Ethical Issues Regarding Nonsubjective Psychedelics as Standard of Care.
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees – October 01, 2022
Source: PubMed
Summary
The profound subjective experiences induced by psychedelics are key to their healing potential. With new hallucinogens emerging that aim to treat mental health conditions in psychiatry without these "trips," bioethics asks a crucial question: Is it ethical to withhold these typically positive, meaningful experiences? While nonsubjective psychedelics have a role for specific cases, the full, transformative subjective journey should be the default standard of care due to its significant therapeutic benefits.
Abstract
Evidence suggests that psychedelics bring about their therapeutic outcomes in part through the subjective or qualitative effects they engender and how the individual interprets the resulting experiences. However, psychedelics are contraindicated for individuals who have been diagnosed with certain mental illnesses, on the grounds that these subjective effects may be disturbing or otherwise counter-therapeutic. Substantial resources are therefore currently being devoted to creating psychedelic substances that produce many of the same biological changes as psychedelics, but without their characteristic subjective effects. In this article, we consider ethical issues arising from the prospect of such potential "nonsubjective" psychedelics. We are broadly supportive of efforts to produce such substances for both scientific and clinical reasons. However, we argue that such nonsubjective psychedelics should be reserved for those special cases in which the subjective effects of psychedelics are specifically contraindicated, whereas classic psychedelics that affect subjective experience should be considered the default and standard of care. After reviewing evidence regarding the subjective effects of psychedelics, we raise a number of ethical concerns around the prospect of withholding such typically positive, meaningful, and therapeutic experiences from most patients.