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Saturday
Apr222017

Ethics, Personal and Societal

 

At a recent psychiatric conference at Yale University, several psychiatrists made the claim that Donald Trump is mentally ill, necessitating his removal from office. Dr. John Gartner, a who is also a founding member of Duty to Warn, an organization of mental health professionals calling for Trump’s removal , said: “We have an ethical responsibility to warn the public about Donald Trump's dangerous mental illness.”

These psychiatrists are violating the so-called “Goldwater Rule,” formulated by the American Psychiatric Association’s Code of Ethics in 1973, which says, “it is unethical for a psychiatrist to offer a professional opinion unless he or she has conducted an examination and has been granted proper authorization for such a statement. 

A psychiatrist occupies a special role in our society, which is circumscribed by educational, legal, practice, and ethical standards. When the average citizen hears the pronouncement of such a professional, he or she is assuming that the statement  is being made by someone who is following the dictates of his or her profession. This means that a psychiatrist can say whatever he or she wants as a private citizen, but, once his or her title as a professional is invoked, these statements must adhere to the rules that the public relies upon such professionals following. If the public takes a statement  regarding the mental health of a public figure the mental health professional  has not examined personally, nor known outside of his or her public persona, as implying the same clinical and professional standards that apply to other statements made by that professional, then the public is being misled and this is unethical.

The argument made by Dr. Gartner and others is that their personal ethics demand that they violate their professional ethics and that they issue a diagnosis as well as a recommendation for action with regard to President Trump. This raises a substantive issue about what kinds of situations justify one’s personal ethical concerns overriding what society has accepted as normative ethical rules of behavior.

This issue has similarities to the one in which those who claim that their adherence to the legal and ethical guarantees of free speech must be suspended in cases where someone’s exercise of the right of free speech presents a danger to society. In both cases, the individual is taking it upon him or herself to violate ethical (and perhaps legal) principles because of his or her personal ethical concerns.

The best way to think about this (and to distinguish it from cases such as Martin Luther King’s refusal to follow laws that mandated segregation) is to ask whether the ethical rule in question has merit. If the answer is no, the decision is easy. One should not follow a flawed ethical rule. But most mental health professionals and most Americans agree with the Goldwater Rule and the first amendment guarantees of free speech, respectively. 

The tendency for individuals to make exceptions to ethical guidelines when their own opinions and emotions are involved is the reason such guidelines were encoded in the APA Code of Ethics and the United States Constitution. Neither the profession of psychiatry nor a democratic United States would work if exceptions to the ethical rules were allowed whenever individuals decide they are warranted. Such rules are precisely what allows professions and democracies to function. Public statements made by psychiatrists and protests on campuses rely upon a substrate of rules that lend such activities legitimacy. If such statements and protests violate the rules that support them, they are undermining the social contract upon which they were built.

 

 

 

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