Psychiatrists, Politics & The "Goldwater Rule"

I, VERY MUCH, OPPOSE ANY WEAKENING OF THE "GOLDWATER RULE" AS IT REPRESENTS YET ANOTHER DETERIORATION OF ETHICAL STANDARDS AMONG TOO MANY PHYSICIANS. 
                           /James Pawlak

A PROBLEM WITH THE GOLDWATER RULE IN PSYCHIATRIC ETHICS.

Peter A. Olsson MD

The Goldwater rule is the informal name for a precept of medical ethics promulgated by the American Psychiatric Association. It forbids psychiatrists from commenting on individuals' mental state without examining them personally and being authorized by the person to make such comments.^[1] The rule has no official name; it is simply Section 7.3 of the APA's ethics principles.^[2]

The issue arose in the 1960s when Fact magazine published the article "The Unconscious of a Conservative: A Special Issue on the Mind of Barry Goldwater." The magazine polled psychiatrists about American Senator Barry Goldwater and whether he was fit to be president.^[3][4]  en.wikipedia.org/wiki/Goldwater_rule

The rule itself reads:

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.^[2] en.wikipedia.org/wiki/Goldwater_rule

PARADOXICAL INTENTIONS AND HISTORICAL CONUNDRUMS

It is interesting to explore what conservative psychiatrists, (If some could be found?), would have opined about’ Lyndon Johnson’s conscience of a Liberal’ ,  like Barry Goldwater’s  Conscience of a Conservative was analyzed. The majority of psychiatrists in the FACT MAGAZINE article thought Goldwater was dangerous. Johnson who was thought to be safer for America by psychiatrists actually escalated America’s tragic involvement in the Vietnam War. Would Goldwater have been more conservative about escalation in Vietnam? I think so.

Should no psychiatric perspective or opinion be available about prospective candidates for president of the United States?  The liberal and conservative presses appropriately and sometimes inappropriately , investigate details about a presidential candidates family background, education or lack of it, and the writings offered by candidates for president. Many candidates write books about themselves and their prospective policies, etc. If journalists can speculate as amateur “Shrinks”, why can’t psychiatrists offer their spectrum of opinions?

If a psychiatrist has seen a candidate professionally, he or she must of course adhere to the ethic of confidentiality.  But, it seems unfortunate for the electorate to be devoid of perspectives from psychiatry about the candidates. Mature psychiatric observations about candidates for president would be of great value especially in light of the gray-hair- promoting- stresses the presidency brings and the importance the position holds for America.

How could opinions about the candidates by psychiatrists be accomplished?  One domain of difficulty is that in general, psychiatrists tend to be liberal Democrats or liberal Republicans. In fact, it seems at times that some psychiatrists automatically assume that it is inherently “therapeutic” to be liberal politically. Conservatives are subtly or not- so- subtly,  assumed  to be cold, unempathic  and therefore, “anti-therapeutic”.

One approach to this dilemma would be to have a psychiatric journal or magazine survey a sample of psychiatrists who would agree to disclose whether they were liberal, independent, or conservative. They could offer their observations and opinions about the candidates’ strengths, possible blind spots, and vulnerabilities. An equal number of conservative, independent,  and liberal opinion holders could be published.

The American Psychiatric Association should reframe the Goldwater Rule so psychiatrists can offer informed opinion about presidential candidates.

SUGGESTED ADDITION TO THE GOLDWATER RULE (Section 7.3 of the APA  Ethics Principals.)

The process of electing an American president is so important that voters would benefit from having mature observations, opinions and perspectives by psychiatrists.  Such discussion must be clearly labeled as OPINION in the media. Of course, if a presidential candidate has been seen professionally by a psychiatrist in private consultation this situation would be covered as usual by section 7.3,  as would be the case with all other public figures.