Psychoanalysts Raise Ethical Questions by Lifting Ban on Diagnosing Trump

This week the American Psychoanalytic Association (APsaA) sent a letter to its 3,500 members that effectively lifted the "Goldwater Rule," which banned psychiatrists from publicly diagnosing the mental health of public figures who are not under their care.

The APsaA says that it "does not consider political commentary by its individual members an ethical matter," and that “the field of psychoanalysis addresses the full spectrum of human behavior, and we feel that our concepts and understanding are applicable and valuable to understanding a wide range of human behaviors and cultural phenomenon.”

What is The Goldwater rule?

It’s the informal name given to Section 7 of the American Psychiatric Association’s (APA) Principles of Medical Ethics. Section 7 encourages mental health professionals to educate the public about psychiatric matters and current behavior. Sometimes, however, a psychiatrist may be asked about "an individual who is in the light of public attention"—say, a President. Here, the APA is clear that “it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement.”

In summary: if you haven’t treated a person, you have no professional business diagnosing them.

The APA continues to require its members to abide by the Goldwater Rule.

How’d it get its name?

In 1964, Senator Barry Goldwater ran as the Republican nominee for President against Lyndon Johnson. During the contentious campaign, Fact magazine surveyed psychiatrists asking if they believed Goldwater was mentally fit to be POTUS. Fact then ran this cover story:

In the article, The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater," the Presidential nominee was diagnosed as being unfit for office as he suffered from a number of psychological disturbances, including, as the New York Times explained, "paranoia, a grandiose manner and a Godlike self-image. One doctor called him ‘a dangerous lunatic.’”

Goldwater lost the election by a landslide. He sued Fact for libel, winning over half-a-million dollars (adjusted for 2017). A few years later, to prevent the same kind of thing from happening again, the APA adopted the Goldwater Rule.

Why am I hearing about it over 40 years later?

President Donald J. Trump’s unusual behavior has led many people to question his mental health and the comparisons to Goldwater were inevitable.

"We have an ethical responsibility to warn the public about Donald Trump’s dangerous mental illness," said Dr. John Gartner, a psychotherapist who has advised psychiatric residents at John Hopkins Medical School.

Gartner made the remarks in April 2017, during a conference at Yale University. He’s also the founding member of Duty to Warn, an organization of mental health professionals who believe Trump is mentally unfit to serve.

Why’s It Matter?

If Trump was diagnosed as mentally unfit to be President, it could be grounds to enact the 25th Amendment, which states that if the "President is unable to discharge the powers and duties of his office, the Vice President shall immediately assume the powers and duties of the office as Acting President."

Applying the 25th Amendment to Trump’s mental health would be unprecedented to say the least. Normally, the 25th Amendment is enacted when a president is incapacitated due to an injury or undergoing surgery, and the vice president temporarily becomes the acting president.

We’ll just have to wait and see what the psychoanalysis community has to say about Trump’s mental state.

Do you think mental health professionals should be able to comment on Trump? Or was the Goldwater Rule created for a reason? Hit the Take Action button and let us know your diagnosis of the matter.

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—Josh Herman

(Photo credit: Gage Skidmore via Wikipedia/ Creative Commons)