Ethical and Clinical Complexities in the Treatment of Schizophrenia

This unique book offers a methodical exploration of biological, social, and ethical topics on the treatment (or lack thereof) of psychotic brain disease. Part I provides an empirical engagement with neuroscience and covers the neurobiology and pharmacology of schizophrenia, providing the reader with a current understanding of the disease. Topic areas include anosognosia, community treatments, and early intervention. Part II looks at international policy approaches to schizophrenia featuring topics such as the policy, funding, and historical elements contributing to frequently misguided approaches to severe brain disease, and it explains why some societies won't/can't support human beings with psychotic disease. Part III focuses on neuroethics and asks: 'What is right?' through chapters discussing the concepts of consciousness and free will, as well as the principles of nonmaleficence, beneficence, autonomy, and justice. Collectively the comprehensive approach of this book allows the reader to gain a full understanding of the ethical and clinical complexities in treating schizophrenia.

Part I. Neuroscience: 1. The story of schizophrenia: liberty over life; 2. What is the neurobiology of schizophrenia?; 3. What is schizophrenia - symptomatology; 4. Assessment and treatment of anosognosia in schizophrenia; 5. Anosognosia in schizophrenia; 6. 'How antipsychotics work in schizophrenia: a primer on mechanisms'; 7. Do antipsychotics work in people with schizophrenia? A review of outcomes and effect sizes; 8. Do antipsychotic medications work: an exploration using competency to stand trial as the functional outcome; 9. When do psychiatric interventions work? An argument for using functional outcomes when evaluating the effectiveness of treating schizophrenia; 10. Medications for psychosis in people with Schizophrenia: what happens if you take them and what happens if you don't?; 11. Assisted outpatient treatment: are court ordered antipsychotic medications effective?; 12. Forensic assertive community treatment: an emerging best practice; 13. Does compulsory community treatment for discharged forensic hospital patients work? The recent evidence base; 14. Early intervention for schizophrenia: a pathway to improved clinical outcomes; 15. 'Cardiometabolic disorders in persons living with schizophrenia: the right to equality'; Part II. International Policy Perspectives: 16. Failure to treat: an American policy perspective; 17. The Italian general psychiatry and forensic psychiatry treatment model: a unique story; 18. Liberty or life: mental health care in Australia; 19. Liberty or life: the Aotearoa New Zealand perspective; 20. Autonomy and compulsory care in the Netherlands; 21. Canadian mental health laws: a review of involuntary admission and treatment pending appeal; 22. The current situation of treatment for patients suffering from schizophrenia in the Austrian forensic system; 23. Interventions for the unhoused individual with schizophrenia: a civilized plan; 24. What role did serious mental illness play in Jackson Pollock's drip paintings? Abstract expressionism and possible links to serious mental illness and to encrypted images (Polloglyphs); 25. The behavioral healthcare continuum in the United States: what should it look like and how we can pay for it; Part III. Neuroethics: 26. A unified understanding of the human mind-a neuroethical perspective: tracing the evolution in western thought and the integration with neuroscience, psychology, psychiatry, and relational dimensions; 27. A neuroethical approach to human life, identity, and liberty of schizophrenic patients; 28. Neuroethics and treatment without consent; 29. Advance directives in patients with schizophrenia; 30. Dignity restored: the power of treatment first; 31. Four principles of bioethics in cases of anosognosia; 32. Complexities of competency and informed consent as applied to individuals with symptoms of Anosognosia; 33. Evidence-based treatment for schizophrenia: a personal perspective; 34. Inmate mental health assistants: an emerging best practice for carceral settings; 35. Remarks of father Alberto Carrara to the American Psychiatry Association - May 2025 Father.