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APA Calls for End to 'Arm Chair' Psychiatry

Wednesday, January 10, 2018  
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January 9, American Psychiatric Association

Today, the American Psychiatric Association (APA) reiterates its continued and unwavering commitment to the ethical principle known as "The Goldwater Rule." We at the APA call for an end to psychiatrists providing professional opinions in the media about public figures whom they have not examined, whether it be on cable news appearances, books, or in social media. Arm chair psychiatry or the use of psychiatry as a political tool is the misuse of psychiatry and is unacceptable and unethical.

The ethical principle, in place since 1973, guides physician members of the APA to refrain from publicly issuing professional medical opinions about individuals that they have not personally evaluated in a professional setting or context. Doing otherwise undermines the credibility and integrity of the profession and the physician-patient relationship. Although APA's ethical guidelines can only be enforced against APA members, we urge all psychiatrists, regardless of membership, to abide by this guidance in respect of our patients and our profession.

A proper psychiatric evaluation requires more than a review of television appearances, tweets, and public comments. Psychiatrists are medical doctors; evaluating mental illness is no less thorough than diagnosing diabetes or heart disease. The standards in our profession require review of medical and psychiatric history and records and a complete examination of mental status. Often collateral information from family members or individuals who know the person well is included, with permission from the patient.

"The Goldwater Rule embodies these concepts and makes it unethical for a psychiatrist to render a professional opinion to the media about a public figure unless the psychiatrist has examined the person and has proper authorization to provide the statement," said APA CEO and Medical Director Saul Levin, M.D., M.P.A. "APA stands behind this rule."

The President is about to undergo his annual physical examination, and APA has confidence that his physician will follow the standard of care in examining all systems, which includes an age-appropriate medical and mental health evaluation. If mental health concerns are raised, the standard of care would result in the examining physician seeking consultation from an experienced psychiatrist who would approach the consultation with objectivity and within the physician-patient confidential relationship.

APA is ready to make recommendations from among our 37,000 psychiatrist members, physicians who have the knowledge, training, expertise, discretion, and objectivity to perform a thorough and apolitical evaluation. Using psychiatry for political or self-aggrandizing purposes is stigmatizing for our patients and negatively impacts our profession.

For further information on the Goldwater Rule, go here.