How have professional psychiatric organizations other than the APA responded to the Goldwater Rule during political crises?
Executive summary
Professional psychiatric organizations outside the American Psychiatric Association have not presented a single, unified stance on the Goldwater Rule during political crises; responses range from explicit rejection of APA-style prohibitions to cautious endorsements of restraint and calls for renewed debate about boundaries for public commentary [1] [2] [3]. European and specialty groups have frequently favored nuance — permitting individual commentary in some forums while warning against reductive psychiatric labeling of politicians in others [1] [2] [3].
1. A split between organizational silence and individual freedom
Some associations have distinguished institutional voice from individual member speech, permitting clinicians to comment privately or publicly while the organization refrains from diagnosing public figures: the American Psychoanalytic Association (APsaA) explicitly told members that APA ethics bind APA members only and that APsaA does not treat political commentary by individual members as an ethical violation, even as its executive council agreed the organization itself should not comment on specific politicians [1].
2. European psychiatry: heterogeneity and a push for discussion
European psychiatric bodies and national societies display heterogeneous approaches that reflect varied legal cultures and political histories; a recent study surveying European Psychiatric Association member associations found mixed responses and recommended that the EPA consider developing guidance tailored to Europe rather than simply transplanting the APA’s rule, noting that about half of European countries lack an equivalent prohibition and that some national societies have explicitly warned against psychiatric labelling of politicians [2] [3].
3. Crisis moments produce pragmatic statements rather than doctrinal overhaul
When high-stakes events provoke public concern over leaders’ mental fitness — from the Trump presidency to other international crises — non-APA organizations have tended to produce pragmatic, case-specific responses: some endorse public education about mental health principles and commentary on policies rather than remote diagnosis, while others call for broader ethical debate and possible exceptions for foreign leaders or clear public-danger scenarios [4] [5] [3].
4. Dissenting professionals and advocacy groups pressure organizations to act
Clinicians and activist collectives have openly challenged restrictive norms, arguing a “duty to warn” when a leader’s behavior appears dangerous; volumes such as The Dangerous Case of Donald Trump compiled clinicians who explicitly defied the APA’s prohibition and argued civic obligation trumped the Goldwater Rule during what they called a political crisis, a stance that prompted debate within and beyond professional societies [4] [6]. These pressures have pushed some organizations to revisit their guidance or at least to entertain public conversations about the rule’s limits [6] [7].
5. Warnings about politicization, stigma, and legal risk shape many responses
Countervailing arguments from professional leaders emphasize the historic rationale for restraint: the Goldwater Rule emerged after the 1964 “Fact” magazine episode to protect professional credibility and to avoid politicizing diagnoses, and organizations outside the APA frequently reiterate concerns about stigmatization, libel risk, and the profession’s reputation even while permitting educational commentary [8] [9] [5].
6. Hidden agendas and institutional incentives behind different stances
Where organizations relax proscriptions, motives include a specialty’s disciplinary culture (psychoanalytic traditions that privilege individual analyst speech), local legal tolerance for public commentary, and political context that pushes clinicians toward civic engagement; where organizations retain restraint, motives include risk management, protection from politicization, and preserving public trust — all of which can reflect institutional self-interest as well as genuine ethical concern [1] [2] [10].
Conclusion: plural, pragmatic, and contested
Outside the APA, the response to the Goldwater Rule during political crises is plural and contested: some societies, notably certain psychoanalytic and national European bodies, allow or encourage individual commentary while institutional voices avoid naming specific leaders; others call for renewed debate and tailored guidance rather than wholesale adoption or rejection of the APA approach, and many stress alternatives — public education about psychiatric concepts and discussion of policy consequences rather than remote diagnosis — as ethically safer paths [1] [2] [3]. The literature documents active disagreement among clinicians and organizations rather than convergence on a single solution [6] [4].