Psychiatry Group: Yes, We Can Comment on Trump

A psychiatric group has told its members they're not obligated to adhere to something called the "Goldwater Rule," which has long prevented members of the profession from commenting on the mental health of public figures. The American Psychoanalytic Association emailed its members this month to that effect, though the Atlantic explains it wasn't so much a change in policy as a reminder that the Goldwater Rule is not officially part of the group's ethical guidelines. One thing of note: This APA has 3,500 members, but the larger American Psychiatric Association, with 37,000 members, still has the rule in place. The development comes amid lots of chatter about President Trump's behavior, which is "so different from anything we've seen before" in a president, a past leader of the smaller APA tells STAT. Coverage:

• Milestone? The move "represents the first significant crack in the profession's decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians' behavior," writes Sharon Begley at STAT. In a statement, however, a spokesperson emphasized that the group isn't encouraging members to go against the Goldwater Rule, notes Time. It's just that "we don't want to prevent our members from using their knowledge responsibly," adds the former leader.

• Still opposed: The American Psychiatric Association reiterated that its own policy is unchanged. In March, the group formally reaffirmed its view that it's unethical for doctors to speculate on the mental health of a person they haven't personally evaluated. The full policy is here.
• 'Gag rule'?: Last week, Dr. Leonard Glass of Harvard wrote an essay in Psychiatric Times likening the Goldwater prohibition to a "gag rule" and calling it "an unacceptable infringement on my right and duty." In the essay, he resigned from the American Psychiatric Association.
• Why Goldwater: In 1964, about 1,200 psychiatrists responding to a magazine survey declared conservative candidate Barry Goldwater unfit for the presidency, explains the Los Angeles Times. He later sued for libel and won, and the larger APA's ethics board established the rule in 1973.
• An expert weighs in: You don't have to search the topic long before finding someone arguing that Trump has narcissistic personality disorder. Well, the psychiatrist who literally wrote the definition for that disorder wrote a much-publicized letter to the editor earlier this year to the New York Times in which he states clearly that Trump doesn't meet the criteria. "He may be a world-class narcissist," writes Allen Frances, "but this doesn't make him mentally ill, because he does not suffer from the distress and impairment required to diagnose mental disorder."

(More Barry Goldwater stories.)