STAT May 24, 2023
For psychiatrists, Donald Trump’s third run for the presidency means that we’ll once again face the challenge of diagnosis: Should we, or shouldn’t we? For 50 years, the American Psychiatric Association’s code of ethics has forbidden any member from diagnosing public figures unless the doctor has interviewed them and obtained their permission, a constraint known as the Goldwater Rule. During the 2016 presidential race, some psychiatrists skirted the rule and, through indirection, labeled Trump paranoid, sociopathic, or pathologically narcissistic. In justification, they referred to a competing obligation to warn the public about impending disaster.
Ever since, the field has debated the merits of diagnosis from a distance. I won’t rehash the arguments. Instead, I want to make a strange, speculative...
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