The American journal of bioethics : AJOB
January 1, 2025
Katherine Cheung, Brian D Earp, Kyle Patch et al.
30 citations
The authors argue against the idea that psychedelics raise uniquely exceptional ethical issues in clinical medicine, comparing this position to earlier debates about genetic exceptionalism in bioethics. They contend that psychedelics share more commonalities with existing medical interventions than is often assumed, and that adopting a stance of "psychedelic ethical exceptionalism" carries risks. Instead, they propose that consistent ethical rules and evidentiary standards should apply across all relevant areas of clinical medicine. While changes to existing standards may be warranted, such changes should not be justified by appealing to the alleged uniqueness of psychedelics.
American Journal of Bioethics
May 2, 2024
Edward Jacobs, B. Earp, Paul S. Appelbaum et al.
29 citations
A workshop on psychedelic ethics, the first Hopkins-Oxford Psychedelic Ethics (HOPE) meeting, was held in August 2023 at the University of Oxford to address ethical issues surrounding psychedelics. The organizers (BDE, DBY, EJ) aimed to foster interdisciplinary discussion on topics such as informed consent, therapeutic use, and societal implications. The report outlines the workshop's structure, key themes, and proposed guidelines for ethical research and practice in the field.
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees
June 27, 2023
Katherine Cheung, Kyle Patch, Brian D Earp et al.
27 citations
Psychedelics like psilocybin produce altered states of consciousness that change perception, cognition, and affect. They show promise as therapeutic agents combined with talk therapy for conditions such as major depression and substance use disorder. It remains unclear whether these acute subjective effects are necessary for therapeutic benefits. This uncertainty has sparked debate about whether psychedelics without subjective effects could still have therapeutic impact, or whether the subjective effects are essential for full therapeutic realization.
Palliative Medicine
January 22, 2024
Louis Plourde, Sue-Ling Chang, Houman Farzin et al.
22 citations
A survey of 2,800 adults in four Canadian provinces found high social acceptability of psilocybin-assisted therapy for existential distress at the end of life. 79.3% considered it a reasonable medical choice, 84.8% agreed public health insurance should cover it, and 63.3% would support legalization for medical purposes. More favorable attitudes were linked to prior psilocybin use, exposure to palliative care, and progressive political orientation. The findings suggest public support is strong enough to help mobilize resources and improve access to this emerging therapy in palliative and end-of-life care.
Bioethics
March 1, 2025
Emma C Gordon, Katherine Cheung, Julian Savulescu et al.
8 citations
A common objection to cognitive or athletic enhancement is that using drugs or technologies to improve performance 'cheapens' the resulting achievement. This paper extends that objection to moral enhancement—using biotechnology to become a morally better person. The authors argue that if the cheapened-achievement objection holds for cognitive or athletic enhancement, it can also apply to some forms of moral enhancement, but not all. Highly speculative or determinative technologies might diminish the value of moral self-improvement. However, more practical forms—where drugs or technologies play an adjunctive or facilitative role, such as psychedelics in moral learning, 'Socratic AI,' or empathy enhancement via virtual reality—largely evade the objection, assuming those technologies work as intended. The most promising forms of moral enhancement thus avoid a leading critique of other enhancements.
The Lancet Child & Adolescent Health
September 2, 2025
Khaleel Rajwani, Edward Jacobs, Lori Bruce et al.
6 citations
No Summary
Perspectives in biology and medicine
January 1, 2024
Katherine Cheung, Brian D Earp, David B Yaden
5 citations
A psychedelic experience might be valuable in itself, not just for its lasting therapeutic benefits. Using the concept of psychological richness and ideas from aesthetics and enhancement philosophy, this essay argues that the acute subjective experience can be a source of value independent of any persisting positive effects.
AJOB empirical bioethics
July 16, 2025
Katherine Cheung, Caleigh Propes, Marianna Graziosi et al.
4 citations
Informed consent documents from U.S. psilocybin clinical trials often emphasize mental health and physical risks but rarely include psychedelic-specific elements like ineffability or therapeutic touch, despite calls from bioethicists for tailored consent forms. A content analysis of 28 documents from 13 sites found good coder reliability. The results suggest that while general risks are well covered, the unique features of psychedelic experiences are not consistently addressed in consent materials. The authors recommend ongoing debate about which elements are most important for potential participants to consider when deciding whether to join a study.
Philosophical Psychology
September 8, 2025
Mina Caraccio, Katherine Cheung, Sebastian Porsdam Mann et al.
3 citations
As interest in psychedelics like psilocybin, ketamine, and MDMA revives and their legal status changes in many places, ethical guidelines are urgently needed for both medical and non-medical use. This paper argues that focusing only on medical applications neglects potentially valuable uses in other contexts and raises ethical issues including hype, exceptionalism, informed consent, therapeutic touch, data collection, and balancing access with safety. The authors call for renewed attention to the treatment-versus-enhancement distinction from bioethics and stress that guidelines should be flexible and context-sensitive. They recommend incorporating diverse stakeholder perspectives and cross-sector collaboration in future research and policy for psychedelic bioethics.
The Journal of Law Medicine & Ethics
January 1, 2025
Katherine Cheung, M J Brodie, Sue-Ling Chang et al.
2 citations
Physicians may hesitate to prescribe psilocybin for conditions like end-of-life anxiety and depression due to stigma and potential medical malpractice liability. This paper examines the risk of malpractice claims arising from psilocybin treatment in Canada, using exploratory vignettes to illustrate the relevance and limits of such claims. It argues that the absence of established medical standards, standardized training, and credentialing increases liability risks. More clinical trials, meta-studies, and knowledge sharing are needed to develop training programs and medical standards of practice to better realize psilocybin's potential.
American Journal of Bioethics
July 30, 2025
Caleigh Propes, Katherine Cheung
1 citation
Informed consent is intended to give potential study participants clear information about risks and benefits, but participants often misunderstand key aspects of what they are told. The paper examines the persistent problem of participant misconceptions in medical and psychological research, discussing how these misunderstandings undermine the ethical goals of informed consent and suggesting possible reasons and remedies.
Journal of psychopharmacology (Oxford, England)
May 1, 2025
Katherine Cheung, Rebecca Ehrenkranz, Jared T Hinkle et al.
1 citation
A commentary responds to a proposed framework for assessing adverse events in psychedelic-assisted therapies, which includes spiritual, existential, religious, and theological impacts. The authors argue that adverse event assessment in psychedelic clinical trials should match the rigor and standards of other research areas, and emphasize the need for transparency and accessibility in reporting. The commentary discusses the framework's feasibility and various assessment methods, focusing on ensuring systematic and unbiased evaluation of adverse events.
Accountability in research
May 1, 2026
Katherine Cheung, Rebecca Ehrenkranz, Brian D Earp et al.
Several proposals across fields suggest including independent actors in research to manage bias, such as independent auditors for adverse events in psychedelic science or independent researchers in trial teams. However, the concept of independence is often undefined. While introducing independent actors seems beneficial for reducing bias and improving rigor, it may also have significant drawbacks. The authors argue that the implicit sense of independence is freedom from influences that could reduce the trustworthiness or accuracy of findings. They explore whether such actors can be identified without trade-offs with other scientific goals, like expertise. Two models from law and science are offered to guide incorporation of independent actors.