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THE GOLDWATER RULE TODAY

As the New Yorker magazine comments, Pres. Trump is the only modern President to be the subject of sustained public discussion about his mental competence and fitness for office.

Increasingly, those on the liberal end of the spectrum are offering long-distance psychiatric evaluations on him.

Some examples:

  • James Clapper, the former director of National Intelligence, said on CNN, “I really question his…fitness to be in this office,” describing a Trump address as “scary and disturbing” and characterizing him as a “complete intellectual, moral, and ethical void.”

 

  • Following Pres. Trump’s blaming “many sides” for white supremacist violence in Charlottesville, Tennessee Senator Bob Corker, a Republican, said that the President “has not yet been able to demonstrate the stability, nor some of the competence, that he needs” to lead the country

 

  • Representative Zoe Lofgren, a California Democrat, introduced a House resolution urging a medical/psychiatric evaluation of the President, pointing to an “alarming pattern of behavior and speech causing concern that a mental disorder may have rendered him unfit and unable to fulfill his Constitutional duties.”  Lofgren asked, in a press release, “Does the President suffer from early stage dementia?  Is the President mentally and emotionally stable?”

 

  • After Pres. Trump’s “fire and fury” remarks about North Korea, Dr. Bandy Lee, a professor of psychiatry at Yale Medical School, sent her second letter about Trump to all members of Congress, warning that his “severe emotional impediments” pose “a grave threat to international security.” Her book, “The Dangerous Case of Donald Trump,” forthcoming in October, collects essays by more than a dozen mental health experts and contends that the Trump Presidency is an emergency that not only allows – but perhaps even requires – psychiatrists to speak out..

 

However tempting such long-distance evaluation for progressives, it seems to violate guidelines of both the American Psychiatric Association [APA] and American Psychological Association.

The APA follows a principle often called the Goldwater Rule.   An Association 2017 press release quotes the APA president cautioning that it is “unethical and irresponsible” for psychiatrists to offer a professional opinion upon “someone they have not thoroughly examined [since it] compromises the integrity of the doctor and the profession” and “violates the principle that a psychiatric evaluation must occur with consent or authorization” of the individual.

Historically, the Goldwater Rule surfaced after the 1964 presidential election defeat of Senator Barry Goldwater.  He successfully sued Fact magazine for defamation after it published a special issue in which psychiatrists declared him “severely paranoid” and “unfit” for the Presidency.  [For a public figure to prevail in a defamation suit, he/she must demonstrate that the defendant acted with “actual malice.”   A crucial bit of evidence in the Goldwater case was Fact’s disregard of a letter from the American Psychiatric Association warning that any survey of psychiatrists who hadn’t clinically examined Goldwater was invalid].

A recent article in the New Yorker magazine reports that psychoanalyst Justin Frank, a clinical professor at George Washington University, resigned from the APA  in 2003 before publishing his book “Bush on the Couch.” He went on to write “Obama on the Couch,” and is now working on “Trump on the Couch.”

Within professional mental health association circles:

  • The APA reaffirmed and arguably expanded the Goldwater rule in March 2017, stating that it applies not only to a “diagnosis” but also to “an opinion about the affect, behavior, speech, or other presentation of an individual that draws on the skills, training, expertise, and/or knowledge inherent in the practice of psychiatry.”

 

  • The American Psychological Association, with double APA’s membership, also reconfirmed its support for the Goldwater rule.

 

  • According to the New Yorker magazine, the much smaller American Psychoanalytic Association told its 3,000-plus members they were free to comment about political figures—a reprieve more symbolic than practical, since many members concurrently belong to the APA.

Some on the left argue that the Goldwater Rule unfairly muzzles First Amendment free speech, gagging 37,000 APA members from contributing to a useful, healthy public conversation.

The New Yorker article speculates that many US presidents may have served despite various forms of mental illness – depression, anxiety, social phobia, or bipolar disorder.  President Ronald Reagan’s staff, for example, worried about signs of dementia.  And concerned about Richard Nixon’s paranoia and heavy drinking in his last days in office, his Defense Secretary supposedly told the Joint Chiefs to disregard any White House military orders.

 


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