Red:
Section 7 of the
American Psychiatric Association [APA] The Principles of Medical Ethics With Annotations Especially Applicable to Psychiatry reads, “A physician shall recognize a responsibility to participate in activities contributing to the improvement of the community and the betterment of public health.” The point of Section 7 is all physicians have a duty to promote public health and safety. The AMA principle does not specifically oblige physicians to whistle-blowing or impose a “duty to warn” of the sort Lee and her colleagues take themselves to have, but it commits a physician with a concern about local environmental pollutants, safety in schools, infectious disease transmission,or other public dangers to notifying others of the risk. Protecting public health and safety is part of the ethical commitments physicians make.
The problem is that psychiatric diagnostic terminology has been colloquialized, so the public and the press use it to describe Trump, but when a psychiatrist does so, use of the same words is considered to be a formal diagnosis, regardless of whether it is. As a result, psychiatrists are the only members of the citizenry who may not express concern about the mental health of the president using psychiatric diagnostic terminology.
Truly, however, a physician who hasn't formally evaluated a patient is not making a diagnosis in the medical sense, but rather positing informally, based on his/her education/experience, about what s/he sees. That characterization applies to the orthopedist or physical medicine specialist remarking on a knee injury of a football player limping off the field, or the dermatologist wincing at a stranger’s melanoma in the grocery line as well as to the psychiatrist interpreting Trump’s public statements. Physicians don’t leave their knowledge on a shelf in their clinics.
Clinical psychiatric terms have joined the vernacular; thus the question is whether psychiatrists are the ones we should hear it from. If one is to have any measure of reasonable understanding of the nature of risk we all face (or don't, depending on the nature of the remarks the psychiatrist(s) make), the answer must be "yes," for no one else (other than psychologists) is in a position to credibly sound the alarm.
I suppose for cursory conclusion formers, one's reminding them of the Goldwater Rule and simply stating it will do; however, more rigorous thinkers will find such a banal depiction and analysis insufficient because the Rule itself (1) pertains to something other than the potential
accuracy of any remarks a psychiatrist might make but rather with the
ethicality of making certain types of remarks --
ethicality/unethicality has no bearing on the factual or probabilistic accuracy of a claim about or description of an existential state of being, (2) is an annotation to a principle, not a proscription of the principle itself, (3) was modified on the
Ides of March 2017, and (4) the
document to which Haymarket refers and in which several psychiatrists' have offered their thoughts about the nature of Trump's personality,
complies with the constraints of the 2017 revision. Thus
nobody has from afar diagnosed anyone and the ethical mores of the APA have been complied with.