BY HANK REICHMAN
Bandy Lee, a former Yale University faculty member in the Department of Psychiatry in the School of Medicine, filed suit in federal court March 22 against the University alleging “unlawful termination… due to her exercise of free speech about the dangers of Donald Trump’s presidency.” Lee charges that Yale fired her in response to a January 2020 tweet that characterized “just about all” of former president Donald Trump’s supporters as suffering from “shared psychosis” and said that Trump attorney Alan Dershowitz had “wholly taken on Trump’s symptoms by contagion.” Dershowitz then sent a letter to Yale administrators, in which he complained that Lee’s tweet constituted “a serious violation of the ethics rules of the American Psychiatric Association” and asked that she be disciplined.
According to the university, Lee was “a voluntary faculty member” who received a faculty affiliation in exchange for up to four hours of teaching per week. She had been reappointed annually to that position since 2003.
After Dershowitz sent his letter in January, the chair of the Psychiatry Department, John Krystal, emailed Lee that the department “would be compelled to terminate [her] teaching role” if she continued to make similar public statements. She continued to tweet about Trump’s mental fitness, however. Lee then met with Krystal and was told that she had “breached psychiatric ethics.” On May 17, 2020, Lee was terminated. Appeals were unsuccessful.
Lee is the co-editor of the 2019 book, The Dangerous Case of Donald Trump: 37 Psychiatrists and Mental Health Experts Assess a President, and author of the October 2020 book, Profile of a Nation: Trump’s Mind, America’s Soul.
In a September 4 letter to Lee, Krystal wrote that the termination “was not because of the political content” of her statements. Instead, he invoked her “repeated violations of the APA’s Goldwater Rule and your inappropriate transfer of the duty to warn from the treatment setting to national politics,” which, the letter claimed, “raised significant doubts about” Lee’s grasp of professional ethics in psychiatry.
The American Psychiatric Association’s Goldwater Rule states that 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. Like many psychiatrists and professors of psychiatry Lee considers the Goldwater Rule as akin to a gag order. According to a report in the New York Times, Jonathan Moreno, a bioethics professor at the University of Pennsylvania, said he had not heard of anyone being disciplined by the APA for violating the rule, even though people repeatedly broke it. Lee’s complaint also contends that she was not diagnosing Dershowitz, “but rather commenting on a widespread phenomenon of ‘shared psychosis.’” Lee has not been a member of the APA since 2007.
Yale’s invocation of the Goldwater Rule prompted a letter to Krystal signed by several prominent psychiatrists and professors of psychiatry. The letter, also published in the Yale Daily News, reads:
Dear Dr. Krystal:
We write to you concerned about the publicly available information about the firing of our colleague, Dr. Bandy Lee. Our specific concern is with the report that she was fired in part for purportedly violating the Goldwater Rule. It is this connection to the Goldwater Rule that is deeply problematic.
Reliance on Dr. Lee’s violation of this rule would reflect a fundamental misunderstanding of the evolution of psychiatric ethics since 1973, when that rule was established by the American Psychiatric Association, and an abdication of the academy to set its own standards for conduct, rather than importing those of arguably self-serving professional guilds.
We rely on the report in the Yale Daily News (March 23, 2021) that quoted your letter terminating Dr. Lee as follows:
“Although the committee does not doubt that you are acting on the basis of your personal moral code,” the letter read, “your repeated violations of the APA’s Goldwater Rule and your inappropriate transfer of the duty to warn from the treatment setting to national politics raised significant doubts about your understanding of crucial ethical and legal principles in psychiatry.”
In the opinion of many prominent mental health professionals, the Goldwater Rule arose to protect the image of the psychiatric profession in the wake of its humiliation after the successful lawsuit initiated by Barry Goldwater against Fact magazine (Martin-Joy, J., Diagnosing from a Distance: Debates over Libel Law, Media, and Psychiatric Ethics from Barry Goldwater to Donald Trump, Cambridge University Press, New York, 2020).
The validity of the Goldwater Rule has been widely disputed: many professionals consider it a scientifically untenable privileging of corporate psychiatry’s interests over individual psychiatrists’ rights of free speech and expressions of conscience (Lilienfeld, S., Miller, J., Lynam, D., The Goldwater Rule, Perspectives From, and Implications for, Psychological Science, Perspect Psychol Sci . 2018 Jan;13(1):3-27. doi: 10.1177/1745691617727864. Epub 2017 Oct 12; Post, J., Narcissism and Politics: Dreams of Glory, New York: Cambridge University Press, 2015; Pouncey, C., President Trump’s Mental Health-Is It Morally Permissible for Psychiatrists to Comment?, New England Journal of Medicine 2018, 378 (5), pp. 405-407).
