Researchers and clinicians face ethical and policy-based challenges in disclosing, preventing and treating psychosis. Which diagnostic labels should be considered to motivate more effective public and professional dialogue about psychosis risk?

Physicians should provide women considering abortion after Down syndrome screening with unbiased information and not attempt to influence their decision.

Although the stigma of the psychosis risk label can cause harm, the label can also confer benefit and provides an explanatory framework for symptoms.

Physicians with a mental illness can have good, empathic relationships with their patients, even if patients know of their condition.

Treatment of pregnant women with psychosis may involve reconciling conflicting ethical obligations.

Refusals of psychotropic medication by detained criminal defendants raise conflicting dual loyalties for psychiatrists between the duty to treat a patient and the duty to protect society from that patient.

Overriding a proxy decision maker’s refusal of medication for a psychotic patient is justified when the patient poses a danger to himself or others.

The harms of communicating autism risk can be avoided by helping families to understand risk and to distinguish between poor and good sources of scientific information, which should take families’ interests into account.

The Boston Health Care for the Homeless Program (BHCHP) seeks to build trusting relationships with patients before addressing their medical needs and to take account of their surrounding environment in treatment.

In treating children with autism, physicians should reframe the common dynamic in which the family wants medication that the doctor is withholding to focus instead on the family’s and physician’s share goal—the patient’s well-being.