Ethics of early prevention in schizophrenia

Objective: To represent a cross-section of current thinking on the ethics of early (primary) prevention in schizophrenia. Method: Ethical considerations presented at the First Australian Schizophrenia Prevention Conference, Sydney, March 1999, particularly from the final session on 'Ethics', are recorded here together with complementary referenced material. Results: Ethical concerns arise in the arenas of research over clinical priorities; screening ethics, including stigma, confidentiality, informed consent and support required through waiting periods; and the ethics of prolonged assessments in the absence of disorder, the right not to know and the possible ethical prematurity or otherwise of screening for schizophrenia. Conclusions: There are several legitimate ethical concerns that must be understood and addressed by those undertaking the developing of primary preventive measures in schizophrenia. Such measures must still be regarded as more experimental the further ahead the measures are undertaken from the onset of the disorder. Anticipatory ethical guidelines should be developed to inform such research.