Schizophrenia as a symptom of psychiatry's reluctance to enter the moral era of medicine

Abstract

We interpret the within-psychiatry debate about a name change for schizophrenia as a broader debate about the future of psychiatry itself. The epistemic stance of psychiatry can be summarized as "finding the right medication for the right brain disease". This is the prism through which academic psychiatry - and thus society - has chosen to perceive the world of mental variation. In doing so, psychiatry has set a trap for itself, in that it is forced to act as the jealous gatekeeper of "true knowledge" where in fact only uncertainty exists. Changing the name of schizophrenia would be "wrong" given an underlying belief system dictating that the "right way" to perceive schizophrenia involves the construct of a "debilitating genetic brain disease". This stalemate does not have to endure, however. The Japanese name change, now spreading to other Asian countries, provides hope, as it shows that is it possible for a psychiatric association to abandon its position as epistemic gatekeeper and participate in a process of cocreation with stakeholders. This course of action is in line with the novel moral era of medicine, in which medical professionals are focussed on delivering treatments that "make a difference" - meaning it adds value to the life of patients beyond organ measures of symptom reduction.