How do psychologists apply the Goldwater rule when assessing public figures like presidents?
Executive summary
The Goldwater Rule is an ethical constraint that discourages psychiatrists and, in practice, many psychologists from offering professional diagnoses of living public figures they have not personally examined and from whom they have not obtained authorization [1] [2]. In application this rule often leads clinicians to avoid categorical diagnoses of presidents while still allowing measured, research-grounded commentary on behavior, risk, and public safety—a balance that remains contested within the professions [3] [4].
1. What the rule says and why it exists
Originating after the 1964 Fact magazine episode and codified by the American Psychiatric Association in 1973 as “Annotation 7.3,” the Goldwater Rule forbids psychiatrists from publicly offering professional opinions about a person’s mental health without a personal examination and proper authorization, a policy meant to protect the profession’s scientific credibility and individuals’ rights [5] [1].
2. How psychologists and psychiatrists differ in practice
Although the Goldwater Rule is an APA psychiatric rule, the American Psychological Association and other psychology bodies have echoed similar cautions—urging members to base public statements on professional knowledge, avoid implying an established professional relationship, and refrain from definitive diagnoses absent examination—so practitioners across disciplines commonly apply the same restraint when discussing presidents [2] [3].
3. What clinicians will say instead of a diagnosis
Clinicians frequently shift from diagnostic labels to behavioral descriptions, risk assessments, and discussion of observable patterns (e.g., impulsivity, grandiosity) grounded in literature and theory; the APA’s guidance and subsequent commentaries encourage “precautious” public statements that educate rather than diagnose [2] [6]. Academic work also argues for carefully framed "informed opinions" from qualified psychological scientists in select, high-risk instances, provided caveats and methodology are explicit [4].
4. The “duty to warn” argument and its limits
Some clinicians invoke a perceived “duty to warn” about public figures whose behavior may pose societal risks, a rationale that has driven debate and occasional breaches of the rule, but professional bodies tightened language in 2017 to broaden the prohibition and blunt ad hoc public diagnoses [7] [3]. Critics say the in-person-exam requirement is scientifically imperfect and can silence expert voices on matters of public safety; proponents counter that it prevents politically biased, unverifiable armchair diagnoses [8] [9].
5. Enforcement, sanctions, and real-world gray zones
Enforcement is uneven: the rule is ethical guidance rather than a criminal statute, and high-profile commentators have both defied it and escaped sanctions, creating a perception of inconsistency and fueling disputes about the rule’s efficacy and fairness [2] [7]. Scholarly critiques argue the rule prioritizes the profession’s reputation over an individual clinician’s moral imperative to speak out, while defenders warn about reputational and legal fallout from speculative diagnoses [9] [10].
6. Proposals for refinement and international variations
Scholars and editorialists propose narrowing or clarifying the rule to permit structured, evidence-based commentary—such as hypothetical scenarios, disorder-specific effects, or expert testimony in government contexts—while many national psychiatric associations in Europe take varying stances, with some endorsing strict limits and others allowing more nuanced public commentary [6] [11].
7. Practical effect on public discourse about presidents
The net result is a mixed media landscape: psychiatrists and psychologists often avoid naming disorders when discussing presidents, opting instead for educational explanations, behavioral analysis, and warnings framed as professional concern; simultaneously, non-specialists and some clinicians continue to offer diagnoses in public, which critics say amplifies confusion and political polarization [12] [8].