Psychiatry group tells members they can defy ‘Goldwater rule’ and comment on Trump’s mental health

Should psychiatrists be able to comment on public figures' mental states without examination? Would that necessarily veer over into political commentary? Should the 'Goldwater rule' be retained?

https://www.yahoo.com/news/psychiatry-group-tells-members-defy-083037831.html

Psychiatry group tells members they can defy ‘Goldwater rule’ and comment on Trump’s mental health
Sharon Begley,STAT News 9 hours ago


A leading psychiatry group has told its members they should not feel bound by a longstanding rule against commenting publicly on the mental state of public figures — even the president.

The statement, an email this month from the executive committee of the American Psychoanalytic Association to its 3,500 members, represents the first significant crack in the profession’s decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians’ behavior. It will likely make many of its members feel more comfortable speaking openly about President Trump’s mental health.

The impetus for the email was “belief in the value of psychoanalytic knowledge in explaining human behavior,” said psychoanalytic association past president Dr. Prudence Gourguechon, a psychiatrist in Chicago. “We don’t want to prohibit our members from using their knowledge responsibly.”

That responsibility is especially great today, she told STAT, “since Trump’s behavior is so different from anything we’ve seen before” in a commander in chief.

An increasing number of psychologists and psychiatrists have denounced the restriction as a “gag rule” and flouted it, with some arguing they have a “duty to warn” the public about what they see as Trump’s narcissism, impulsivity, poor attention span, paranoia, and other traits that, they believe, impair his ability to lead.

Read more: Trump’s New York Times interview is a window into his psyche

Reporters, pundits, and government officials “have been stumbling around trying to explain Trump’s unusual behavior,” from his seemingly compulsive tweeting to his grandiosity, said Dr. Leonard Glass, a psychiatrist at Harvard Medical School. The rule against psychiatrists offering their analysis of the emotions, thought patterns, and beliefs underlying such behaviors, Glass said, robs the public “of our professional judgment and prevents us from communicating our understanding” of the president’s mental state.

Last week, in an essay in Psychiatric Times, Glass called the prohibition on such communication “an unacceptable infringement on my right and duty” to discuss issues “where the perspective of psychiatrists could be very relevant and enlightening.” He ended the essay by announcing his resignation from the American Psychiatric Association, which adopted the rule in 1973. He had been a member for 41 years.

Called the “Goldwater rule,” the prohibition on offering opinions about the mental state of public figures was adopted after some psychiatrists answered a 1964 survey on whether Sen. Barry Goldwater, the Republican presidential candidate that year, was mentally fit for the Oval Office. The rule states that it is unethical to offer a professional opinion about a public figure’s mental health, including the presence or absence of a disorder, without that person’s consent and without doing a standard examination. In March, the psychiatric association reaffirmed the rule.

The group acted despite growing criticism that the Goldwater rule is outdated and even unethical for preventing psychiatrists from pointing out behaviors that raise questions about a government official’s mental state. No other medical specialty has such a rule; cardiologists are not prohibited from offering their views of an official’s fainting spell, for instance, as long as they make clear that they have not examined the person.

Although opposition to the Goldwater rule has existed for years, it intensified with Trump’s candidacy and then election. In October, a book titled “The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President” will be published.

“When the book comes out, there will be renewed furor about the Goldwater rule, since it is precisely about what is wrong with him,” said psychiatrist Dr. Lance Dodes, a retired professor at Harvard Medical School who is now in private practice in Los Angeles.

Read more: ‘Crazy like a fox’: Mental health experts try to get inside Trump’s mind

A number of psychologists have spoken to reporters about what Trump’s statements and actions might reveal about his emotional and cognitive state. Although the American Psychological Association “prefers” that its members not offer opinions on the psychology of someone they have not examined, it does not have a Goldwater rule and is not considering implementing one, an official told STAT.

The psychoanalytic association went further. In its July 6 email, it explicitly stated for the first time that the organization does not subscribe to the rule. That position had been implicit for years, but the association’s “leadership has been extremely reluctant to make a statement and publicly challenge the American Psychiatric Association,” said one psychoanalytic association member who asked not to be publicly identified criticizing the other group.

