精神心理從業人員可以評價公眾人物的精神健康狀況嗎？

寫在前面：

稍微強調一下，這篇文章裡面提到了三個協會，一個是美國精神分析協會，一個是美國精神病協會，一個是美國心理協會。

提到的被討論對象也有三種：人物（指任何一個人）、公眾人物（指在公眾視線下的人物，原文是an individual who is in the light of public attention or who has disclosed information about himself/herself through public media）、政治人物。

文中「金水法則」指的是美國精神病協會的一個規定，這篇新聞報道的主要內容就是美國精神分析協會2017年6月對精神病協會的這個規定的抗議。

翻譯的時候我特別注意了措辭，原文也給出來了，不理解的地方可以自行核對。

然後下文但凡括弧內出現的內容全是我加的，不是原文就有的。

趕時間弄的，翻譯有誤的地方可以評論區告訴我。

Psychiatry Group Says Members Can Comment on Trump』s Mental Health

The decision overturns decades-old norms

精神分析團體說他們成員可以評價川普的精神健康狀況

——這個決定顛覆了數十年來的舊規程

By Sharon Begley, STAT on July 25, 2017

作者 Sharon Begley，STAT網站2017年6月25日訊

A leading psychiatry group has told its members they should not feel bound by a longstanding rule against commenting publicly on the mental state of public figures—even the president.

一個重磅的精神醫學團體近日告訴他們的成員他們不必受制於一個長期以來反對公開評價公眾人物的心理狀態的規定——公眾人物包括（因顧及國家利益不宜評價的）總統。

The statement, an email this month from the executive committee of the American Psychoanalytic Association to its 3,500 members, represents the first significant crack in the profession』s decades-old united front aimed at preventing experts from discussing the psychiatric aspects of politicians』 behavior. It will likely make many of its members feel more comfortable speaking openly about President Trump』s mental health.

這則聲明在本月通過郵件由美國精神分析協會執行委員會發送給他們的3500名成員，意味著他們數十年來執業統一戰線首次標誌性地出現了裂痕。這一統一戰線著眼於避免精神衛生專家從精神分析的角度討論政治人物的行為。因此，該聲明很可能會使他們的成員能夠更自然地公開指出川普總統的精神健康問題。

The impetus for the email was 「belief in the value of psychoanalytic knowledge in explaining human behavior,」 said psychoanalytic association past president Dr. Prudence Gourguechon, a psychiatrist in Chicago. 「We don』t want to prohibit our members from using their knowledge responsibly.」

來自郵件的信息代表著這樣一種趨勢：「相信精神分析知識用於解釋人類行為的價值。」精神分析協會的前任主席、來自芝加哥的精神病學家Dr. Prudence Gourguechon如是說。「我們不希望禁止我們的成員去負責人地使用他們所掌握的知識。」

That responsibility is especially great today, she told STAT, 「since Trump』s behavior is so different from anything we』ve seen before」 in a commander in chief.

這種責任在今天顯得尤其重要，她告訴STAT記者，「既然川普的行為和我們之前所見到的總統相比如此不同。」

An increasing number of psychologists and psychiatrists have denounced the restriction as a 「gag rule」 and flouted it, with some arguing they have a 「duty to warn」 the public about what they see as Trump』s narcissism, impulsivity, poor attention span, paranoia, and other traits that, they believe, impair his ability to lead.

在今天，（不能評價公眾人物精神健康狀況的）禁令已經受到了越來越多的心理學家和精神病學家譴責和輕視，他們將它稱之為「封口布」，並且其中的一部分人進一步地爭辯說他們有「提醒他人、作出警示的義務」，鑒於他們已經看出川普的自戀、衝動、注意力分散和偏執（心理學的偏執指妄想性的多疑），他們相信，這些會損害他的領導能力。

Reporters, pundits, and government officials 「have been stumbling around trying to explain Trump』s unusual behavior,」 from his seemingly compulsive tweeting to his grandiosity, said Dr. Leonard Glass, a psychiatrist at Harvard Medical School. The rule against psychiatrists offering their analysis of the emotions, thought patterns, and beliefs underlying such behaviors, Glass said, robs the public 「of our professional judgment and prevents us from communicating our understanding」 of the president』s mental state.

