A physician diagnosed Prince Harry with ADHD while live on air after reading a few passages from the prince’s memoir, Spare. Experts are not cool with that.
When asked about this scenario, Arthur Caplan, founding head of the Division of Medical Ethics at NYU Grossman School of Medicine in New York City, fired off an email to Psychiatrist.com stating, “Diagnosis by reading a book is utterly unethical and unprofessional. Especially when books are ghost written, as was Spare. Offering diagnoses in this manner makes a mockery of efforts to promote evidence based medicine.”
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To back up for a moment, here is the scenario as described by ADDitude, an online magazine for people with attention-deficit hyperactivity disorder (ADHD).
While chatting with Prince Harry during a 90-minute Zoom event, Gabor Maté, MD, a Canadian therapist and author, announced that, having read the Duke of Sussex’s autobiography, he was diagnosing him with attention-deficit disorder (ADD), the outdated term for ADHD.
“Reading the book, I diagnose you with ADD,” Maté said. “I see it as a normal response to normal stress, not a disease,” adding that “whether or not” the prince liked it, he could “agree or disagree.”
Maté then went on to diagnose the Prince with numerous other disorders including anxiety, panic disorder, depression, PTSD, and substance abuse. Maté referred to his declarations as a “clinical diagnosis.”
“I don’t see it as a disease. I see it as a normal response to abnormal stress.”
Prince Harry answered, “OK. Should I accept that or should I look into it?”.
Maté replied, “You can do what you want with it.”
Drew Ramsey, MD said he has done thousands of media interviews and it has never once occurred to him to make a snap diagnosis on air.
“Maybe there is a temptation to comment on what is happening in the mental health of public figures, but that is very, very treacherous territory. In a way, it weaponizes psychiatry and becomes psychiatry at its worst,” said Ramsey, who is an assistant clinical professor of psychiatry at Columbia University College of Physicians & Surgeons.
It is inappropriate to make a judgmental diagnostic observation of someone without having treated them and without really knowing them, especially in a public setting where a psychiatrist’s words may actually mislead or even harm a viewer, Ramsey stressed. He said that even though Prince Harry is not a politician, the spirit of the Goldwater Rule still applied. The rule, proposed by the American Psychiatric Association in 1973, was named for Barry Goldwater after a magazine surveyed more than 12,000 psychiatrists about the presidential candidate’s mental health.
“You can’t diagnose or remark on someone’s mental health unless you have an individual’s explicit permission,” Ramsey said. “Even if he seemed to have Harry’s permission in this case, I don’t see how you could properly diagnose somebody from reading a couple passages in a book.”
Putting aside the question of accuracy, experts are not pleased with the off-the-cuff way Maté spoke about the prince’s mental health. Shortly after the interview aired, The ADHD Foundation, a British-based neurodiversity charity, tweeted the following:
Gabor Mate-it is neither ethical nor appropriate to tell someone for the first time,- in a public interview, that they have ADHD. @DrGaborMate It is for the individual to decide whether to disclose their Neurodiversity. @SussexroyalU https://t.co/oDXUSnelVu
— The Neurodiversity Charity ADHD Foundation (@ADHDFoundation) March 4, 2023
Ramsey lamented how common it has become for psychiatrists and other mental health experts to offer their opinion about a public figure’s psychological state by the media or on social media. He advised psychiatrists who find themselves posed with such questions to refrain from responding.
“You don’t have to answer every question you are asked, even if you are on live TV.”
The prince live streamed the chat with Maté from his home in Montecito, California. The talk was billed as an “intimate conversation [to] discuss living with loss and the importance of personal healing.” Viewers from the US, Canada, and the UK who paid $25 to watch the program received a copy of the memoir.
