The Goldwater Rule at 50 and its relevance in Europe: Examining the positions of National Psychiatric Association Members of the European Psychiatric Association

Abstract

BACKGROUND: Fifty years after its introduction, the American Psychiatric Association's (APA) Goldwater Rule remains contentious, prohibiting member-psychiatrists from providing mental health commentary on individuals they have not treated and where they lack consent. Whilst its resonance extends beyond the United States, there is limited awareness about the Goldwater Rule's applicability elsewhere, notably within Europe. METHODS: In 2022, we investigated whether the European Psychiatric Association's (EPA) forty-four National Psychiatric Association Members (NPAs) had similar guidelines to the Goldwater Rule or comparable ethical positions around media and public commentary. We initially searched NPA websites and subsequently contacted NPAs via email and phone. Findings were coded to four categories: "NPA-level rules or position", "No NPA-level rules orposition but noted country-level rules", "No NPA-level rules or position and did not note country-level rules", and "No response". RESULTS: n=27 NPAs had relevant web materials or replied to our correspondence (61.3% of total NPAs). From these 27, based on our interpretation, n=6 (22.2%) had rules or positions, n=6 (22.2%) indicated that country-level rules existed, and n=15 (55.5%) did not have applicable NPA-level or country-level regulations. CONCLUSIONS: A sizeable proportion of NPAs included in our study have not yet formally developed or considered ethical issues addressed by the Goldwater Rule and psychiatric commentary on an individual's psychopathology. Accordingly, the EPA could consider broader discussions about this, accounting for national traditions and sociocultural aspects of clinical practice. These could integrate the advantages and disadvantages of the APA's rubric towards an evolved ethical debate.