記者、專家和政府職員「受困於怎麼解釋川普不尋常的行為」，在這些行為中川普看上去強迫性地炫耀他的威嚴，在哈佛醫學院供職的精神病學家Leonard Glass博士說。Glass博士進一步說，這個規定反對精神病學專家呈現他們對一個人的一些行為背後的情感、思維模式和信念的分析，剝奪了公眾對我們專業性評價的知情權，也阻止了我們向公眾傳播我們的思想。這些專業評價和思想討論的正是川普的精神狀態。

Last week, in an essay in Psychiatric Times, Glass called the prohibition on such communication 「an unacceptable infringement on my right and duty」 to discuss issues 「where the perspective of psychiatrists could be very relevant and enlightening.」 He ended the essay by announcing his resignation from the American Psychiatric Association, which adopted the rule in 1973. He had been a member for 41 years.

上個星期，在一篇精神病時報上的評論文章里，Glass指出，禁止這樣的一些討論「不可以接受地侵犯了我的權力和義務」，他認為，「，在這些方面。精神病學家的觀點非常有意義和啟發人」。他的評論文章以退出美國精神病協會的聲明結束。美國精神病協會在1973年執行這一規定，而他已經加入這一協會有41年了。

Called the 「Goldwater rule,」 the prohibition on offering opinions about the mental state of public figures was adopted after some psychiatrists answered a 1964 survey on whether Sen. Barry Goldwater, the Republican presidential candidate that year, was mentally fit for the Oval Office. The rule states that it is unethical to offer a professional opinion about a public figure』s mental health, including the presence or absence of a disorder, without that person』s consent and without doing a standard examination. In March, the psychiatric association reaffirmed the rule.

被稱為「金水法則」的禁令，禁止人們表達關於公眾人物精神健康狀況的看法，誕生於1964年。在那年精神病學家們答覆了一個關於是否參議員Barry Goldwater——他在那年競選美國總統——在精神上適合任職總統。這個規定的內容是，提供關於公眾人物精神健康狀況的專業的意見不符合倫理道德，「專業意見」具體指在不經過當事人同意且沒有進行過標準化的測評的情況下，說出對一個人有沒有精神疾病的判斷。在今年三月份，精神疾病協會重申了這個規定。

The group acted despite growing criticism that the Goldwater rule is outdated and even unethical for preventing psychiatrists from pointing out behaviors that raise questions about a government official』s mental state. No other medical specialty has such a rule; cardiologists are not prohibited from offering their views of an official』s fainting spell, for instance, as long as they make clear that they have not examined the person.

美國精神病協會的行為無視了呼聲漸高的認為金水法則已經過時的批評，並且其實禁止精神病學家指出政府成員行為背後的精神健康狀況存在越來越多的問題，這一做法根本不合倫理。沒有其他的醫學行業有這種類型的禁令；比如，心臟病專家並不被禁止談論他們關於政府成員突然暈厥的看法，就算他們也同樣明顯地沒有給當事人做過體檢。

Although opposition to the Goldwater rule has existed for years, it intensified with Trump』s candidacy and then election. In October, a book titled 「The Dangerous Case of Donald Trump: 27 Psychiatrists and Mental Health Experts Assess a President」 will be published.

雖然對金水法則的抗議已經存在多年，但是這種抗議隨著川普競選總統且被選上而變得強烈。在今年十月份（指2017年），一本名為《唐納德川普的危象：27個精神病學家和精神健康專家評價一名總統》的書籍將會出版。

「When the book comes out, there will be renewed furor about the Goldwater rule, since it is precisely about what is wrong with him,」 said psychiatrist Dr. Lance Dodes, a retired professor at Harvard Medical School who is now in private practice in Los Angeles.

