Now, with Trump in office, there’s something of a tug-of-war taking place over whether the Goldwater Rule should remain in place. The APA says yes, unequivocally: “It is unethical to offer a professional opinion about an individual without conducting an examination,” the association said in a statement in March. “The complexity of today’s media environment demands that we take special care when speaking publicly about mental health issues, particularly when what we say has the potential to damage not only our professional integrity, but the trust we share with our patients, and their confidence in our abilities as physicians.”
Other groups and individuals, however, aren’t so sure. A president who smashes political norms, it seems, may also be tearing down ethical standards in other realms.
The American Psychoanalytic Association emailed its 3,500 members in July to remind them, in essence, that the Goldwater Rule isn’t part of its ethics code. The association “does not consider political commentary by its individual members an ethical matter,” it said in the email, which a spokesperson for the association forwarded to The Atlantic. Despite the psychoanalytic group’s relatively small size compared with peer organizations, its position is already reigniting debate. It’s also likely to spread some confusion. (It doesn’t help that the American Psychoanalytic Association shares an acronym with the wider known American Psychiatric Association.)
The health website Stat calls it “the first significant crack in the profession’s decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians’ behavior.” But the psychiatrist and psychoanalyst Prudence Gourguechon—who says she is a member of both the American Psychiatric Association and the American Psychoanalytic Association—told me the issue is slightly more nuanced.
“We did not tell our members to defy the Goldwater Rule,” she told me on Tuesday. “It’s just that the Goldwater Rule is an American Psychiatric Association rule and each association has its own rules. Our rule at the American Psychoanalytic Association is different.”
“I think we psychoanalysts have enormous and unique insight into human behavior,” she added. “Basically we [at the American Psychoanalytic Association] believe in our members’ free speech and don’t want to prohibit them from speaking out in public. We see Trump’s mental state being discussed and don’t think it’s necessary or right to withold our expertise. ”
That said, the American Psychoanalytic Association does have ethical guidelines for its members, including a set of specific recommendations for how to describe observations about a public official’s behavior.
“Basically you don’t guess what’s going on in somebody’s mind,” Gourguechon told me.
The Goldwater Rule goes further, and says psychiatrists should never comment on the “behavior, symptoms, diagnosis, etc.,” of a public figure without that person’s consent, according to the March statement from the American Psychiatric Association. Even calling the president “impulsive,” for example, “probably breaks the Goldwater Rule,” Gourguechon said.