Additionally, the APA’s 2017 restatement of the Goldwater Rule broadened its wording to proscribe apparently any discussion by psychiatrists and, by extension, other mental health professionals, not only of putative diagnoses but of the psychology and behavior of public figures. This colonizing of scholarly discourse by the APA flies in the face of academic traditions of inquiry.
Given the spectrum of conscientiously held views of the Goldwater Rule and the thoughtful attempts to reform and update it (Begley, S. Psychiatrists Urge Rollback of Goldwater Rule, STAT News, 6/28/18), it would be highly improper to terminate Dr. Lee’s association based on this antiquated and widely disputed rule of a professional association of which she has not been a member for fourteen years.
Further, Dr. Lee’s profound contributions to the field (Lee, B. editor. The Dangerous Case of Donald Trump; St. Martin’s Press, 2017, p. 83-93) would have been impossible if she allowed herself to be gagged by the Goldwater Rule. Bearing in mind that the 37 contributors to this book which Dr. Lee edited include many scholars and international exemplars of psychiatric ethics, we wonder if they too would be terminated were they to be members of your department.
Universities need to articulate their own criteria for judging appointments and reappointments, for quality of scholarship and for ethical conduct within and outside their walls. They cannot do that in a way that is faithful to the academic mission if they appropriate standards developed by professional organizations that, with all their many worthy purposes, are nevertheless highly influenced by protection of their professions, not the academy, and which, as documented in the case of the APA, are compromised by commercial interests. Using the APA Goldwater Rule as a basis for terminating Dr. Lee is an embarrassment to Yale and an affront to universities and academics everywhere.
We await your response acknowledging that compliance with the Goldwater Rule is not an appropriate basis for the termination of appointment of any academic professional.
Leonard L. Glass, M.D., M.P.H.
Associate Professor of Psychiatry (Part-time)
Harvard Medical School
Senior Attending Psychiatrist
McLean Hospital
Past-President, Boston Psychoanalytic Society and Institute
Distinguished Life Fellow
American Psychiatric Association (resigned in protest 2017)Edwin B. Fisher, Ph.D.
Professor, Department of Health Behavior
Gillings School of Global Public Health
University of North Carolina-Chapel Hill
Past-President, Society of Behavioral MedicineLance M. Dodes, M.D
Asst. Clinical Professor of Psychiatry (retired)
Harvard Medical School
Training and Supervising Analyst Emeritus
Boston Psychoanalytic Society and Institute
Faculty, New Center for Psychoanalysis (Los Angeles)Philip Zimbardo, Ph.D.
Professor Emeritus in psychology
Stanford UniversityHenry Friedman, M.D.
Associate Professor of Psychiatry (part-time)
Harvard Medical SchoolSteve Wruble, MD
Board Certified Child & Adult Psychiatry
Ridgewood, NJ & Manhattan, NYJohn Gartner, Ph.D
Former assistant professor of psychiatry (part-time)
Johns Hopkins University Medical SchoolMichael J Tansey, PhD
Assistant Professor, Adjunct Faculty, 1978-2008
Northwestern University Feinberg School of Medicine
Chicago, IL 60610
The authors of the letter do not explicitly invoke academic freedom or AAUP principles, but Lee’s case raises an interesting and potentially important question regarding the academic freedom of medical school and other professional faculty members. Clearly Lee’s research activities, as exemplified by the books cited above, should be protected by academic freedom, and Yale did not, apparently, raise objection to that work. The university’s invocation of the Goldwater Rule came instead in response to her extramural comments on social media about Dershowitz, Trump, and others. The AAUP has long stressed that extramural expression “cannot constitute grounds for dismissal unless it clearly demonstrates the faculty member’s unfitness for his or her position. Extramural utterances rarely bear upon the faculty member’s fitness for the position. Moreover, a final decision should take into account the faculty member’s entire record as a teacher and scholar.” So, in judging the “fitness” of a faculty member, like Lee, who teaches in an applied professional discipline in which a reputable professional association has established standards of behavior, should any extramural violation of one such standard — even when the standard is controversial within the profession — justify a finding of lack of fitness? Sometimes, perhaps, but personally I think it definitely would not in Professor Lee’s case.
It is interesting that Dershowitz also was largely responsible for getting Norman Finkelstein denied tenure and fired by DePaul, also for the thoughtcrime of being mean to Alan Dershowitz (he also asked California Gov. Arnold Schwarzenegger to ban Finkelstein’s book from being published by the University of California Press, because it was mean to Dershowitz). It makes me wonder how often Dershowitz asks for professors to be fired, and perhaps Dershowitz should be crowned the king of cancel culture.
