Whether revisions to the "bible" of mental illness should be carried out in secret might seem like an academic question.
But the issue carries real weight for parents desperate to address children's difficult behavior or people in distress over their mental state. It also speaks to citizens' concerns over news accounts of an overmedicated America and the troubling financial links between the pharmaceutical industry and some psychiatric researchers.
An update is under way for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, known as the DSM, which defines the emotional problems for which doctors prescribe drugs and insurance companies pay the bills. Psychiatrists working on the new manual were required to sign a strict confidentiality agreement.
Critics say the American Psychiatric Association should lift the curtain of secrecy so outside observers can review the scientific debate behind new and revised diagnoses.
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