• Goldwater

Revisiting the Goldwater Rule: Psychiatry, Ethics, & Politics 

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The American Psychiatric Association’s Goldwater Rule — which proscribes members from speculating publicly about the mental health of a public figure—was issued in the aftermath of Fact Magazine’s survey of psychiatrists who weighed in on the fitness of Senator Barry Goldwater, the Republican presidential nominee in the 1964 election.  

Here we provide, for fair use, the entire issue of Fact Magazine, which prompted a continuing debate about the appropriate role of psychiatrists engaging in political commentary.  In addition, below, you'll find an interview with Michael Dukakis discussing the intersection of politics, psychiatry, and ethics. We’ve also catalogued a number of resources related to the Goldwater Rule in the context of the 2016 election.

The Goldwater Rule

"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.”

Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry

Conversations about the Goldwater Rule

Recent Articles, Books, & Media 

"President Trump’s Mental Health — Is It Morally Permissible for Psychiatrists to Comment?" Claire Pouncey, New England Journal of Medicine, December 27, 2017.

The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President edited by Bandy X. Lee, October, 2017.

"Who Decides Whether Trump Is Unfit to Govern?", Peter Kramer and Sally Satel, August 29, 2017

"It’s time to talk about Trump’s mental health", Eugene Robinson, The Washington Post, August 21, 2017.

"Lawmakers Will Meet to Discuss Trump’s Mental Health Next Month", Tonic (Vice News), August 16, 2017.

"‘Diagnosing’ Trump Is More About Politics Than Mental Health",  FiveThirtyEight, August 8, 2017.

Journal of the American Academy of Psychiatry and the Law, Special Section on the Goldwater Rule. June 2017

From the Duty to Warm Vidcast: "Dr. David Reiss describes Trump's narcissistic distortion of reality and "quasi-delusional" thinking." June 2017

"Eternal Emperor in His Own Mind: The Distorted Reality of Donald Trump," by Seth Davin Norrholm, HuffPost, May 27, 2017. 

"Psychiatry’s “Goldwater Rule” has never met a test like Donald Trump," Brian Resnick, Vox Media, May 25, 2017.

"Psychologists have a duty to warn the country about Trump: We can no longer pretend that he is stable," John Gartner, New York Daily News, May 12, 2017.

"Psychiatrists fight over the ethics of diagnosing Trump," by Jen Christensen, CNN

"Donald Trump and The Definition of Insanity,"  by Shane Snow.

A Clear and Present Danger: Narcissism in the Era of Donald Trump edited by Leonard Cruz and Steven Buser, 2016.

"An Eminent Psychiatrist Demurs on Trump’s Mental State" letter by Allan Frances, NY Times

"It’s OK to Speculate About Trump’s Mental Health," Sally Satel, (October 12, 2016, Slate.com)

"The Real Story Behind the Goldwater Rule" by Jonathan Moreno, PhD (The Hastings Center)

"The Goldwater Rule: Why breaking it is Unethical and Irresponsible" by Maria Oquendo, MD (American Psychiatric Association blog)

"Psychiatrists Can’t Tell Us What They Think About Trump" by Maggie Koerth-Baker (fivethirtyeight.com)

"Deconstructing and Reconstructing the Goldwater Rule" by Ronald Pies (Psychiatric Times)

The Diane Rehm Show: "Debate Over Armchair Psychological Assessments Of Donald Trump," Amy Ellis Nutt science writer, The Washington Post, Dr. Paul Appelbaum professor of psychiatry, medicine, and law, Columbia University, William Doherty psychologist and director, Citizen Professional Center, University of Minnesota, Ron Elving senior Washington editor, NPR New

WHHY RadioTimes: "Psychoanalyzing the candidates" NASSIR GHAEMI, professor of psychiatry and director of the Mood Disorders Program at Tufts Medical Center, DAN MCADAMS, professor of psychology at Northwestern University, and PAUL APPELBAUM, professor of psychiatry, medicine and law at Columbia University.

"The Psychiatric Question: Is It Fair to Analyze Donald Trump From Afar?" by Benedict Carey (The New York Times, August 15, 2016)

"Psychiatrists Reminded To Refrain From Armchair Analysis Of Public Figures" by Bret Stetka (NPR.org)

Kroll, Jerome, and Claire Pouncey. "The Ethics of APA's Goldwater Rule." Journal of the American Academy of Psychiatry and the Law Online 44, no. 2 (2016): 226-235.

Redinger, Michael J., Tyler S. Gibb, and Peter L. Longstreet. "In Defense of Prudence and the APA's Goldwater Rule: A Response to Kroll and Pouncey." Journal of the American Academy of Psychiatry and the Law Online J44, no. 3 (2016): 407-408.

Cooke, Brian K., Emily R. Goddard, Tonia L. Werner, Erinn O. Cooke, and Ezra EH Griffith. "The risks and responsible roles for psychiatrists who interact with the media." Journal of the American Academy of Psychiatry and the Law Online 42, no. 4 (2014): 459-468.

Politics, Psychiatry, & the Goldwater Rule: An Interview with Michael Dukakis

In this videotaped interview excerpt, 1988 Democratic presidential candidate Michael Dukakis discusses the intersection of politics, psychiatry, and ethics.  He recalls the 1988 campaign, in which he was vilified based on false rumors about his mental health; gives his views on depression and stigma; and considers the Goldwater Rule.  Gov. Dukakis asserts that to be ethical, a psychiatric opinion must be based on a personal interview and informed consent from the public figure, “for the sake of the profession…as well as those who are being analyzed.” 

Michael Dukakis is Distinguished Professor of Political Science at Northeastern University and a visiting professor at the Luskin School of Public Affairs at UCLA.  The interview was conducted on November 12, 2014 by John Martin-Joy, M.D., a psychiatrist at Mount Auburn Hospital in Cambridge, MA; Sagar Vijapura, M.D., now a fellow in Addiction Psychiatry at UT Southwestern Medical Center in Dallas, TX; and Jonathan E. Carey, J.D., an attorney in Farmington Hills, MI. 

This clip was presented as part of “Ethical Perspectives on Psychiatric Evaluations of Public Figures,” an invited forum held at the Annual Meeting of the American Psychiatric Association, Toronto, Ontario, May 18, 2015.  Address for correspondence: John Martin-Joy, M.D. at jmartin1@mah.harvard.edu.



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