Renowned psychiatrist Robert Jay Lifton on the Goldwater Rule: We have a duty to warn if someone may be dangerous to others.
There will not be a book published this fall more urgent, important, or controversial thanThe Dangerous Case of Donald Trump, the
work of 27 psychiatrists, psychologists and mental health experts to
assess President Trump’s mental health. They had come together last
March at a conference at Yale University to wrestle with two questions.
One was on countless minds across the country: “What’s wrong with him?”
The second was directed to their own code of ethics: “Does Professional
Responsibility Include a Duty to Warn” if they conclude the president to
be dangerously unfit?
As
mental health professionals, these men and women respect the
long-standing “Goldwater rule” which inhibits them from diagnosing
public figures whom they have not personally examined. At the same time,
as explained by Dr. Bandy X Lee, who teaches law and psychiatry at Yale
School of Medicine, the rule does not have a countervailing rule that
directs what to do when the risk of harm from remaining silent outweighs
the damage that could result from speaking about a public figure —
“which in this case, could even be the greatest possible harm.” It is an
old and difficult moral issue that requires a great exertion of
conscience. Their decision: “We respect the rule, we deem it subordinate
to the single most important principle that guides our professional
conduct: that we hold our responsibility to human life and well-being as
paramount.”
Hence, this profound, illuminating and discomforting book undertaken as “a duty to warn.”
The
foreword is by one of America’s leading psychohistorians, Robert Jay
Lifton. He is renowned for his studies of people under stress — for
books such as Death in Life: Survivors of Hiroshima (1967), Home from the War: Vietnam Veterans — Neither Victims nor Executioners (1973), and The Nazi Doctors: Medical Killing and the Psychology of Genocide(1986). The Nazi Doctors was
the first in-depth study of how medical professionals rationalized
their participation in the Holocaust, from the early stages of the
Hitler’s euthanasia project to extermination camps.
The Dangerous Case of Donald Trump will be published Oct. 3 by St. Martin’s Press.
Here is my interview with Robert Jay Lifton — Bill Moyers
Bill Moyers: This book is a withering exploration of Donald Trump’s
mental state. Aren’t you and the 26 other mental health experts who
contribute to it in effect violating the Goldwater Rule? Section 7.3 of the
American Psychiatrist Association’s code of ethics flatly says: “It is
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.” Are you putting your profession’s reputation at risk?
Robert Jay Lifton: I don’t think so. I think the Goldwater Rule is a little
ambiguous. We adhere to that portion of the Goldwater Rule that says we don’t
see ourselves as making a definitive diagnosis in a formal way and we don’t
believe that should be done, except by hands-on interviewing and studying of a
person. But we take issue with the idea that therefore we can say nothing about
Trump or any other public figure. We have a perfect right to offer our opinion,
and that’s where “duty to warn” comes in.
Moyers: Duty to warn?
Lifton: We
have a duty to warn on an individual basis if we are treating someone who may
be dangerous to herself or to others — a duty to warn people who are in danger
from that person. We feel it’s our duty to warn the country about the danger of
this president. If we think we have learned something about Donald Trump and
his psychology that is dangerous to the country, yes, we have an obligation to
say so. That’s why Judith Herman
and I wrote our letter to The New York Times. We argue that Trump’s difficult relationship to reality and
his inability to respond in an evenhanded way to a crisis renders him unfit to
be president, and we asked our elected representative to take steps to remove
him from the presidency.
Moyers: Yet some people argue that our political system sets no
intellectual or cognitive standards for being president, and therefore, the
ordinary norms of your practice as a psychiatrist should stop at the door to
the Oval Office.
Lifton: Well, there are people who believe that there should be a
standard psychiatric examination for every presidential candidate and for every
president. But these are difficult issues because they can’t ever be entirely
psychiatric. They’re inevitably political as well. I personally believe that
ultimately ridding the country of a dangerous president or one who’s unfit is
ultimately a political matter, but that psychological professionals can
contribute in valuable ways to that decision.
Moyers: Do you recall that there was a comprehensive study of
all 37 presidents up to 1974? Half of them reportedly had a diagnosable mental
illness, including depression, anxiety and bipolar disorder. It’s not normal
people who always make it to the White House.
Lifton: Yes, that’s amazing, and I’m sure it’s more or less true.
So people with what we call mental illness can indeed serve well, and people
who have no discernible mental illness — and that may be true of Trump — may
not be able to serve, may be quite unfit. So it isn’t always the question of a
psychiatric diagnosis. It’s really a question of what psychological and other
traits render one unfit or dangerous.
Moyers: You write in the foreword of the book: “Because Trump is
president and operates within the broad contours and interactions of the
presidency, there is a tendency to view what he does as simply part of our
democratic process, that is, as politically and even ethically normal.”
Lifton: Yes. And
that’s what I call malignant normality. What we put forward as self-evident and
normal may be deeply dangerous and destructive. I came to that idea in my work
on the psychology of Nazi doctors — and I’m not equating anybody with Nazi
doctors, but it’s the principle that prevails — and also with American
psychologists who became architects of CIA torture during the Iraq War era.
These are forms of malignant normality. For example, Donald Trump lies
repeatedly. We may come to see a president as liar as normal. He also makes
bombastic statements about nuclear weapons, for instance, which can then be
seen as somehow normal. In other words, his behavior as president, with all
those who defend his behavior in the administration, becomes a norm. We have to
contest it, because it is malignantnormality. For the
contributors to this book, this means striving to be witnessing professionals,
confronting the malignancy and making it known.
Please continue this interview here: http://billmoyers.com/story/dangerous-case-donald-trump-robert-jay-lifton-bill-moyers-duty-warn/
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