Commentary: on the transformation of the moral economy of care.

The documentation amassed in these provisional assessments of the changing terms and conditions of psychiatric work amounts to a reconfiguring of the moral economy of care--those root value-laden assumptions about what constitutes proper conduct in a service or treatment context. Such a transformation appears to have been in the works for some time, but the acuity with which it afflicts the consciousness of present-day actors suggests that a threshold has been crossed. The loss of "slippage" in everyday clinical work, limited recourse of those who would resist the trend, deep "persuasive" impact on non-believers of being forced to "go through the motions," all argue that the ethos of psychiatric work has been thoroughly infiltrated by efficiency, with costs yet to be reckoned. Anthropology may have been slow to take cognizance of such trends, but its improvisational methods and flexible tools should be of use in mapping such costs, direct and indirect, and any countervailing benefits.