Transient or transformative? Psychedelics, agency and informed consent

Summary

Psychedelic experiences are often viewed as transformative, raising ethical concerns about the validity of informed consent in therapy. If these experiences can significantly change a person's values in ways they cannot anticipate, their consent may be questionable. However, this perspective may oversimplify the transformation process, which involves a subsequent sober and authentic engagement by patients. This two-step model suggests that informed consent can still be valid despite the initial altered state.

Study at a glance

Abstract

The literature on psychedelic experiences often highlights their transformative potential. This raises ethical questions about informed consent in psychedelic-assisted therapy: if the altered state of consciousness induced by psychedelic drugs can profoundly alter a person's value system in ways that are epistemically inaccessible to them beforehand, it is unclear whether their informed consent before the experience can be considered valid. I argue that this view stems from a simplistic understanding of psychedelic-mediated transformation, which overemphasises the power of the psychedelic experience in driving change. In most psychedelic-mediated changes, the experience of an altered state of consciousness is only the beginning of the transformative process: a lasting transformation requires patients to undertake a sober, authentic agential process following the psychedelic experience. I suggest that this two-step view of psychedelic transformation alleviates the pressure on informed consent.

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