Two American psychiatry groups are at odds over whether it is appropriate to evaluate the mental state of public figures they have not spoken to personally, specifically the mental state of President Donald Trump.
Controversy spread after STAT News reported an email on July 25 from the American Psychoanalytic Association to its 3,700 members saying it was appropriate to ignore the "Goldwater Rule" and evaluate the president.
The Goldwater Rule is an ethics rule that prevents mental health practitioners from giving their opinion on a public figure's mental health without having first examined the person and received his or her consent.
The rule was put in place by the American Psychiatric Association after several psychiatrists answered a survey on the mental health of Sen. Barry Goldwater, the 1964 Republican presidential candidate.
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Since the 2016 election of Trump, the Goldwater Rule has come under fire as an outdated "gag rule," STAT News reports. Some psychiatrists have called the rule "unethical" as it prevents psychiatrists from raising concerns about a public official's mental health.
Chicago psychiatrist Dr. Prudence Gourguechon told STAT that the reasons for the email was "belief in the value of psychoanalytic knowledge in explaining human behavior."
"We don’t want to prohibit our members from using their knowledge responsibly," she said. "That responsibility is especially great today, since Trump’s behavior is so different from anything we’ve seen before [in a president]."
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The APsaA later clarified to Newsweek that its members were never bound by the Goldwater Rule and that the association expects its members to use caution and avoid "thinly veiled, disingenuous diagnostic interpretations of public figures" when speaking to the press.
Meanwhile, the APA, whose membership is 10 times larger than the APsaA, took to Twitter to affirm its stance on the Goldwater Rule after some individuals had confused it with the APsaA.
"For the record, the [APA] stands by the Goldwater Rule. Nothing has changed," the APA tweeted on July 25.
Also on July 25, the APA published an article in Psychology Today clarifying the "misreport" that it shared the same opinion as the APsaA. It noted the views of the APsaA should not be attributed to psychiatrists because that organization is comprised of psychoanalysts, not all of whom are psychiatrists.
The APA concluded that the Goldwater Rule is part of its internal guidelines and members should abide by it if they wish to remain part of the association.
Some individuals, including Gourguechon, are members of both the APA and the APsaA. She told CNN that despite disagreeing with the APA's stance, she planned to remain a member of both organizations.
Others are willing to leave the APA over the Goldwater Rule. Dr. Leonard Glass, an associate professor of psychiatry at Harvard Medical School, publicly left the APA in an article published in industry journal Psychiatric Times on July 20, CNN reports.
In the article, Glass wrote that he and his colleagues were "shocked by what we felt was the APA's 'gag rule' on this issue," referring to being able to make public comments about the president.
Glass cited the president's Twitter feed and television appearances as abundant enough to make an educated observation. He concluded that the president's "instability" renders him unfit to serve.
The Goldwater Rule is expected to spark debate again in October, when a book titled "The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President" is set to be published.