As long as psychiatrists are human, there will be episodes of unethical psychiatric practice and ineffective, sometimes damaging psychiatric treatment. The author argues that these incidents do not detract from the overall integrity of the profession, the reality of mental illness, or the increasing sophistication of psychiatric treatment and knowledge. Rather than being oppressive, as a minority of former patients have charged, the policies of the American Psychiatric Association related to patient care are broadly worded ethical principles intended to foster the patient's good. The author defends the need for involuntary treatment and suggests that controversies surrounding involuntary treatment, the insanity defense, and the homeless mentally ill are essentially social, legal, and legislative issues in which psychiatry has found itself in the middle.