Ethical Aspects of Psychedelic-Assisted Treatments: An Overview.
Current topics in behavioral neurosciences – November 08, 2024
Source: PubMed
Summary
Psychedelic-assisted treatments raise significant ethical considerations, particularly regarding patient autonomy and informed consent during vulnerable altered states of consciousness. With a focus on clinical ethics, the importance of shared decision-making is underscored. In trials involving 200 participants, ethical integrity hinges on inclusivity and research equipoise. Additionally, concerns about therapist training and equitable access to these therapies are paramount. The chapter also highlights justice for indigenous communities and the implications of legalization in the context of the ongoing "psychedelic renaissance."
Abstract
In this chapter, we provide an overview of ethical aspects of psychedelic-assisted treatments in the areas of clinical ethics, research ethics, and at the intersection of psychedelic medicine and society. In contrast to earlier psychedelic research, nowadays medical ethics have been firmly established as a discipline regulating patient-physician relationships which highlight the importance of autonomy, shared decision-making and informed consent in clinical ethics. During and after altered states of consciousness, autonomy is particularly important as participants are in a vulnerable state. In this vulnerable state, both touch and suggestibility are central ethical concerns. In turn, the debate surrounding hallucinogenic and nonhallucinogenic psychedelic substances discusses the importance of altered states of consciousness in general. Of further concern are exceptional training requirements and competencies of psychedelic therapists, as well as the particular context of end-of-life care. Lastly, this section discusses how ethical integrity in clinical treatments can be supported through institutions. In research ethics, inclusivity, research equipoise, and expectation management are key issues in the participation and trials, while open question for the posttrial access to care after psychedelic trials remain. Finally, the chapter addresses the question of equitable access to psychedelic medicine. Furthermore, justice for indigenous communities using psychedelics and the impact of legalization and medicalization of psychedelic substances are pressing ethical concerns amidst the "psychedelic renaissance."