Numerous psychiatrists believe that the APA’s vehement defense of the Goldwater rule is disingenuous and that something else besides a sudden revival of interest in this ethical guideline accounts for its intransigence. In the fall of 2017, John Zinner, a psychiatrist at George Washington University, told The New Yorker that he had heard a “high official” of the APA acknowledge that its leaders were worried that if psychiatrists started criticizing Trump, the president might retaliate by reducing federal dollars for psychiatric treatment. Zinner is also quoted as saying that the Goldwater rule was laid down “really not out of ethical concern, [but…concern for] our pocketbooks.”
Likewise, NYU’s James Gilligan thinks that following the money might provide an explanation for the APA’s actions. “I wonder if the primary worry of academic psychiatrists like Lieberman may be the loss of NIH funding for their biological research,” he says. Trump’s sudden decision earlier this month to suspend the $500 million in funding that the US gives to the World Health Organization lends credibility to Gilligan’s hypothesis. This is clearly a president who uses the power of the federal purse to support his friends and punish his enemies in the scientific community. So perhaps a strict Goldwater rule is one way for the APA to make sure that it stays on amicable terms with Trump.
If this is, in fact, the APA’s strategy, it appears to be working. As the APA noted in a release at the end of 2019, it is pleased with Congressional funding for psychiatric research during the Trump administration, which now includes $2 billion a year to the National Institute of Mental Health (NIMH)—up $155 million from the previous year. And over at Columbia University, where he heads up the New York State Psychiatric Institute (NYSPI) as well as the medical school’s psychiatry department, Lieberman also continues to be the beneficiary of considerable funding by the feds, even though the NYSPSI was slapped with a roughly $10 million fine for overcharging NIH in 2016. According to the latest publicly available figures, in 2018, the NYSPI received about $64 million in NIH grants and, in 2019, the psychiatry department at Columbia another $17 million.