Psychiatrists Bandy X. Lee and Leonard L. Glass (“Institutional silence on Trump’s mental state,” Opinion, Feb. 7) correctly point out the physician’s duty “to ensure public health and safety,” and they rightly argue that “either silence or active cooperation with a destructive regime” runs counter to “medicine’s humanitarian goals.” But it is a long leap of logic from these admirable principles to the claim that psychiatrists are justified in labeling a public figure “unstable and dangerous,” in the absence of a thorough clinical and forensic evaluation.
As an American citizen, I share with Drs. Lee and Glass deep concerns regarding the policies, practices, and pronouncements of the current administration. As a psychiatric physician, however, I am bound by professional standards governing what I can say about individuals I have not personally evaluated.
If the American Psychiatric Association’s “Goldwater rule” did not exist, physicians would be morally justified in inventing it. As a forensic colleague and I argued in Psychiatric Times, the rule is not a “gag order” aimed at imposing “absolute silence on its members who would otherwise speak out in the public square,” as Lee and Glass claim. Rather, the rule limits what psychiatrists can justifiably state in their professional capacity as psychiatrists—not what they can say, as concerned citizens, in the public square. To argue that psychiatrists must choose between violating the Goldwater rule and remaining silent in the face of injustice is to pose a classic false choice.
Dr. Ronald W. Pies
Lexington
The writer, a clinical professor of psychiatry at Tufts University School of Medicine, is a member of the APA. His views here are his own.
