Compromise on the Goldwater Rule is a Step Forward

Compromise on the Goldwater Rule may be the only way forward.

I appreciate the recent letter “Discouraged by the Goldwater Rule” by Jim Fleming, MD, in response to our publication, “The Goldwater Rule Is Fine, if Refined. Here’s How to Do it.” It is nice to see opposing viewpoints represented on this important topic. Psychiatric TimesTM deserves much credit for presenting all views on the Goldwater Rule.

It is not surprising that some psychiatrists feel that our proposed refinements to the Goldwater Rule do not go far enough. In light of psychiatry’s stated mission of bettering public health and improving society, it is reasonable for some mental health experts to believe that rendering opinions on public health and societal matters is within the purview of our field. I concur with that view.

Our intent was to develop a revised Goldwater Rule that reflects a compromise in opposing views as to its usefulness. Personally, I think our recommended changes are reasonable, fair, and balanced. Do they go far enough? That is the central question, going forward. I know I am open to the possibility of refining our refinements.

Compromise is a wonderful thing. It is what our democratic form of government is founded upon. In my opinion, compromise is almost always preferable to being stuck or paralyzed in polar-opposite stubbornness. In today’s America, where compromise is a dirty word in some circles, finding an acceptable middle ground is refreshing. The art of compromise has seemingly been quelched by political allegiances. That is a sad commentary on the state of our country.

As I have noted before, the January 6th insurrection of our government posed a unique problem for mental health experts in light of the present Goldwater Rule. Is there anything more dire than facing an attempted coup of our democracy? I do not think so. In my mind, the insurrection required a response from mental health experts. After all, no one is better trained to offer an opinion about an obvious ill in our society. At the same time, I agree that we cannot condone flip, unreasonable, or provocative comments that only serve to inflame already-present divisions in our country.

There is no easy path to the perfect Goldwater Rule. I think everyone would agree that ethical principles are needed to provide parameters for psychiatrists’ interactions with community and society. But, as I have frequently reiterated, there must be ethically acceptable ways for psychiatrists and other mental health experts to impact public health and societal issues. Being quiet, sticking our heads in the sand, or making innocuous statements are not serious options, in my view. Especially at times when public wellbeing and welfare are being threatened or compromised, mental health experts must feel duty-bound to speak up and speak out.

Compromise is not a dirty word to me—it is quite an accomplishment at times. I hope we can continue to dialogue so that further revisions can be made to the Goldwater Rule. By doing so, we can inch closer to meeting the stated mission of our profession.

Dr Blotcky is a clinical and forensic psychologist in private practice in Birmingham, Alabama. He is also clinical associate professor in the Department of Psychology at the University of Alabama at Birmingham.