In this month's lead article, John Z. Sadler, M.D., and Bill Fulford, D.Phil., M.B., summarize arguments for and against the inclusion of patients and family members on committees that are working to produce the next edition of DSM. The authors conclude that psychiatry should seriously consider such a step. "Genuine and direct" contributions by patients and their families would create a heightened sense of ownership in the outcome of the process and in the manual's acceptability, they contend. They also point out that DSM is a public policy instrument as well as a scientific document, and they argue that its development should therefore embrace a consensus-building ethic—one that reflects democratic political values, such as openness, citizen participation, and due process (see page 133). In Taking Issue, Robert L. Spitzer, M.D., who was instrumental in creating the science-based DSM development process in the 1970s, calls these arguments "politically correct nonsense" that ignore the realities of the revision process (see page 113).