The EOLAWKI and the Goldwater Rule

Alas, it’s election season. Every other TV commercial is stridently predicting the End of Life as We Know It (EOLAWKI) if Candidate X is elected instead of Candidate Y. Radio broadcasts are similarly plagued with outraged reminders that Candidate Z once brazenly spoke out of turn in kindergarten, according to a former classmate who remembers the day like it was yesterday and who is sure that we are facing the EOLAWKI should Candidate Z weasel his way into office.

November can’t get here soon enough.

We urge our psychiatrist-customers to remember the ‘Goldwater Rule’. If this is a term you don’t recognize, you may know it as Section 7.3 of the American Psychiatric Association’s Principles of Ethics*.  The rule is simple: a psychiatrist should refrain from offering a professional opinion about an individual unless the psychiatrist has personally conducted an examination of the individual who then properly authorized the psychiatrist to release publicly his findings. The Goldwater Rule is also implicated when the media representatives seek out comments from psychiatrists in the wake of a tragedy involving an allegedly mentally ill person.

Accordingly, the APA’s Principles of Ethics would likely take a dim view of an APA member saying, “Everything I’ve read and heard about Candidate Z leads me, a psychiatrist, to conclude that he has narcissistic personality disorder and attention deficit-hyperactivity disorder; further, it’s likely he has oppositional defiant disorder as well.”

Psychiatrists ARE encouraged to educate the public about the signs, symptoms and epidemiology of mental illness IN GENERAL. In fact, if you purchase your professional liability insurance through PRMS, you are covered in the unlikely event you are sued in connection with your efforts to educate the public about mental illness (e.g., through a newspaper column, a radio show, an interview about the symptoms of depression, etc.).

Good psychiatric risk management instincts will, however, keep a psychiatrist from moving from the general to the specific in dealing with a reporter’s questions. If you’re approached by the media, keep it generic, keep it educational, and remind the reporter that you have no personal knowledge of the individual situation. (Of course if you do have personal knowledge, talking to the reporter is ill-advised.)

* Section 7.3. 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.

American Psychiatric Association, The Principles of Medical Ethics, With Annotations Especially Applicable to Psychiatry (2010 Edition Revised)

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