I agree that the Goldwater Rule is an outdated rule that was pretty terrible to begin with, and invoking it to punish faculty is a violation of academic freedom. But the key issue here is whether there was due process (which should exist even for unpaid adjunct faculty). Was there a faculty committee hearing where Lee had the opportunity to defend herself? Or did Krystal merely talk to some professors who agreed with him and tossed Lee out? If due process was followed and a faculty committee determined that Lee violated professional norms, then her lawsuit should be dismissed, even though I would disagree with the faculty and believe that they should be condemned for silencing political speech.
Due process, I agree, is a key question. One signatory of the letter, who I happen to know, sent it to me and didn’t know; the signatories, he says, have not been in contact with Professor Lee about this. Media coverage in the Yale Daily News says there were appeals, but who to and on what basis is unclear. Perhaps there is more detail on that in her legal complaint, but I have not read it.
I am not familiar with the FACTS in these Dershowitz cases — and that’s because John K. Wilson (as usual) does not provide a fact-based LINK. As usual, the old rhetorical trick is used by putting words in the mouth of the person you want to discredit or slime.
Thus, we hear that Norman Finkelstein lost tenure because of “the thoughtcrime of being mean to Alan Dershowitz (he also asked California Gov. Arnold Schwarzenegger to ban Finkelstein’s book from being published by the University of California Press, because it was mean to Dershowitz). I’ll bet that any document or phone call that Dershowitz made that there was no such wording as “He was MEAN to me!” Maybe “libelous” or “slanderous”?
As for the OPINIONS about the Trump “diagnosis” — and the even worse diagnosis of the Donald’s followers — Dershowitz MAY be right IF ““a serious violation of the ethics rules of the American Psychiatric Association” was enacted by Bandy Lee. It appears that both Hank Reichman and John K. Wilson admit that Lee may have violated the Goldwater Rule, which seems not to have any loopholes and seems to exist for good reasons (what if Psych profs said that most Democratic officials or their supporters were nutcases?). The complaint is that the Goldwater Rule isn’t a good one. Well, if that is the case, then APA should simply change the rule, no? Until then, observe the law — a guideline that is fast falling by the wayside (especially at the U.S-Mexico border).
I fought long and hard for changes in civil rights laws, against several U.S. military “incursions” (i.e., WARS), and many other causes — including Free Speech. However, it appears that APA has an exemption to Free Speech, just as SCOTUS has set a few exceptions to the First Amendment. And APA seems also to have a rightful influence on academia.
OK, you got a bunch of signatories (9) to sign a petition decrying the Goldwater Rule (including the heavily criticized Zimbardo of the famous Stanford prison experiments); if that petition wins the day, fine. If not, then the university’s judgment sounds sound to me.
What ever happened to examining a patient ON THE COUCH before diagnosing them with a mental disease or defect? Also, I was under the impression that it is professionally inappropriate for a shrink (or Psych prof) to bellow a 4th-hand diagnosis to the world without permission — and without even meeting the person!!! In a way, this is like the flat-earther argument that is often used to stifle free Speech.
Perhaps worthy of note is that fact that medical schools, or, as they are often termed in university systems, “research campuses” are even more dependent than the usual sort of university on outside grants, contracts, donations, and government support. The threat to academic is thus all the higher owing to the fear among administrators of losing favor with those government and granting-agency officials on whom they somewhat slavishly rely. Similarly, the very high number of non-tenure-stream faculty, including clinical faculty, increases the intimidation factor.
As an older U.S. citizen I follow Dr. Lee. She is my go to person to help me understand the why, and the WTH is happening in the four years of DJT as our president. He lied to every American citizen as if he were speaking the truth, we listened to his words. We watched as he ridiculed a disabled reporter. We continue to suffer as trump ignored the onset of the coronavirus and the reality of of this pandemic. He abused his position and the American taxpayers with unnecessary expenses; all made for his personal gain. He created chaos, diversity and anger almost everyday. Trump raped America’s National Parks with his budget cuts. He encouraged his supporters to “Stop The Steal” of an election he lost, then went on to tell them to fight like hell against our elected representatives on January 6, 2020 at the US Capitol.
I tried to understand why Trump had millions of supporters despite his unethical behavior.
Dr. Bandy Lee helped me to understand the whys, of his acceptance by many, the behaviors he exhibited and even the words he spoke.
I believe YOUR LACK and APAs LACK of attention to Trumps dangerous personality is sadly…
.. motivated by money.
AMERICA & THE WORLD now face more destruction because of Trump and the Goldwater Rule.
I felt that Dr. Lee, with her expertise on violence, upheld her ethical and civic duty to inform and alert the world as to what was actually happening all around us.