One stated rationale for the Goldwater rule is that psychiatrists need to examine patients in order to properly evaluate them. In fact, for decades the State Department and other federal agencies have asked psychiatrists to offer their views on the psychological state of foreign leaders, Glass pointed out, evidence that government officials believe it is possible to make informed inferences about mental states based on public behavior and speech.

“In the case of Donald Trump, there is an extraordinary abundance of speech and behavior on which one could form a judgment,” Glass said. “It’s not definitive, it’s an informed hypothesis, and one we should be able to offer rather than the stunning silence demanded by the Goldwater rule.”

The Goldwater rule has long been odd in that violating it carries no penalties. In principle the psychiatric association could file a complaint with a member’s state medical board. That has apparently never happened. Nor has the association ejected a member for violating the Goldwater rule. That is something it, as a private association, would be legally permitted to do.

A state agency, however, is subject to the U.S. constitution, civil liberties experts say, and penalizing psychiatrists for speaking out would likely be a violation of their first amendment rights.

 

If it's a violation to offer public comment about a patient who is under the care of a doctor. Why would it be ok for a doctor to offer public comment about what amounts to medical speculation about a public figure? Sorry, but an "informed hypothesis"? Anyone who thinks we won't be seeing inappropriate, politically motivated "hypothesis" that have nothing to do with reality? They either aren't living in the reality of today's politically charged environment, or they're politics is so far left that they feel their narrative needs to be bolstered in any way possible.

 

Trump isn't under their care so isn't a patient.

If medical doctors thought Trump was physically ill and his toadys were trying to hide it the doctors would have the responsibility to comment on it..

Now, of course righties think mental illness really isn't an illness so they'll scream ,"" NO, he's not cursed! by voodoo! He's as mentally healthy as we are!"

But a President's mental health should be important even though American standards on that have fallen into the toilet...

 

So how long before doctors are offering opinions about all kinds of things? Would you feel just as strongly that doctors should be able to say crazy things like "Hillary Clinton is clearly dying" because she has a fainting spell?

If Trump isn't under a doctor's care, anything that doctor says about Trump is pure speculation. Why shouldn't the same medical ethics that make it improper for a doctor to discuss a doctor's knowledge about a patient of theirs not extend to a doctor discussing their uninformed opinion of a particular person not under their care? See, the other problem I have is this: are you making a general rule, or are you making a rule that applies only to Trump? If you're making a general rule, you'd better think good and hard about the implications of what it is you're supporting.

 

Hope springs eternal...

 

You are erroneously conflating patient-doctor confidentiality with a professional opinion.

Unless the person expressing the opinion has a doctor-patient relationship with the BLOTUS there is no violation when it comes to providing a professional opinion.

That your beloved BLOTUS is a raving whackjob with dementia and other issues is something that We the People do need to be aware of since he has the power to start a nuclear war!

 

IF Clinton was the President, YES, ALL Americans should expect to know the state of her health...as they have other Presidents.

Trump supporters were quick to point out she wasn't healthy enough to be President...... health includes mental health, too, even if Regressives deny it.

Mental illness IS part of "health". IF a President has health issues it's the business of every citizen.

Trump was correct, he could shoot someone and his supporters wouldn't care. They would claim it's no one's business.




Also , he can act like he has a mental illness and supporters, who identify closely with him, wouldn't admit it nor would they even notice.

 

If Barak Obama had stepped on the podium one morning and had a three pound tumor protruding from his neck, would people have freaked out if doctors around the world had pointed out that Obama had a three pound tumor protruding from his neck?

That is how obvious Trump's mental condition is - the equivalent of a three pound tumor. How can we be surprised that doctors comment on it?

 

I'm not conflating anything. I'm asking about the medical ethics of the situation you're proposing. That your despised, validly elected President (want to see the county map of GOP/Dem and vice versa flips from 2012?) needs to be attacked by medical professionals who have never met the man, because what could possibly motivate these people other than informing the American public about the dangers of the President's condition, right? I'm so glad to hear that these doctors have absolutely no political agenda whatsoever. Excellent news. Now excuse me, I have to email my bank account info to a nigerian who wants to be my friend.

