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Is it “politics” for a psychiatrist to call a politician dangerous?

Prof. Bandy X. Lee, M.D., is a brilliant Yale-educated psychiatrist who wrote a “comprehensive textbook on violence.”

According to Wikipedia, Dr. Lee (photo, left) “studied the anthropology of violence in East Africa as a fellow of the National Institute of Mental Health and co-authored academic papers on Côte d’Ivoire, Tanzania, and Rwanda. She is a specialist in violence prevention programs in prisons and in the community and worked for several years in maximum security prisons in the United States where” she studied prison gangs, and “was instrumental in initiating reforms at New York’s Rikers Island jail complex. She has consulted with five different U.S. states on prison reform.” Read her bio here.

By the way, she’s not irreligious; in addition to her M.D. degree from Yale, she also has a Master of Divinity degree from the Yale Divinity School (note the crucifix in the photo).

Dr. Lee isn’t a political activist, and certainly not a political candidate, but she recognizes pathology when she sees it; and listening to Trump’s campaign speeches in 2016 alarmed her. So she did what academics do: She organized a conference to discuss the issue of Trump’s mental health, framing that subject in ethical terms by naming it, “Does Professional Responsibility Include a Duty to Warn?”

According to Wikipedia, “The event was initially sponsored by Yale’s schools of public health, medicine, and nursing, but Lee ended up running it independently to avoid the perception of ‘politicization.’” Meaning, of course, shielding Yale from the appearance of endorsing or opposing a candidate for president, because there was no way the conference wasn’t going to look “political.”

But was it “political”? That’s not an idle question, because thoughtful people often look to academics with relevant expertise for objective assessments about matters of public concern (e.g., the best way to stay safe during a pandemic). And not everything is “political” just because it involves a politician; for example, if the local mayor drives around running over curbs and denting parked cars, it’s not “political” to say he’s a lousy driver.

But Yale didn’t see it that way, which brings up the American Psychiatric Association’s “Goldwater Rule” stating “it is unethical for psychiatrists to comment on a public figure’s mental faculties in an official capacity unless granted permission or after a medical examination.” Dr. Lee wasn’t a member of APA, deemed the rule a “gag order,” and didn’t abide by it.

The “Goldwater rule” came about from Goldwater suing a magazine that ran an article by “dozens of leading psychiatrists” about his psyche before the 1964 election. The jury awarded him $1 of compensatory damages, probably thinking nobody read the magazine and LBJ’s famous “Daisy” ad did far more damage to Goldwater’s presidential prospects. (And that dollar may have been for one of the shrinks calling him a “latent homosexual,” which was a slur in those days.) In adopting the rule, the APA may have figured mouthy psychiatrists might not be so lucky the next time.

Anyway, apparently at the urging of retired Harvard law professor Alan Dershowitz, who defended sex predator Jeffrey Epstein and Trump in his first impeachment trial, Yale fired Dr. Lee for sharing her views on Dershowitz’s mental health with the public, and she then sued Yale for wrongful termination (see story here). That case is still pending in the courts, and the firing has been criticized by academics with better reputations than Dershowitz, e.g. Laurence Tribe of Harvard and Jeffrey Sachs of Columbia.

Therein is a fascinating glimpse into the tawdry world of academic backstabbing, which I have on good authority (I know some professors) is even more vicious than the normal workplace backstabbing most of us are familiar with, because its practitioners are more intelligent and creative at slipping in the shiv than the rest of us.

The APA, needless to say, didn’t back Dr. Lee’s conference or her bestselling book titled The Dangerous Case of Donald Trump (buy it here). As Mother Jones noted here, “Shortly after the book came out, leaders of the American Psychiatric Association began publicly attacking Lee, arguing she was acting irresponsibly” for violating the Goldwater Rule holding “it is unethical for a psychiatrist to offer a professional opinion of anyone without conducting a personal examination and getting proper approval.” I gather there’s no exception for notorious public figures, and presumably they would’ve sanctioned any American psychiatrist who tried to warn the world about Adolf Hitler back in 1933, or warn Chicago about Al Capone in 1923.

The APA’s position was something like this: “Anything a psychiatrist says without examining a patient is likely to be inaccurate, so it can harm the public figure,” said Paul Appelbaum, a Columbia University professor and a past APA president. Mother Jones says, “Appelbaum is also concerned that diagnosing people from a distance casts the profession in a negative light: ‘These seemingly cavalier and politically motivated public statements can prevent people from getting the psychiatric care that they need.’” There you go: From a distance, and without examining Dr. Lee’s motives (e.g., legitimate concern that Trump might be a dangerous demagogue who incites violence, based on her vast experience with studying violent personalities), he concluded her alarm about Trump was “politically motivated.” And he’s worried that her public comments might discourage him from seeking psychiatric treatment.

Hey, I’m alarmed by Trump’s behavior, and that doesn’t make my comments about him “politically motivated.” So let’s cut the bullshit that criticizing Trump pathological behavior is partisan, politically motivated, and biased. A psychopath is a psychopath, no matter what his occupation is.

And how about giving Dr. Lee credit for being right? As Mother Jones points out, her warnings about Trump “turned out to be remarkably prescient.” But isn’t that history, and why are we talking about it? Because Trump is currently the 2024 Republican frontrunner, threats of violence are “a staple of Republican campaign rhetoric,” and in that context Dr. Lee’s “assessment begs a second look.”

But do we really need a psychiatrist to tell us Trump is unhinged? Even Nancy Pelosi said, “This unhinged president could not be more dangerous.” But wait, isn’t that “politically motivated”? And not being a psychiatrist, what business does she have assessing Trump is “unhinged” and “dangerous”?

Well, I guess the answer is, “As a pioneering scholar of violence, Lee has plenty to say about what can be done to address the growing disregard for law and democratic institutions that Trump helped normalize.” And that is — what? Don’t vote for him? What else? Indict, prosecute, convict, and throw him in jail so he can’t run again? (That might not work; he not only could still run, but Republican voters would still vote for him.)

But I’m drifting off the topic of this article, which is whether calling a politician “dangerous” is “political.” If you’re saying he shouldn’t be elected because he’s unhinged, violent, and dangerous, then I guess that’s a politically-motivated argument if his opponent says it to get votes. It might even be politically motivated if I say it, because I don’t like his policies (weakening NATO and cozying up to Putin, etc.).

But if a psychiatrist who’s a leading expert on violence says he’s dangerous, I think we should listen, regardless of our political leanings or loyalties. As for the Goldwater Rule, is it ethical to remain silent when innocent people are in danger?

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