Recent news that Yale University declined to reappoint Dr. Bandy X. Lee as a professor in the psychiatry department has stirred broad concern in the mental health care community and academic world. Yale’s disciplinary actions against Lee arose in the wake of a complaint from Alan Dershowitz, at the time an adviser to Donald Trump’s impeachment defense. Echoing Dershowitz’s complaint, Yale’s actions against Lee were explicitly grounded on her alleged violation of the widely disputed Goldwater Rule. The decision ultimately to terminate her appointment fueled letters of protest, including one from the three of us.
Our concerns transcend the dismissal of Lee, editor of the groundbreaking book, “The Dangerous Case of Donald Trump” who has championed the importance of mental health professionals’ engagement with the public and whose warnings of the dangers to the country inherent in the pronounced character flaws of Donald Trump have proven prescient. Clearly Yale has the right to select and promote its faculty. But choosing to sever ties with an outspoken thought leader in her field following a request that she be disciplined has created the appearance of the university’s abandonment under pressure of its core value of the open exploration of challenging ideas.
In his e-mail to Yale, Dershowitz referenced a January tweet by Lee about his psychological state and the ethical guidelines of the American Psychiatric Association that proscribe psychiatrists from commenting on the mental health of public figures without examining them and without their permission, that is, the Goldwater Rule. In his termination letter to Lee, Dr. John Krystal, chair of Yale’s department of psychiatry, noted “your repeated violations of the APA’s Goldwater Rule.”
This is problematic in two ways.
First, and setting aside that Lee hasn’t been a member of the APA for 14 years, the Goldwater Rule has been shown to be scientifically untenable. It was promulgated in 1973 to defend psychiatry against further embarrassment in the wake of a lawsuit against Fact magazine for publishing psychiatrists’ critical comments about the mental status of the 1964 Republican presidential candidate Barry Goldwater. It privileges the APA’s reputational concerns over the rights of free speech and conscience of its members. Further, it misunderstands the difference between commenting on readily observable public speech and behaviors, which are reliable bases for evaluating certain types of personality disorders, and internal mental states which do require an individual examination.
In a recent op-ed in the Baltimore Sun, Dr. Jacob Appel, director of ethics education in psychiatry at the Icahn School of Medicine at Mount Sinai, wrote, “The APA is a voluntary professional association ... it is not a licensing or credentialing organization.” Thus it has no legal standing in matters of the ethics, especially of nonmembers such as Lee. Appel goes on to warn of the danger of self-censorship arising from Yale’s reliance on the Goldwater Rule in dismissing Lee.
Further, the rule has been explicitly set aside by a major mental health organization, the American Psychoanalytic Association, which said it did not want “to prohibit our members from using their knowledge responsibly.”
Second, Krystal, on Yale’s behalf, has relied on unsuitable and broadly criticized external grounds for assessing the worthiness of a faculty member whose job it is to challenge accepted precepts without regard to peripheral interests. In doing so within several days of the request from Dershowitz that the faculty member be disciplined, he has amplified the disquiet in academic circles.
While we each contributed chapters to the book Lee edited, along with subsequent op-eds and letters to editors asserting Trump’s dangerousness, none of us has been questioned about the ethics of such writing by any of the respected academic and health care institutions with which we are affiliated.
We wrote our open letter to Krystal on March 25, stating the concerns noted here and requesting that he acknowledge “that compliance with the Goldwater Rule is not an appropriate basis for the termination of appointment of any academic professional.” Our letter was reprinted in the Yale Daily News the next day. We haven’t received a response from Krystal or Yale, so we are left to conclude they stand by the inappropriately invoked and widely critiqued Goldwater Rule.
We believe this constitutes an abandonment by Yale under pressure of its core value of the open exploration of challenging ideas — even and especially — amid political controversy. This is a disturbing development for the exercise of free speech and academic freedom.
Dr. Leonard L. Glass is associate professor of psychiatry at Harvard Medical School and a senior attending psychiatrist at McLean Hospital. Edwin B. Fisher is professor of psychology at the Gillings School of Public Health at the University of North Carolina-Chapel Hill and past president of the Society of Behavioral Medicine. Dr. Lance Dodes is assistant clinical professor of psychiatry emeritus at Harvard Medical School.