Psychedelics can change minds by destabilizing the neurobiology of belief systems, raising ethical and epistemic concerns. This article argues for a skeptical attitude toward beliefs formed under psychedelic influence, contrasting with common epistemic practices in the field. It proposes four norms for ethically altering others' beliefs, based on outcomes and processes. The concept of 'doxastic vulnerability' describes heightened susceptibility to belief change, as induced by psychedelics. Placing people in this state creates responsibilities to prevent or mitigate harm, motivating epistemic harm reduction in psychedelic therapy. This supports a more active role for therapists as epistemic guides, contrary to recent calls for a passive non-directive stance.
The FDA's 2024 rejection of MDMA-assisted therapy sparked debate about ethics in drug regulation. This paper examines that debate through a human rights lens, particularly the right to health. It argues that drug approval decisions must consider the interdependent relationships among patients, regulators, pharmaceutical sponsors, and the public. While acknowledging the ethical concerns raised, the analysis suggests that typical arguments for rejection insufficiently considered the costs to patients who would have benefited. The paper also argues that a human rights-based approach supports expanding unlicensed use programs under certain conditions and that evidentiary standards for approval may need reconsideration if double-blind trials are practically infeasible in psychedelic research.