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Paper short abstract:

Moral agency can be subtle and implicit, existing in simple forms of accountability and participation in health monitoring activities. Psychological anthropologists can engage more directly with both immediate and longer-term experiences of what moral agency means in biomedical treatment settings.

Paper long abstract:

A diagnosis of schizophrenia comes with significant threats to one’s moral agency, including through experiences of institutional treatment regimens. This is especially the case for those who have been socially and systematically marginalized throughout their lives. Access to the medication clozapine, prescribed for ‘treatment-resistant schizophrenia,’ is contentious due to its serious side effects, which require intensive monitoring. Yet clozapine clinic treatment can also facilitate moral agency. Doing fieldwork in two clozapine clinics in Australia and the UK, I observed how moral agency can be subtle and implicit, existing in simple forms of accountability and participation in health monitoring activities. This paper argues that psychological anthropologists can engage more directly with both immediate and longer-term experiences of what it means to be seen as a “good” person in biomedical treatment settings. First, I discuss how ethnographers can attune themselves to small, mundane details of sociality to contribute to the making of moral agency without introducing anything not already available. Second, drawing on the case of one Indigenous Australian participant in my research, I discuss the importance of not concealing additional structural oppressions in our written work even if the ethnographic present did not invite such active acknowledgements. I reflect on what differences in access to psychopharmaceutical treatments mean in terms of widening health disparities, on the one hand, and prospects for building moral agency, on the other hand.