be any about the standard that applies; it is stated with admirable clarity.

            Radicals have their place Dan, but legal process and debates about the law usually aren’t fertile ground for them.

          • Dan Flynn

            Point taken and, yes, Radicals are on much less stable ground with regard to legal process etc.
            I do think it’s interesting that professionals are choosing to break with tradition at this stage in history. Some would argue they are simply breaking the rules and should be called to account, others might argue that Mr Trump has caused such seismic shifts in the political landscape that established ethical boundaries also deserve a re-think.

          • BJ

            “Mr Trump has caused such seismic shifts in the political landscape that established ethical boundaries also deserve a re-think”

            Very slippery slope Dan.

            Many professional ethical rules have been around for centuries, and have served well through all sorts of political climates and turmoil. Upending the cart because some of the population don’t like Trump seems precipitous and dangerous. Can you really argue that the Goldwater rule should be dumped just to damage Trump? It protects many other people as well.

            I wonder how you would feel if a doctor who you have never met, looked at a couple of your posts as evidence and then went public questioning your sanity. My guess is that you would feel aggrieved?

          • Dan Flynn

            If somebody questioned my sanity based on a couple of posts then I’d say they are a fool. However if somebody questioned by sanity based on a whole lifetime in front of a camera, hundreds of speeches and interviews and a leaked video of me boasting about sexual assault (otherwise known as locker room banter), I’d think they might have a point…

          • BJ

            That’s an evasion and you know it. Film and television is edited, and you never see the raw footage. And public personas are crafted for effect, and often the private people are nothing like the public image.

            The reality is we have no idea what they based it on, so how can you say that it is a proper opinion?

          • Dan Flynn

            You got me BJ! You had me with your first two paragraphs and then dropped the sloppy metaphor which I pounced upon to avoid further acknowledging your point.

            I’ll concede. The Goldwater rule should stand.

            ‘you never see the raw footage’,
            I can’t agree with this though, the pussy grabbing video was indeed about as raw as footage can get.

          • Karen Dwyer

            You, sir, are a gentleman and a scholar.

            I, being a scholar but no gentleman, would merely have said, “what a load of cobblers!” :-))))))

      • BJ

        You are correct; the Frances letter is also a breach of the rule, which refers to a public statement of a professional opinion. Many people inappropriately read into the rule a requirement, or simply assume, that it only applies to a statement asserting that the subject has a condition, but that is not what the rule says. A proper reading of the rule shows that a statement of professional opinion that a person does not suffer from a condition is a breach because it is an opinion about the mental health of the public figure. In this case it is also overlaid with yet another nasty swipe based on nothing more than political differences.