The Case of Donald Trump and the Goldwater Rule: Politics and Professional Ethics Intertwined

• Author: Justin T. Piccorelli,R. McGreggor Cawley
• DOI: http://doi.org/10.1177/10659129211004785
• Published date: 01 December 2022
• Date: 01 December 2022
• Subject Matter: Articles

https://doi.org/10.1177/10659129211004785

Political Research Quarterly

© 2022 University of Utah

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DOI: 10.1177/10659129211004785

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Introduction

In 2017, a group of predominantly psychiatrists and men-

tal health professionals published a compendium of

assessments expressing concern about President Donald

Trump’s dangerous personality traits (Lee 2019).1 These

assessments ostensibly represented judgments based in

professional knowledge and training—not politics. While

the book garnered less public attention than the contribu-

tors perhaps hoped for, it set off a rather spirited debate

within the mental health professional community. The

central issue in the debate was a provision from the

American Psychiatric Association (APA) code of ethics,

commonly referred to as the “Goldwater rule”:

On occasion psychiatrists are asked for an opinion about an

individual who is in the light of public attention or who has

disclosed information about himself/herself through public

media. In such circumstances, a psychiatrist may share with

the public his or her expertise about psychiatric issues in

general. However, 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. (APA 2013, 9)

Critics charged that since none of the contributors had

undertaken a direct examination of Trump, nor secured

his permission for public comment, they had violated this

established standard for acceptable professional conduct.

A primary response of the contributors was that, as pro-

fessionals, they had a responsibility, even duty, to publish

their assessments in an effort to protect the public (Lee

2019). What interested us in this controversy is that the

contributors’ actual assessments received little attention,

instead, the prominent theme was the potential damage

the book might cause to the prestige and integrity of the

mental health profession. For example, discussing vari-

ous criticisms of the project, Herman and Lee (2019,

liii–liv) noted, “Psychiatry, we were warned, should stay

out of politics; otherwise, the profession could end up

being ethically compromised.”

In consequence, our intent is to use this controversy as

an occasion to investigate the broader dialogue about the

tension between professionalism and politics in the gov-

erning process. Our specific interest in this regard is the

recurring contention that professional ethical standards

fall outside the purview of, if not in opposition to, the

political realm. As Frederick Mosher (1982, 117) argued

in his now seminal study, Democracy and the Public

Service, a profession has a “continuing drive . . . to

1004785PRQXXX10.1177/10659129211004785Political Research QuarterlyPiccorelli and Cawley

research-article2022

1University of Wyoming, Laramie, USA

Corresponding Author:

Justin T. Piccorelli, School of Politics, Public Affairs and International

Studies, University of Wyoming, 1000 E. University Ave., Dept. 3197,

Laramie, WY 82071, USA.

Email: jpiccore@uwyo.edu

The Case of Donald Trump and

the Goldwater Rule: Politics and

Professional Ethics Intertwined

Justin T. Piccorelli1 and R. McGreggor Cawley1

Abstract

In 1964, after a group of psychiatrists questioned Barry Goldwater’s mental health during the presidential campaign,

the Goldwater rule became part of American Psychiatric Association’s medical ethics. The events surrounding the

Goldwater rule indicate changes in the practice of psychiatry, but also politics. More recently, thirty-seven psychiatrists

were compelled to question the mental health of President Donald Trump believing their greatest responsibility is

to the well-being of the citizenry. These psychiatrists point to the intertwining of politics and professional ethics, a

relationship, which our paper attempts to better understand.

Keywords

ethics, professional ethics, politics, ecology of profession, psychiatry, Goldwater rule

2022, Vol. 75(4) 1313–1320

Article