Ethics and ego dissolution: the case of psilocybin
Journal of Medical Ethics – May 27, 2020
Source: OpenAlex
Summary
Half a century ago, **hallucinogens** like **psilocybin** were proscribed from medical **psychology**. Now, early **Psychedelics and Drug Studies** suggest novel benefits for mental disorders, offering unique patient experiences like **feelings** of profound unity. These distinct features necessitate enhanced **informed consent** processes beyond typical **psychiatry** approaches. As these **chemical synthesis and alkaloids** move towards **mainstream** clinical use, **psychotherapists** must address novel risks, drawing on **social psychology** and **Complementary and Alternative Medicine Studies** for ethical integration.
Abstract
Despite the fact that psychedelics were proscribed from medical research half a century ago, recent, early-phase trials on psychedelics have suggested that they bring novel benefits to patients in the treatment of several mental and substance use disorders. When beneficial, the psychedelic experience is characterized by features unlike those of other psychiatric and medical treatments. These include senses of losing self-importance, ineffable knowledge, feelings of unity and connection with others and encountering ‘deep’ reality or God. In addition to symptom relief, psychedelic experiences often lead to significant changes in a patient’s personality and worldview. Focusing on the case of psilocybin, we argue that the peculiar features of psychedelics pose certain novel risks, which warrant an enhanced informed consent process–one that is more comprehensive than what may be typical for other psychiatric medications. We highlight key issues that should be focused on during the consent process and suggest discussion prompts for enhanced consent in psychedelic psychiatry. Finally, we respond to potential objections before concluding with a discussion of ethical considerations that will arise as psychedelics proceed from highly controlled research environments into mainstream clinical psychiatry.