As a psychiatrist, I find Jacob Appel’s assertions in his recent commentary (“‘Goldwater Rule’ stifles psychiatrists’ free speech,” April 2) concerning. Commenting on the possible psychiatric diagnosis of any individual, public or private, without a detailed and expert clinical evaluation of the individual is not only a fool’s errand but also undermines psychiatry as a scientific, evidence-driven medical profession.
To develop accurate diagnoses and treatment recommendations, we must complete thorough and objective evaluations and benefit from an honest and open account by the individual being assessed as to their past and present experiences of their thoughts and behavior and its consequences and their insight into both. When any individual regardless of political office or public position engages in bombastic and boastful anti-democratic statements, it does not necessarily constitute a psychiatric diagnosis if their intent is to volitionally lie to Americans in the pursuit of power and money. Without examining the individual we have no knowledge of their insight, or the motivation or intent of their behavior even as we can acknowledge the dangerousness of their behaviors.
As psychiatrists, we can certainly offer a valuable service to the American public by describing the broad range of possibilities of a public individual’s motivation and intent especially those actions which appear to be harmful to society as a whole but to place a diagnosis on an individual who is engaging in these behaviors is as dangerous to our profession as it is to our society.
Drew Pate, Baltimore
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