Validity and limits of the Goldwater Rule. Ethics, psychiatry and politics

The “Goldwater Rule”, introduced in 1973 by the American Psychiatric Association (APA), prohibits psychiatrists from publicly expressing diagnostic opinions about public figures whom they have not personally examined and without their consent. Originating in the aftermath of the 1964 presidential campaign and the Fact Magazine case, this rule stands as a central point of ethical debate between freedom of expression, professional responsibility, and the protection of individual dignity. This article traces the origins and evolution of the rule, analyzing its major violations and reinterpretations—from Jerrold Post’s psychological profile of Saddam Hussein to Bandy X. Lee’s The Dangerous Case of Donald Trump—and examining their connection to the legal principle of Duty to Warn derived from the Tarasoff ruling. The discussion also includes the perspective of psychology, which proposes a more flexible approach based on observable and documentary data, and reviews contributions that downplay psychiatric diagnosis as the sole criterion of leadership fitness, drawing on psychohistorical studies and the notion of “depressive realism” in historical leaders. A section is devoted to the European context, where there is no uniform consensus on the Goldwater Rule. Finally, the article examines contemporary defenses of the rule by scholars and ethics committees, reaffirming its importance in safeguarding the credibility of psychiatry and preventing political or media misuse. The concluding reflections emphasize the rule’s inherent ambiguity and contextual nature, its limited enforceability, and the need for its revision to align with the ethical and communicative challenges of modern society.