If I were going to be prudent, I would run this past the professional psychotherapists in my life (brother, daughter, first wife, friend) before going public. But I am not feeling so cautious about this issue, because the issue of the “Goldwater Rule” seems clear enough to me. (Besides which, I’ve got half a credential of my own, having done graduate work in Clinical Psychology and spent a year’s internship as a psychotherapist myself, back long ago when I was in my early twenties.)
So here is what seems clear to me: the “Goldwater Rule,” backed though it is by the American Psychiatric Association, is nonsensical. (Except, perhaps, as a profession’s act of CYA.)
That rule is stated thus:
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.
It’s called the Goldwater rule because back in 1964, the journal Fact polled psychiatrists about the fitness of Barry Goldwater (then Republican candidate for President) for that office, and published a piece reporting how over a thousand psychiatrists declared him unfit. Goldwater sued the editor of the journal for libel, and won a judgment for what today would be more than half a million dollars.
OK. That’s the background. Now to show the nonsense behind the rule, by which I mean the idea that it is unethical for a psychiatrist (or presumably any other expert in the field of personality assessment) to “offer a professional opinion unless he or she has conducted an examination.”
I am assuming that the thought behind this idea goes like this: although one can responsibly make a professional judgment about a person’s mental health or personality after conducting “an examination,” one is in no position to make such a judgment from simply observing that person from afar.
Really? Why should one believe that? Is it so clear that an “examination” provides so much more insight than any amount of exposure to a person — observed in other circumstances, not encountered face to face — could possibly yield?
This issue has come up again lately, of course, in relation to the question of Donald Trump’s “fitness” for the office of president. We’re talking here about Trump, a man who has been manifesting himself non-stop as a candidate, and now as president for almost two years, exposing many remarkable tendencies and characteristics.
Can anyone really argue, with a straight face, that sitting down with a person for an hour, and conducting a professional “examination,” would provide a great evidentiary basis for a professional judgment than all that Trump has revealed publicly about himself over this period of time?
I sure couldn’t. I expect that a good professional who has been paying attention to Trump these past two years has as clear a notion of Trump’s mental health as if he or she had not only done some intake exam but had been seeing him as a patient for a goodly while.
It is said that, with the “Goldwater rule,” the American Psychiatric Association affirmed the right of “medical privacy.” But how does privacy enter in at all, when no confidential relationship has been entered into between the professional observer and the person observed?
So if professionals see what they see, why should it be “unethical” for them to say what they’ve got to say?
The text of the rule goes on to mention some need for “proper authorization” for the psychiatrist (or equivalent) to make it OK for that expert to “offer a professional opinion.”
Really? Why should any such “authorization” be necessary?
I assume that “proper authorization” would mean the consent of the person being discussed. Somehow, one needs permission to share one’s judgments about a person like Donald Trump, who was running for to be president of the world’s most powerful nation, and who now holds power of life and death over pretty much everyone on the planet.
Every other American citizen has a right to express their opinion. But not people in the mental health fields?
Constitutional scholars are entitled to give their opinion based on what their expertise indicates about how the Constitution would fare under this individual.
Presidential historians are entitled to give their opinion on how this person’s demeanor stands in relation to previous occupants of the office.
Those experts don’t need to ask for “proper authorization” to express to the public the insights their expertise affords them regarding what the choice of this individual to be president might mean for the nation.
But somehow only the mental health professionals are supposed to be mute about what their expertise enables them to tell the public. Only shrinks are supposed to be shrinking violets and keep to themselves their professional insights into how this person’s character and inclinations might disable them from exercising responsibly the duties of the presidency?
Goldwater, it is true, did get that libel judgment. One must reckon with that. But on what basis did Goldwater win his suit? Really terrible things were said about President Obama quite regularly, and as I understand it, there was no way he could win a libel suit against anyone for any of that.
The standard for libel of a public figure is supposed to be not only the the statements are incorrect and harmful, but also that “the writer or publisher acted with actual malice (knowledge of falsity or reckless disregard for the truth).”
What reason is there to believe that in either the Goldwater case, or in the case of Donald Trump these days, the professional judgments are made with any knowledge of falsity or reckless disregard for the truth?
In today’s situation, clearly neither is the case. The professionals who have published judgments about Trump’s unfitness have declared that a “duty to warn” should outweigh whatever legitimate weight should be given the Goldwater Rule. (Is there any legitimate weight?)
None of this is to deny, of course, that such professional judgments may sometimes be wrong-headed, and no useful guide for the public to use in coming to its judgment. (One thinks, for example, of the psycho-biography of Woodrow Wilson written by Sigmund Freud and William Bullitt– a work not much respected now, considered something of an unfair hatchet job, and not regarded as up to Freud’s usual standard.)
But where else in our democracy do we require people to be mute because what they say might be wrong-headed? We get wrong-headed opinions from politicians, from Supreme Court justices, from journalists, from historians, from medical scientists — from every category of expert we could name.
But our society is predicated on the idea that there is “a marketplace of ideas,” and that we can survive best by having ideas — even wrong-headed ones — contending with each other.
The Goldwater Rule singles out a particular category of idea for exclusion from that marketplace.
In defense of what value is that particular kind of idea to be excluded? The answer seems to be that value often pursued by those who wish to stay neutral in a conflict: to stay out of harm’s way by avoiding antagonizing anyone.
Understandable, perhaps. But hardly noble. And hardly what best serves the nation, with its most powerful public official now someone whose mental health and contact with reality are legitimately open to question.