It was a presidential election year. A magazine called "Fact" had reached out to all 12,356 members of the American Psychiatric Association (APA) about the Republican presidential candidate, who hailed from the party's extreme right-wing and was intensely disliked by liberals. Of the 2,417 psychiatrists who responded, nearly half said the Republican nominee was psychologically unfit to be president (1,189), with the rest split almost evenly between saying that he was fit (657) and demurring altogether (571). Even though this means that fewer than 10 percent of the APA members actually denounced the Republican candidate as mentally unfit for office, the ones who did so used such colorful and memorable language that it made headlines. To understand way, simply look at one one of the quotes from the anti-Goldwater psychiatrists:
"He is a mass-murderer at heart and ... a dangerous lunatic. ... Any psychiatrist who does not agree with the above is himself psychologically unfit to be a psychiatrist."
While one might imagine those words being written about former President Donald Trump, their actual target was Sen. Barry Goldwater of Arizona, who ran in the 1964 election against President Lyndon Johnson. Even though the Johnson-Goldwater contest happened nearly six decades ago, Americans are still living with the ramifications of these psychiatrists' public statements. For one thing, it will never be clear if they contributed to his landslide defeat; that said, Goldwater eventually sued Fact magazine for defamation and won, achieving an important symbolic victory over the liberal media outlets that had attacked him. Even before Goldwater's legal victory, however, the APA released a new rule — later dubbed "the Goldwater Rule" — which prohibits psychiatrists from publicly commenting on an individual unless they have previously performed a "thorough clinical examination" on them as a patient.
In theory, the Goldwater Rule stops psychiatrists from abusing the public's trust by misleadingly presenting subjective partisan opinions as objective medical information. Yet a bipartisan case could be made that the Goldwater Rule is out-of-date. Many of Trump's critics claim that the Republican shows signs of narcissism and serious psychological diseases, while President Joe Biden's opponents often accuse him of dementia and other cognitive disorders. Few medical experts would argue that it is appropriate for laypeople like pundits to diagnose politicians — but does that mean mental health professionals should not be able to offer informed observations?...