APA Remains Committed to Supporting Goldwater Rule
Today, APA’s Ethics Committee issued an opinion that reaffirms our organization’s support for “The Goldwater Rule,” which asserts that psychiatrists should not give professional opinions about the mental state of individuals that they have not personally and thoroughly evaluated. The opinion from the Ethics Committee clarifies the ethical principle of the rule and answers several questions that have recently cropped up surrounding its use.
APA member psychiatrists have abided by the Goldwater Rule since it was implemented in 1973. It is so named because of a controversy that emerged during the 1964 presidential election, when Fact magazine published the results of a survey in which 12,356 psychiatrists were asked whether Sen. Barry Goldwater, the GOP nominee, was psychologically fit for the presidency. Out of 2,417 total responses to the survey, 1,189 said that Goldwater was unfit for office. Goldwater eventually won a defamation suit against Fact.
In its opinion, APA’s Ethics Committee asserts that while it is perfectly fine for a psychiatrist to share their expertise about psychiatric issues in general, it is unethical to offer a professional opinion about an individual without conducting an examination. The committee clarified that the rule applies to all professional opinions offered by psychiatrists, not just diagnoses. For example, saying an individual does not have a mental disorder would also constitute a professional opinion.
Three main points form the rationale for the opinion:
- When a psychiatrist comments about the behavior, symptoms, diagnosis, etc. of a public figure without consent, that psychiatrist has violated the principle that psychiatric evaluations be conducted with consent or authorization.
- Offering a professional opinion on an individual that a psychiatrist has not examined is a departure from established methods of examination, which require careful study of medical history and first-hand examination of the patient. Such behavior compromises both the integrity of the psychiatrist and the profession.
- When psychiatrists offer medical opinions about an individual they have not examined, they have the potential to stigmatize those with mental illness.
I touched on these points in my blog post from June of 2016 on the Goldwater Rule, but our Ethics Committee goes into far greater detail with the opinion it offered today. The Committee even offers rebuttals to the some of the most commonly heard arguments against the Goldwater Rule, including concerns centered on freedom of speech and civic duty; professional opinions or psychological profiles solicited by courts or law enforcement officials for forensic cases; and the Tarasoff Doctrine, which states that mental health professionals have a duty to protect individuals who are being threatened with bodily harm by a patient.
I urge you to take a moment to read the full opinion from the Ethics Committee. It is a thorough and well-reasoned explanation on why the Goldwater Rule is more important than ever. 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.