Ah, so this new rule only applies to the president? Because it's obvious that if a president has health issues, it's the business of every citizen to know everything about it. Got it. So just out of curiosity: if a doctor who's never met the president states that the president is suffering from X, and a second doctor who has actually examined the president stands up and states that the president is not suffering from X (after receiving a signed statement by the president that it's ok to release that information), does the president then have the right to file a malpractice suite against the first doctor? Hey, this could actually be interesting. I'm beginning to warm up to the idea...

Any comment about a three pound tumor protruding from Obama's neck would have been portrayed as extreme racism. You know it and I know it.

 

You last two asinine sentences are a fitting disclosure of what the rest of your post is worth....

 

We don't have to look far to find where the asinine thinking is coming from...

 

Yes, as I said first , from your post........


...and what's this "we" ?....multiple personality disorder or gang mentality or you need back up??

 

Ah yes. Sorry for being non-specific, and causing you confusion.

The revised statement: My wife and I don't have to look far to find where the asinine thinking is coming from...

(Don't want you rounding up doctors to comment on my mental health...). Hope that helps.

 

It isn't a professional opinion if he hasn't treated him or personally interviewed him it's a damn guess and it's not one whit damn better than anyone else's guess no matter how many letters he has in his degrees.

 

You are entitled to your opinion but there is a growing consensus that your beloved BLOTUS is a raving whackjob who is a threat to this nation!

 

The commies are pulling out all stops.

 

Trump has AT LEAST 25 clinical Mental Disorders that are currently recognized by the DSM-5.

The PATHETIC PARANOID NARCISSISTIC IMBECILE is a mentally-disordered case history.

Period. End of story.

 

I am not thrilled with this idea. I think a lot of these guys really really really want to tell us what they think, and want to 'educate' us and they have mistaken their desires to do so, for a duty to comment. There certainly is no duty to throw around labels that sound like diagnosis, by people we are used to seeing as diagnosticians, about public political figures. This is the very definition of 'armchair' psychology/psychiatry. Frankly, what they have to say about Trump is worth every dime they got paid by him to examine him.

I don't see what good it does to have this half baked psychobabble sent out there by people who we are used to seeing as credible clinicians. It does not get him one inch closer to a real diagnosis, or any treatment, and it does not get any of us an inch closer to invoking the 25th. Its precedent setting and we will end up with warring clinicians of different ideologogies 'diagnosing' candidates in 30 second spots and blogs for governor races, Congressmen, and even judges . I don't see real value, because the quality of what they are doing is limited by access.

 

I can see both sides to this but I do agree that maybe having some validated opinions is better than having wild speculation

 

I agree that there is a potential for abuse here but I would far rather that a whackjob like the BLOTUS be called out BEFORE he makes it into office than to have him wreaking the havoc that he is currently creating.

Yes, ALL politicians in my opinion should be scrutinized for their mental health! Far too many are just greedy power hungry maggots who should never be allowed to be elected to office.

If this ends up weeding out some of the worst then sobeit.

And let's just take an example to illustrate this point. The religious right were calling Bill Clinton a "sex addict". What if that were to be clinically analysed by professionals on both sides of the aisle? What would have been the outcome? Would he never have been elected at all? Or would he have been elected anyway because there is no such clinical diagnosis as "sex addiction"?

 

It's only 'armchair psychology' if it's not a trained person doing it and the fact Trump's such a public figure with all of his behaviours on display 24/7 means it's a far deeper environment to mine information from than a sterile, limited clinical setting.

 

Trump be crazy like de fox.

 

Yet those righty Trump supporters ALL become expert psychologists when the issue of transgenders in the military comes up....

....without consulting a doctor!!!!

 

When you have a wannabe despot in the WH, it's time to step away for the usual norm and fight fire with fire.

 

Is that why the wannabe despot is the color of a dying ember in a cold fireplace?