Physicians at the annual meeting of the American Psychiatric Association (APA) in San Diego debated the ethics of diagnosing a public figure, like President Donald Trump.

The debate centered around a 1964 ethics ruling from the APA known as the “Goldwater Rule,” which prohibits psychiatrists from offering medical opinions on someone they have not personally evaluated, Axios reported Sunday. The rule was established after Fact magazine published a survey from some 12,356 psychiatrists that claimed Goldwater was psychologically unfit to be president.

Psychiatrists appear to be somewhat torn on the rule. Former APA President Paul Appelbaum thinks the ruling should stand not only for possible defamation concerns stemming from a misdiagnoses, but for the possible detouring effect it could have for individuals that need treatment, Axios reports.

Others in the field, like Nassir Ghaemi, professor of psychiatry at Tufts, think psychiatrists already diagnose individuals without their consent, or use third party information (prior behavioral or medical history) to reach a diagnoses. He also noted that some diagnoses could be beneficial, as some illnesses correlate with positive traits for a leader, like creative thinking or realism.

While psychiatrists have shied away from making public claims about Trump’s mental state, a prominent practicing psychotherapist at Yale’s School of Medicine, Dr. John Gartner, is claiming the president has a “dangerous mental illness.”

The president’s condition is apparently, according to Gartner, worse than just “being a liar or a narcissist, in addition he is paranoid, delusional and grandiose thinking and he proved that to the country the first day he was President. If Donald Trump really believes he had the largest crowd size in history, that’s delusional.”

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