What is the Goldwater Rule and does it apply to diagnosing Donald Trump?
Executive summary
The Goldwater Rule is an American Psychiatric Association (APA) ethics guideline adopted in 1973 that bars APA member‑psychiatrists from offering a professional diagnosis of a public figure without a personal evaluation and consent [1] [2]. Debate over whether it should constrain commentary about Donald Trump has been intense: critics say it prevents experts from warning the public, while defenders argue armchair diagnoses politicize psychiatry and can be inaccurate [3] [4] [5].
1. What the Goldwater Rule actually says — the formal line
The APA’s rule (Section 7) forbids APA psychiatrists from giving a professional opinion about public figures’ mental health unless they have conducted an examination and obtained consent; it was adopted after the 1964 controversy over Barry Goldwater to protect both patients and the profession from politicized, unverified judgments [1] [2] [6].
2. Why the rule was created — history matters
The rule grew from the fallout when psychiatrists publicly assessed Barry Goldwater’s fitness in 1964 and a resulting libel suit and reputational damage convinced the profession that public armchair diagnosing was unethical and dangerous to psychiatry’s credibility [6] [7].
3. How the rule applies in practice — limits and enforcement
The Goldwater Rule governs APA members’ professional conduct; it does not create a legal ban on speech, and critics note there’s little practical enforcement and no comparable rule for non‑psychiatrists or professionals outside the APA [5] [8] [9].
4. The Trump debate — two conflicting schools of thought
One camp argues psychiatrists have a “duty to warn” when leaders’ behavior poses public risk and that modern diagnostic methods rely on observable behavior, so public commentary can be justified (advocates such as Bandy X. Lee are cited) [1] [10]. The opposing camp contends that diagnosing at a distance politicizes medicine, risks inaccuracy, and undermines trust in psychiatry — opponents invoke historic abuses and argue the Goldwater Rule avoids those pitfalls [4] [11].
5. What critics say about free speech and relevance
Some commentators and psychologists argue the rule impinges on free expression and academic input, especially as diagnoses are increasingly presented as behavior‑based rather than interview‑based; this has led to calls for legal or policy challenges, and for professional exceptions in matters of public safety [3] [5].
6. Examples from recent years — how people have reacted
During and after the 2016–2024 period many mental‑health professionals publicly speculated about President Trump’s mental state; some APA members violated or pushed against the rule (e.g., The Dangerous Case of Donald Trump project), while other professional bodies like the American Psychoanalytic Association signaled members could comment — illustrating fragmentation within the field [12] [13] [10].
7. Scholarly and journalistic perspectives — no unanimous consensus
Academic reviews argue the rule retains ethical force but may be out of step with modern media and security concerns; other scholars say the rule is obsolete because there’s no enforcement and professional consensus has frayed [14] [8] [5]. Journalistic accounts similarly present both the APA’s prohibition and the public‑interest arguments for speaking up [7] [15].
8. Practical takeaway for the question “Does it apply to diagnosing Donald Trump?”
If the question is whether APA member‑psychiatrists are professionally bound by the Goldwater Rule when discussing Trump, the answer in the sources is yes — APA guidance prohibits diagnosing public figures without examination and consent [1] [2]. If the question is whether the rule prevents all professionals or citizens from commenting, sources show it applies only to APA members and is contested and unevenly observed; many non‑APA clinicians, allied professionals, and commentators have publicly assessed Trump despite the guideline [9] [8] [10].
9. Limitations, disputes and hidden agendas to watch for
Sources show partisan and institutional motives shape positions: critics frame the rule as a “gag” that suppresses warnings about national risk [3] [16], while defenders warn about psychiatry’s politicization and reputation [4] [11]. Available sources do not resolve whether behavior‑based assessments without interviews are clinically equivalent to formal diagnoses — that remains a matter of professional disagreement [1] [5].
10. How to interpret future claims
When experts cite a psychiatric diagnosis of a public figure, check who the speaker is (APA member or not), whether they conducted an examination, and whether their comments are framed as formal diagnosis or as behavioral analysis; the presence or absence of these elements is central to whether the Goldwater Rule is implicated [1] [9].
Sources cited above summarize the APA rule, its origin, and the sustained debate over its application to Donald Trump and other public figures [1] [2] [3] [4] [5].