Ethics Lesson

Thanks to Dr. Stotland for her January 16 column, which was both about, and not about, the man who is no longer governor of Illinois. Her column was a“ lemons-to-lemonade” accomplishment on her part. She managed to turn a major embarrassment for our state into an opportunity to educate the public, and our membership, about a not-too-well-known section of our ethics code.

As chair of the Illinois Psychiatric Society's Ethics Committee, I'm aware that the so-called “Goldwater Rule”—the prohibition on APA members making public diagnoses of public figures—is not widely known. One only has to watch major news outlets to see members of various mental health professions violating this ethical canon. The resignation of Gov. Spitzer of New York and recent events in Illinois both provoked such comments.

If we impressionistically feel a public figure is harming the public, it's tempting but still wrong to publicly diagnose that individual. This would lead us down a path fraught with risk to people in public life, to our profession, and to society at large. Were we to ignore this ethics rule, public figures could be stigmatized, psychiatrists would hurt the reputation of our profession by acting outside the bounds of our expertise (diagnosing people we've never met, without their consent), and society might miss the chance to hold politicians and others accountable for their behavior through the psychiatrist's perceived grant of a pathological “excuse.”

By the same token, our knowledge and experience may make us think it likely a public figure suffers from a mental disorder, but we must remember that true psychiatric diagnosis is based on a careful and objective weighing of information, and that information should be obtained directly from the person being diagnosed, at their request or at least with their consent.

As professionals with a responsibility to society as well as to our patients, we must resist the urge to assign a diagnosis to those in public life because of the harm it could do both to public discourse and to our own profession. Thanks, Dr. Stotland, for reminding us, and the public, of this important principle.