Blog | Friday, February 9, 2018

Is Trump mentally unfit for office? The Goldwater Rule violated

Many of my readers do not know who Barry Goldwater was, let alone of the Goldwater rule established by the American Psychiatric Association in 1973. The rule advises against psychiatrists commenting on the mental health of public figures they have not examined. Obviously, a psychiatrist or any physician who has treated a public figure is prohibited to offer any public comment unless he has been authorized by the patient to do so. Dr. Ronny Jackson, President Trump's personal physician, discussed the results of the president's recent medical examination with the press. The boundaries of what Dr. Jackson can report will have been set in advance by the president.

Yet, the Goldwater Rule has appeared in our newspapers and all over cable news and commentary programs. Goldwater has probably been a “trending topic.” This is in response to suggestions that the president may be mentally unfit for office. I have heard physicians who have never examined the president making this claim. And, seemingly beyond the reach of the Goldwater Rule, I have heard pundits and politicians, presumably with no medical training, suggesting or asserting that the president is non compos mentis.

It is beyond obvious that many of these “mental health experts” are simply using a new tool to attack a president whom they oppose politically or despise personally. I oppose this practice both as a physician and as a citizen. We cannot normalize average citizens or medical professionals on the sidelines offering psychiatric assessments of folks they don't really know. If this objectionable process were to become accepted, then it would be ultimately applied throughout society. There would be an inexorable mission creep that would make all of us potential targets of these inquisitions. If a boss at work, a teacher, an athlete or a customer started arguing, might this individual be labeled by onlookers as having a condition?

This practice disrespects those among us who truly have mental illnesses. It furthers the societal stigma associated with these diseases that we have all worked hard to reverse.

There may be instances when it seems inescapable that a person is psychiatrically afflicted. For example, folks who claim they are Napoleon, came from another planet or wrap their heads in tin foil likely have some psychiatric dysfunction. But we don't make policy based on rare anecdotes.

Mental illness is serious business. Mental health professionals train for years and throughout their careers to gain and maintain necessary skills for diagnosing and treating these illnesses. Leave it to the professionals.

Political adversaries, columnists, cable news jockeys and average citizens have enough fodder to criticize the president without shooting arrows from psychiatric quivers.

The wisdom of keeping silent is aged and timeless: Those who guard their mouths and their tongues keep themselves from calamity. Proverbs 21:23.

This post by Michael Kirsch, MD, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.