Another complication in this is that the Goldwater Rule is direct and specific in the ethical guidelines applying to psychiatrists. Here's the language: "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 themselves through public media. In such circumstances, a psychiatrist may share with the public their 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."
For psychologists, there is no direct and explicit language like this. There are guidelines that could be used, probably in combination, to conclude that a psychologist crossed a line. Perhaps by failing to get consent before evaluating a person.
I suspect that everyone who supports a rigid application of Goldwater without exceptions haven't considered all possibilities. Suppose a president claims that North Korea is controlling his thoughts by recently discovered radiation patterns beamed from Korea, reflected off one of the moons of Jupiter, and directly into the President's cranium and that these thoughts are destroying his mind. Then he adds that, accordingly, N. Korea must be destroyed by any and all US assets. Do we really want to say that mental health professionals cannot make public comments about the pathology of that language? (If we applied the rule then, ironically, everyone in the country would be able to say that this hypothetical President was psychotic EXCEPT psychologists and psychiatrists.).
Plus, when you consider the question of “duty to warn,” you would need to weigh the totality of the figure’s influence. For example, was Biden advised by people with expertise in areas of governing, and did he accept their guidance? Was he diminished in vigor and quickness of thought, or was he issuing decrees reflective of a diagnosable personality disorder? Anyway, it seems like full-throttle what-aboutism doesn’t quite work here.
Dale, I just wrote a very long text sharing my thoughts about the current situation and the Goldwater Rule. It’s your lucky day because it was too long,and I accidentally deleted it. Your text is well-stated. I agree in principle with the Goldwater Rule, but out of the ordinary situations call for appropriate responses. This is one of those out of the ordinary times. The Goldwater Rule does not seem appropriate for the current situation. Could one of the mental health professional organizations create a new standard for occasions when the continued unhealthy, erratic behaviors and words of an individual foster possible global unrest? This standard could allow the organization to identify the criteria for a possible diagnosis. Another organization (or department) could decide how or whether to use the information concerning a diagnosis. I’m way out of my depth here. I’m sure this is not easily understood or done or even if it is possible or appropriate. Just my late night thoughts on the matter.
Hi Pat. My preference would be that ethical guidelines about this be more nuanced. I don't think there is any reason to give public figures special status. I don't see why it would be more unethical to declare in public that, say, a Governor appears to be a sociopath than to say a patient's ex-husband is when the professional hasn't examined the ex-husband. Overall, my concern with the Rule is that it's overly rigid. Let's say that a President started making public statements that his thoughts are being governed by chemicals in food and by energy waves being transmitted from an invisible space station built by a foreign government. I'm not sure why everybody in the USA EXCEPT psychiatrists and psychologists would be free to say that the POTUS is displaying clear signs of paranoid delusions.
Based on my experiences with a family member, I diagnosed Biden as at the front end of Stage 4 dementia when he assumed office in 2020, and at the front end of Stage 5 when his term ended in 2024.
I think it would have been wrong for a professional to have made that diagnosis publicly. I'm not convinced it would be wrong for a professional to have said something like, "Based on what I see on television, the President is showing some changes in his gait and speech. Those could be age-related, or due to other causes, including some stage of dementia. I hope he is getting regular evaluations by physicians."
I'm not a professional in this area so it doesn't matter. I just think it's interesting how conservative and nuanced people are with Joe Biden and Trump is instantly diagnosed with all sorts of maladies by people with blue hair and body piercings.
Probably the most hilarious charge leveled against Trump is that he is "stupid."
My husband died of Posterior Cortical Atrophy (an Alz variant) in 2013, and I was his caregiver for the 10 year decline. Biden looked like a 2 or 3 to me, if indeed that turns out to be the path. Our levels of expertise, and personal depth of experience will differ.
Another complication in this is that the Goldwater Rule is direct and specific in the ethical guidelines applying to psychiatrists. Here's the language: "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 themselves through public media. In such circumstances, a psychiatrist may share with the public their 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."
For psychologists, there is no direct and explicit language like this. There are guidelines that could be used, probably in combination, to conclude that a psychologist crossed a line. Perhaps by failing to get consent before evaluating a person.
I suspect that everyone who supports a rigid application of Goldwater without exceptions haven't considered all possibilities. Suppose a president claims that North Korea is controlling his thoughts by recently discovered radiation patterns beamed from Korea, reflected off one of the moons of Jupiter, and directly into the President's cranium and that these thoughts are destroying his mind. Then he adds that, accordingly, N. Korea must be destroyed by any and all US assets. Do we really want to say that mental health professionals cannot make public comments about the pathology of that language? (If we applied the rule then, ironically, everyone in the country would be able to say that this hypothetical President was psychotic EXCEPT psychologists and psychiatrists.).
Did you diagnose Biden as senile and Parkinsonian, or is the Goldwater Rule only for Democrats?
No, I did not. No, the Goldwater Rule is not related to political parties.
Plus, when you consider the question of “duty to warn,” you would need to weigh the totality of the figure’s influence. For example, was Biden advised by people with expertise in areas of governing, and did he accept their guidance? Was he diminished in vigor and quickness of thought, or was he issuing decrees reflective of a diagnosable personality disorder? Anyway, it seems like full-throttle what-aboutism doesn’t quite work here.
Dale, I just wrote a very long text sharing my thoughts about the current situation and the Goldwater Rule. It’s your lucky day because it was too long,and I accidentally deleted it. Your text is well-stated. I agree in principle with the Goldwater Rule, but out of the ordinary situations call for appropriate responses. This is one of those out of the ordinary times. The Goldwater Rule does not seem appropriate for the current situation. Could one of the mental health professional organizations create a new standard for occasions when the continued unhealthy, erratic behaviors and words of an individual foster possible global unrest? This standard could allow the organization to identify the criteria for a possible diagnosis. Another organization (or department) could decide how or whether to use the information concerning a diagnosis. I’m way out of my depth here. I’m sure this is not easily understood or done or even if it is possible or appropriate. Just my late night thoughts on the matter.
Hi Pat. My preference would be that ethical guidelines about this be more nuanced. I don't think there is any reason to give public figures special status. I don't see why it would be more unethical to declare in public that, say, a Governor appears to be a sociopath than to say a patient's ex-husband is when the professional hasn't examined the ex-husband. Overall, my concern with the Rule is that it's overly rigid. Let's say that a President started making public statements that his thoughts are being governed by chemicals in food and by energy waves being transmitted from an invisible space station built by a foreign government. I'm not sure why everybody in the USA EXCEPT psychiatrists and psychologists would be free to say that the POTUS is displaying clear signs of paranoid delusions.
Based on my experiences with a family member, I diagnosed Biden as at the front end of Stage 4 dementia when he assumed office in 2020, and at the front end of Stage 5 when his term ended in 2024.
I think it would have been wrong for a professional to have made that diagnosis publicly. I'm not convinced it would be wrong for a professional to have said something like, "Based on what I see on television, the President is showing some changes in his gait and speech. Those could be age-related, or due to other causes, including some stage of dementia. I hope he is getting regular evaluations by physicians."
I'm not a professional in this area so it doesn't matter. I just think it's interesting how conservative and nuanced people are with Joe Biden and Trump is instantly diagnosed with all sorts of maladies by people with blue hair and body piercings.
Probably the most hilarious charge leveled against Trump is that he is "stupid."
My husband died of Posterior Cortical Atrophy (an Alz variant) in 2013, and I was his caregiver for the 10 year decline. Biden looked like a 2 or 3 to me, if indeed that turns out to be the path. Our levels of expertise, and personal depth of experience will differ.