When board certification in psychiatry became available in 1934, the goal of the new specialty was helping patients understand their behavior—principally through talk therapy—so they could choose to change behaviors that did not contribute to their health and well-being. In psychiatry’s brave new world, therapy is more likely to come in the form of a pill than by talking with a psychiatrist. Contributors this month explain the complex ethical problems that arise as medicine relies increasingly on psychopharmacology and technology to understand and treat mental illness as “brain” illness.