So many norms of politics and civic discourse have been shattered in 2017. Not every smashed convention this year has been the handiwork of President Donald Trump.
In a book of essays published in October, two dozen psychiatrists and psychologists challenged strictures laid down by their professions' leaders and publicly analyzed Trump's mental state. "The Dangerous Case of Donald Trump" is a recitation of evidence for what they contend is Trump's malignant narcissism, hedonism and sociopathy.
Their consensus has two thrusts: First, rump is a "clear and present danger to the United States, and to the well-being of its citizens." And second, as a profession, mental health practitioners are bound by a legal and ethical duty to warn the public of the danger he poses.
The authors' defiance has won them a harsh rebuke from Dr. Jeffrey Lieberman, a past president of the American Psychiatric Association, who denounced the book of essays as "tawdry, indulgent, fatuous tabloid psychiatry."
But in an essay published this week in the New England Journal of Medicine, a psychiatrist and philosopher defends her colleagues' willingness to challenge a decades-old prohibition on the practice of psychiatry in the public square.
When virtually everyone fancies him or herself qualified to render a psychiatric diagnosis, should actual mental health professionals really be muzzled? said Dr. Claire Pouncey.
She readily acknowledges that the psychiatrists and psychologists who speak up will not actually have examined the person whose psyche is under discussion. Even so, she asked, mightn't they have some valuable insights to inform the public debate?
The book of essays, edited by Yale School of Medicine psychiatrist Dr. Bandy X. Lee, has been a finger in the eye of the psychiatric association., which in 1973 prohibited public diagnosis by its members. In what is widely known as "the Goldwater Rule," the APA declared it "unethical for a psychiatrist to offer a professional opinion" on a public figure "unless he or she has conducted an examination and has been granted proper authorization for such a statement."
That rule was adopted to avert any repeat of a Cold-War-era incident that caused the psychiatry establishment acute embarrassment. In an article titled "The Unconscious of a Conservative," Fact Magazine reported in 1964 that 1,189 psychiatrists believed Republican Barry Goldwater to be "psychologically unfit to be president." Goldwater sued the magazine for libel -- and won.
Almost a decade later, the APA's first-ethics committee crafted the Goldwater Rule.