The aftermath of Freud and Frankl
Freud barely made it out in time. His sisters perished. Frankl ended up in several concentration camps and his nuclear family died, but his reflections on his experience have been of immense value to millions of readers. Nevertheless, as a prelude to the Goldwater Rule, neither analyzed nor spoke publicly much, if at all, about Hitler.
If they had or did, would it have made any difference? Is their silence the right model for today?
Today, our leadership targets mostly immigrants and Hispanic minorities. Does that pose a challenge to psychiatrists of that background to speak up in some helpful way?
Silence generally supports the status quo. However, the Preamble of our ethical principles clearly lists “society” as one of secondary ethical priorities after the needs of patients.
I would suggest that if and how we respond to the political issues in society is the quintessential ethical challenge we psychiatrists face today. The risk is reflected in the recent rise in workplace burnout (with physicians at the top of the list), xenophobia, and mental health disorders and suicide. Families and loved ones are being pulled apart due to their different political beliefs. “Lock her [or him] up” is a public chant.
One possibility is to speak up as citizens, but not as psychiatrists. However, that will be a difficult distinction for the public to make if you are known as “Doc.” Any psychiatrist could decide that there is a choice to be made between two ethical goods and to choose the presumed dangers of this Presidency over the Goldwater Rule and accept whatever professional consequences that may ensue. Basically, the consequence is potentially to be barred from the American Psychiatric Association, though formally nothing more. Some resign in protest anyway. At the very least, why not speak out about the ethical dilemmas we face and then hear directly from the public about how they might like us to help or not?
We are in an information age and information can be power. Each of us must decide what information to share with the public.
1. Seethaler R. The Tobacconist. Toronto: Anansi Press; 2016.
2. Freud S. Moses and Monotheism. Vintage (1st ed); 1955.
3. Frankl V. Man’s Search for Meaning. Boston, MA: Beacon Press; 2006.