Part of my trade is keeping my mouth shut. I’m quite prepared to call behaviour foolish, stupid, evil, converged… but I won’t diagnose those I don’t see.
And those I do see I don’t talk about here. I talk about at work. This was broken in a survey of 12,000 psychiatrists done during the Goldwater campaign: I think I was not even at kindergarten then.
“Simply put, breaking the Goldwater Rule is irresponsible, potentially stigmatizing, and definitely unethical,” wrote Oquendo.
The Goldwater Rule remains relevant, said Appelbaum. A diagnosis made at a distance is likely to be inaccurate and simply reflect the commenting psychiatrist’s political views, he said. As a result, the candidate may be unfairly hurt in the eyes of the public. Goldwater felt personally aggrieved by the Fact episode.
“It’s important to be circumspect and be sure that people understand what you’re claiming and what you’re not claiming,” added Ezra Griffith, M.D., a professor emeritus and senior research scientist in psychiatry at Yale University School of Medicine and chair of APA’s Ethics Committee. “It’s difficult to make claims about someone you’ve never examined and about whose background you have limited knowledge, or if you haven’t interviewed any collateral witnesses. The scandal following the Goldwater incident occurred because psychiatrists were making statements without being mindful of an ethics-based practice that guides a professional’s behavior.”
Accusations of mental deficiencies exploit the heightened stigma attached to mental illness. Much has been written about the current candidates’ hair, for example, said Griffith, but no one has asked dermatologists for their professional opinions.
Appelbaum also worries that people who could benefit from psychiatric treatment would look at psychiatrists who assessed candidates based on television reports as being incapable of rendering a scientifically sound diagnosis.
The full rule is as follows (hat tip Cam at WhaleOil)
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.
The short version: It’s okay to talk about psychiatric issues — but not okay to diagnose people you haven’t treated.
Which is what I do here. Sometimes. Most of the papers I quote from are psychiatric and come from my weekly reading around.
But unless I am under oath and/or I have permission to write a letter, or the Tarasoff rule is invoked, what I hear must stay in the room.
I will leave the speculation about politician’s health to others. The policies however… stand and fall by themselves