The Goldwater Rule was meant to prevent psychiatrists from politicizing their authority. But now it’s muzzling them in the midst of a vital public debate.
Photograph by Alex Brandon / AP
At his rally in Phoenix on Tuesday night, Donald Trump remarked, of his decision to take on the Presidency, “Most people think I’m crazy to have done this. And I think they’re right.”
A strange consensus does appear to be forming around Trump’s mental state. Following Trump’s unhinged Phoenix speech, James Clapper, the former director of national intelligence, said on CNN, “I really question his … fitness to be in this office,” describing the address as “scary and disturbing” and characterizing Trump as a “complete intellectual, moral, and ethical void.” Last week, following Trump’s doubling-down on blaming “many sides” for white-supremacist violence in Charlottesville, Senator Bob Corker, a Republican of Tennessee, said that the President “has not yet been able to demonstrate the stability, nor some of the competence, that he needs” to lead the country. Last Friday, Representative Zoe Lofgren, a Democrat of California, introduced a resolution urging a medical and psychiatric evaluation of the President, pointing to an “alarming pattern of behavior and speech causing concern that a mental disorder may have rendered him unfit and unable to fulfill his Constitutional duties.” Lofgren asked, in a press release, “Does the President suffer from early stage dementia? Has the stress of office aggravated a mental illness crippling impulse control? Has emotional disorder so impaired the President that he is unable to discharge his duties? Is the President mentally and emotionally stable?”
The class of professionals best equipped to answer these questions has largely abstained from speaking publicly about the President’s mental health. The principle known as the “Goldwater rule” prohibits psychiatrists from giving professional opinions about public figures without personally conducting an examination, as Jane Mayer wrote in this magazine in May. After losing the 1964 Presidential election, Senator Barry Goldwater successfully sued Factmagazine for defamation after it published a special issue in which psychiatrists declared him “severely paranoid” and “unfit” for the Presidency. For a public figure to prevail in a defamation suit, he must demonstrate that the defendant acted with “actual malice”; a key piece of evidence in the Goldwater case wasFact’s disregard of a letter from the American Psychiatric Association warning that any survey of psychiatrists who hadn’t clinically examined Goldwater was invalid.
The Supreme Court denied Fact’s cert petition, which hoped to vindicate First Amendment rights to free speech and a free press. But Justice Hugo Black, joined by William O. Douglas, dissented, writing, “The public has an unqualified right to have the character and fitness of anyone who aspires to the Presidency held up for the closest scrutiny. Extravagant, reckless statements and even claims which may not be true seem to me an inevitable and perhaps essential part of the process by which the voting public informs itself of the qualities of a man who would be President.”
These statements, of course, resonate today. President Trump has unsuccessfully pursued many defamation lawsuits over the years, leading him to vow during the 2016 campaign to “open up our libel laws so when they write purposely negative and horrible and false articles, we can sue them and win lots of money.” (One of his most recent suits, dismissed in 2016, concerned a Univision executive’s social-media posting of side-by-side photos of Trump and Dylann Roof, the white supremacist who murdered nine black churchgoers in Charleston, South Carolina, in 2015; Trump alleged that the posting falsely accused him of inciting similar acts.)
The left-leaning psychiatric community was shamed by the Fact episode for having confused political objection and medical judgment, and came under pressure from the American Medical Association, whose members had largely supported Goldwater over Lyndon Johnson. The A.P.A. adopted the Goldwater rule in 1973; Dr. Alan Stone, my colleague at Harvard Law School, was at the time the only member of the A.P.A.’s board to oppose the rule, as a denial of free speech “and of every psychiatrist’s God-given right to make a fool of himself or herself.” Stone, who has served on the A.P.A.’s appeals board, told me that a few members over the years have been sanctioned or warned for Goldwater-rule violations, but that the A.P.A. eventually gave up enforcing it, because of the difficulty of providing due process to the accused.