「隨著這本書籍的出版，對金水法則新一輪的抗議將會出現，因為這本書對川普哪裡有問題的討論十分準確。」退休的哈佛醫學院教授、如今在洛杉磯私人執業的精神病學專家Lance Dodes博士如是說。

A number of psychologists have spoken to reporters about what Trump』s statements and actions might reveal about his emotional and cognitive state. Although the American Psychological Association 「prefers」 that its members not offer opinions on the psychology of someone they have not examined, it does not have a Goldwater rule and is not considering implementing one, an official told STAT.

現在已經有很多的精神病學專家向記者報告川普的言行舉止很可能揭示了他的情感和認知狀態。雖然美國心理協會「更喜歡」他們的成員不表達他們對沒有經過他們測評的人物的心理學上的看法，但是美國心理協會並不是真的存在一個金水法則，它也不考慮去實施這種類型的一些法則——美國心理協會的工作人員告訴STAT記者。

The psychoanalytic association went further. In its July 6 email, it explicitly stated for the first time that the organization does not subscribe to the rule. That position had been implicit for years, but the association』s 「leadership has been extremely reluctant to make a statement and publicly challenge the American Psychiatric Association,」 said one psychoanalytic association member who asked not to be publicly identified criticizing the other group.

精神分析協會則走得更遠。在它今年6月6日的郵件中，它頭一次明確地陳述了協會內部取消了這一規定。雖然他們這一立場多年來十分含蓄，但是協會的「領導成員極其不願意去發表一個公開挑戰美國精神病協會的聲明，」一個被要求不公開指名道姓批評其他協會的精神分析協會成員這麼說。

One stated rationale for the Goldwater rule is that psychiatrists need to examine patients in order to properly evaluate them. In fact, for decades the State Department and other federal agencies have asked psychiatrists to offer their views on the psychological state of foreign leaders, Glass pointed out, evidence that government officials believe it is possible to make informed inferences about mental states based on public behavior and speech.

一個陳述金水法則的合理性的說法是，精神病學家需要去測評一個患者，才能合適地評估他們。但事實上，數十年來政府部門和其他聯邦機構總是請求精神病學家提供他們的關於外國領導人的心理狀態方面的看法，Glass指出，這個證明了政府職員相信基於公開的行為和談話，人們就可以有根有據地獲取一個人精神狀態的信息。

「In the case of Donald Trump, there is an extraordinary abundance of speech and behavior on which one could form a judgment,」 Glass said. 「It』s not definitive, it』s an informed hypothesis, and one we should be able to offer rather than the stunning silence demanded by the Goldwater rule.」

「在唐納德川普的例子里，有太豐富的談話和舉止可以讓人們得出一些判斷，」Glass說，「這並非定論，只是有根有據的猜想，並且這是那種我們必須去說出而不是保持沉默、受制於金水法則的猜測。」

The Goldwater rule has long been odd in that violating it carries no penalties. In principle the psychiatric association could file a complaint with a member』s state medical board. That has apparently never happened. Nor has the association ejected a member for violating the Goldwater rule. That is something it, as a private association, would be legally permitted to do.

金水法則在這些年不短的時間裡已經顯得古怪，因為違反它根本沒有處罰。在原則上精神病協會可以向國家醫療委員會提出違規申訴。但這顯然從沒發生過。而且協會也從不驅逐違反金水法則的成員。儘管驅逐是一個私人協會在法律上被允許做的事。

A state agency, however, is subject to the U.S. constitution, civil liberties experts say, and penalizing psychiatrists for speaking out would likely be a violation of their first amendment rights.

不管怎樣，民權專家說，畢竟國家醫療委員會是一個服從美國憲法的國家機構，因此懲罰表達看法的精神病學家是違反第一修正案的。

Republished with permission from STAT. This article originally appeared on July 25, 2017

STAT授權科學美國人轉載。這篇文章首發於2017年6月25日

原文見：

https://www.scientificamerican.com/article/psychiatry-group-says-members-can-comment-on-trump-rsquo-s-mental-health/

金水法則具體內容見：

Goldwater rule - Wikipedia

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