Pragmatic Ethics, Sensible Care is an ethnographic study of how culture and biomedical psychiatry intersect to shape the social and physical experience of mental illness. Though the biological basis of schizophrenia is well established, biomedical technologies alone do not improve the overall outcome of those with serious mental illness. Asymmetrical rates of recovery across the globe illustrate this reality with surprising clarity. My own findings confirm that with few resources, little knowledge, and irregular access to care, people suffering from psychotic illnesses in India fare better than their counterparts in industrialized nations where superior services are available. Drawing from sixteen months of anthropological research in psychiatric hospitals, clinics, and private homes in urban Uttar Pradesh, India, Pragmatic Ethics, Sensible Care offers insight into this paradox of outcome. Focusing on the unconventional, and often deceptive, treatment tactics psychiatrists in North India use, I argue that a model of medical care that deemphasizes patient autonomy and the rational understanding of pathology benefits those diagnosed with schizophrenia. I demonstrate how psychiatry as practiced in this way is at once culturally sanctioned and sensible given familial involvement in treatment, prevalent ideas about effective care, and resources available. I conclude that consuming biomedical technologies, while maintaining distance from the psychiatric conventions that justify their use, lessens negative perceptions of schizophrenia and allows families to conceptualize and manage disorder in ways better adapted to their cultural context. While foremost an ethnographic analysis of how social processes shape psychopathology, Pragmatic Ethics, Sensible Care is also an investigation into bioethics as an object of cultural analysis. By demarcating where the universal ideologies that underlie bioethical protocols reach the limits of their utility, my research interrogates the very conventions used to articulate moral care.