If
You See Something, Don’t Say Something?
If you stroll through any airport, sooner
or later the public address system will blast, “It you see something, say
something”. No problem! We all agree. Well almost. Everyone agrees except the psychiatrists,
with respect to their self-imposed Goldwater Rule. The rule, named after the
1964 Arizona candidate for the presidency, Barry Goldwater—the Republican
candidate, who displayed questionable symptoms of significant mental illness,
was revised in l973 by the American Psychiatric Association in its first
edition of its Code of Ethics [1]:
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.
On July 4, 2017. The Independent, a
UK news source (May Bulman reporting) stated that a “group of psychiatrists at
a Yale University conference warned that President Trump has a dangerous mental
illness”. There have been several
petitions calling for removal from office on the grounds of mental illness.
Other psychiatrists have argued that a mental health professional should not
make a diagnosis public without examining the patient. It is my contention that
if a public official has a physician-patient relationship with a psychiatrist,
then that relationship should be bound to secrecy and the physician should not
release or discuss any diagnosis without the express permission of the patient.
This is considered standard patient confidentiality covering all mental health
providers-public figure patients.
But what if the public figure’s mental
health affects the future of the country or of the world as Danny Wedding PhD,
editor of PsyCRITQUES pointed out? [2]
What
if a public figure contests the outcome of a presidential election duly
authorized as fair and square? Then you have added a different dimension to the
conflict. Then the Goldwater Rule
becomes a gag order. If you are a practicing psychiatrist and on court order,
conclude after examining a patient that that person is a clear danger to
himself and others, you act accordingly.
It happens in our court system every day. So, simple common sense tells us that the
Goldwater Rule is ridiculous and worse, dangerous to the welfare of the
state. Patient-physician confidentiality
is too narrow an argument.
The APA should point out that
psychiatrists have a professional, moral and social responsibility to notify
the public of the danger consequent to the mental state of an elected official
who is capable of great endangerment.
Failure to do so is not only gagging the science, but is thwarting the access
to open discussion and freedom to engage in open debate in the public
square. The psychiatrists, indeed all
mental health workers, by virtue of their education and training, should be the
very people leading the education of the consequences of mental illness.
I
write this on January 4, 2021, two days before the Senate is to meet to
formalize the Electoral College results, with the likelihood of open objections
from twelve senators and over one hundred Republicans of the House stating
their rejection of reality. The
president’s perception of reality has a pervasive effect. So I am saying
something!
==========================================================
1.
www.time.com/48975093/donald-trump-goldwater-rule-history/
2.
www.apa.org/pubs/highlights/psyccritiques-spotlight/issue-20#:[EW1]
