Goldwater rule

The original piece in Fact magazine which prompted the introduction of the Goldwater rule. Likely costing Barry Goldwater a large number of potential votes, this practice was later deemed unethical by the APA.

The Goldwater rule is the informal name given to Section 7 in the American Psychiatric Association's (APA) Principles of Medical Ethics,^[1] which states it is unethical for psychiatrists to give a professional opinion about public figures they have not examined in person, and from whom they have not obtained consent to discuss their mental health in public statements.^[2] It is named after presidential candidate Barry Goldwater.^[3][4]

The issue arose in 1964 when Fact published the article "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater".^[3][5] The magazine polled psychiatrists about American Senator Barry Goldwater and whether he was fit to be president.^[6][7] The editor, Ralph Ginzburg, was sued for libel in Goldwater v. Ginzburg where Goldwater won $75,000 (approximately $579,000 today) in damages.^[3]

Rule

Section 7, which appeared in the first edition of the APA's Principles of Medical Ethics in 1973 and is still in effect as of 2017,^[8] says:

On occasion psychiatrists are asked for an opinion about an individual who is in the light of public attention or who has disclosed information about himself/herself through public media. In such circumstances, a psychiatrist may share with the public his or her expertise about psychiatric issues in general. However, 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.^[1]

American Psychological Association

The APA Ethics Code of the American Psychological Association, a different organization than the American Psychiatric Association, also supports a similar rule. In 2016, in response to the New York Times article "Should Therapists Analyze Presidential Candidates?", American Psychological Association President Susan H. McDaniel published a letter in The New York Times in which she stated:

Similar to the psychiatrists' Goldwater Rule, our code of ethics exhorts psychologists to "take precautions" that any statements they make to the media "are based on their professional knowledge, training or experience in accord with appropriate psychological literature and practice" and "do not indicate that a professional relationship has been established" with people in the public eye, including political candidates.

When providing opinions of psychological characteristics, psychologists must conduct an examination "adequate to support statements or conclusions." In other words, our ethical code states that psychologists should not offer a diagnosis in the media of a living public figure they have not examined.^[9]

Violations

Regarding Donald Trump

In 2016 and 2017, a number of psychiatrists and clinical psychologists faced criticism for violating the Goldwater rule, as they claimed that Donald Trump displayed "an assortment of personality problems, including grandiosity, a lack of empathy, and 'malignant narcissism'", and that he has a "dangerous mental illness", despite having never examined him.^[10][11]

John Gartner, a practicing psychologist, is the leader of the group Duty to Warn. The group includes psychiatrists, psychologists and social workers. Gartner stated in April 2017 that: "We have an ethical responsibility to warn the public about Donald Trump's dangerous mental illness."^[12]

The American Psychoanalytic Association (APsaA), a different organization from either APA, sent a letter on June 6, 2017 that highlighted differences between the APA and APsaA ethical guidelines, stating that "The American Psychiatric Association's ethical stance on the Goldwater Rule applies to its members only. APsaA does not consider political commentary by its individual members an ethical matter."^[13][14] In July 2017, the website Stat published an article by Sharon Begley, labeled "exclusive" and titled "Psychiatry group tells members they can defy ‘Goldwater rule’ and comment on Trump’s mental health". The article, with a photograph of Barry Goldwater as the headline image, stated that "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", first sourcing the statement to the July 6 American Psychoanalytic Association (APsaA) letter, but also claiming that it "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"; the article then repeatedly referred to the "Goldwater rule", quoted an unnamed source as saying "leadership has been extremely reluctant to make a statement and publicly challenge the American Psychiatric Association", and claimed that an unnamed "official" had said that "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".^[15][16] Yahoo News reporter Michael Walsh criticized the Stat article, saying it was "misleading" by stating that the letter "represents the first significant crack": The American Psychiatric Association retains the Goldwater rule, and the APsaA never had the rule and wasn't changing.^[14] Also, even though the APsaA has no Goldwater rule for its members and allows its members to give individual opinions about specific political figures, its Executive Councilors unanimously endorsed a policy that "the APsaA as an organization will speak to issues only, not about specific political figures".^[14]

See also

• Duty to warn § Clinical psychology and psychiatry

References