Don’t Forget about the Goldwater Rule

Did you notice the recent Washington Post headline “The American Psychiatric Association issues a warning: No psychoanalyzing Donald Trump?” The article included many examples of psychologists and physicians (including one psychiatrist) who have never evaluated celebrities but have nonetheless commented on their mental health. No matter how tempting, especially given the sometimes outrageous behavior of public figures, the American Psychiatric Association’s 1973 ethical statement known as “the Goldwater Rule,” does not allow psychiatrists to offer opinions about individuals that they have not evaluated. The “warning” referenced by the article appears to be a blog post done by the APA president, Maria Oquendo, MD. In her blog post (“The Goldwater Rule: Why Breaking it is Unethical and Irresponsible”), she goes through the history of the Goldwater Rule:

“During [the 1964 presidential] election, Fact magazine published a survey in which they queried some 12,356 psychiatrists on whether candidate Sen. Barry Goldwater, the GOP nominee, was psychologically fit to be president.  A total of 2,417 of those queried responded, with 1,189 saying that Goldwater was unfit to assume the presidency.  While there was no formal policy in place at the time that survey was published, the ethical implications of the Goldwater survey, in which some responding doctors even issued specific diagnoses without ever having examined him personally, became immediately clear.”

Here is the Goldwater Rule (Annotation 3 under Section 7 of the Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry):

“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.”

I think it boils down to an ethical prohibition on rendering a professional opinion about a non-patient in the public light with a specific diagnosis and/or prognosis. What is not prohibited is educating the public by providing general information about a condition.

I will point out that some comments in the press that would likely be prohibited by the Rule have been made by psychologists rather than psychiatrists. Psychologists have different ethical rules. Just as an example, under psychiatric ethics, “Sexual activity with a current or former patient is unethical.” [Annotation 1 under Section 2 of the Principles of Medical Ethics with Annotations Especially Applicable to Psychiatry.] However, under the Ethical Principles of Psychologists and Code of Conduct 10.08, “Psychologists do not engage in sexual intimacies with former clients/patients for at least two years after cessation or termination of therapy.”

Donna Vanderpool, MBA, JD
Vice President

As Vice President of Risk Management, Ms. Vanderpool is responsible for the development and implementation of PRMS’s risk management services for The Psychiatrists’ Program. Ms. Vanderpool has developed expertise in the areas of HIPAA and forensic practice, and has consulted, written and spoken nationally on these and other healthcare law and risk management topics. She most recently contributed to a chapter in Gun Violence and Mental Illness (APPI), authored chapters on telepsychiatry in Mental Health Practice in a Digital World (Springer) andPsychoanalysis Online 2(Karnac). She also has co-edited and contributed chapters to several other clinical textbooks. Prior to joining PRMS in 2000, Ms. Vanderpool practiced criminal defense law, taught business and legal courses, and spent eight years managing a general surgical practice. Ms. Vanderpool received a Bachelor’s degree in Business Administration and Management from James Madison University. She also earned a Master of Business Administration degree and Juris Doctor degree from George Mason University.Follow Donna on LinkedIn.

Categories: PRMS Blog, Risk Management