Dr. Lee has many years of experience witnessing and diagnosing these dangerous personalities.
Thank you Dr. Lee for sharing your knowledge, experience, wisdom and dedication to mankind.
Judy Largo
This is not a unique case. A growing number of professions are requiring candidates for licensure to exhibit certain “dispositions” as a condition of obtaining or maintaining credentials, and disqualifying those who don’t. Historically, courts have granted broad deference to the professional bodies imposing these standards, and to the universities that apply and, often, police them. I suspect that as these requirements contravene ever more explicitly, and ambitiously, the First Amendment’s prohibition on compelled speech, that hands-off attitude on the part of the judicial branch is likely to change.
Personally I’d consider any medical professional who purports to diagnose someone he or she has never met to be an idiot, and not somebody to whom I’d wish to entrust my own or my family’s care. But I agree that this is not something that either the APA or Yale should seek to prohibit, far less punish.
Once again, a stickler for precision in language (as I am) will always point out when someone uses rhetorical tricks to subtly (or, this case, overtly) change the meaning of a statement to make it either less offensive or more disturbing, depending on point of view.
Here, Humanities Prof uses an expression — “compelled speech”” — which, of course is not mentioned in the First Amendment. Why does it matter? Because the allegedly aggrieved party in this case was not COMPELLED to say anything at all about the mental health of Donald Trump or his supporters. (BTW, I’m not one of them but I am FAIR-MINDED.)
And, sure, Humanities Prof is perfectly OK with “any medical professional who purports to diagnose someone he or she has never met to be an idiot.” Except that “idiot,” which is not a psychiatric term (although it used to represent an IQ range, along with “imbecile” and “moron,” is NOT AT ALL THE SAME as what the medical professional ACTUALLY DID SAY, namely: ” “just about all of former president Donald Trump’s supporters [are] suffering from ‘shared psychosis.’” Shared psychosis IS, in fact, a mental illness and, according to the Goldwater Rule (which remains in force, if anyone cares about such niceties), is a violation of the APA’s rules of professional conduct.
Anyone want to bet me that NO ONE on this thread will address the positions I’ve taken, mainly to “question authority.” Normally, I’m an ALMOST absolutist on Freedom of Speech issues, although I do recognize the rights of various organizations (i.e., the U.S. military, TV stations, crowded theaters, etc.) to curtail such rights for the better good. This seems to be one of those cases and, as I noted above, if this Goldwater Rule is so restrictive, why doesn’t APA just shelve it? Maybe because they could only get 9 members to support such a move?
ANY RESPONSES? Did I make any mistakes? (Not a rhetorical question.) 🙂
OK; I’ll bite. Prof. Tomasulo is correct that the instant case is not an example of compelled speech. My point, however, was that it falls within a broad category of academic-freedom exceptions, to date largely upheld by the courts, in which professional bodies claim the authority (i) to require candidates for licensure to profess certain views on contested questions; and/or (ii) to refrain from professing certain views on other contested questions (in this specific example, whether President Trump, Senator Goldwater, or other politicians and their followers were unhinged or not). So I imagine that when the judicial branch starts pushing back on these credentialing requirements, as it seems inevitable that it will do, the legal basis for all such rules is likely to come under much more searching scrutiny.
While on the subject of compelled speech, while that phrase is not contained within the text of the First Amendment, many Supreme Court judgments, beginning with *West Virginia Board of Education v. Barnette* (1944), have made clear that the right not to be forced to say something is no less protected than the right to speak one’s mind.
Returning to Dr Lee’s plight, I believe the academy should be vigilant against the tendency to outsource to external bodies the question of whether a violation of academic freedom has occurred or not. Yale appears to take the view: *APA locuta est; causa finita est.” I find myself in Prof. Wilson’s camp in disagreeing with that.
Thanks to Humanities Prof. for responding to my comments. You seem to know a lot about these matters, including the legalities. However, as you freely admit, your views on the matter are not currently in force. We can all HOPE that the courts and/or APA will rectify this in the near future, but, as the saying goes, “Hope is not a strategy.”
Given that “the Donald” appointed so many judges to federal courts, what would be the likelihood of any legal pushback taking place against the Goldwater Rule and similar guidelines used by professional organizations to delimit Free Speech? On the one hand, conservatives and strict constructivists MIGHT be assumed to staunchly defend the First Amendment; on the other, if most test cases involve some shrink calling a Republican officeholder a “nut job” (or something more clinical), then can we guess the outcome? My crystal ball has been rather foggy in the past few years… 🙂
Pingback: More on Yale and the Goldwater Rule | ACADEME BLOG