Adolescents should be included in research into psychedelic therapies such as psilocybin and MDMA, which have shown promise for treating mental disorders in adults. The growing mental health burden among young people creates a pressing need for novel interventions, and psychedelics pose low risk relative to existing psychiatric medications. Concerns about developmental risks and the complexity of informed consent are addressed: the lack of understanding about risks underscores the need for research, and an enhanced consent process can allow capable adolescents to participate. Including adolescents could substantiate innovative treatments that improve their clinical outcomes, long-term mental health, and quality of life.
Mandatory video recording of psychedelic therapy sessions, intended to prevent therapist misconduct, raises serious ethical concerns from the patient perspective that deserve careful consideration. While recording offers benefits such as deterring abuse and providing evidence, it may compromise patient privacy, trust, and the therapeutic environment. The argument that recording is essential for clinician safety is also examined. The paper proposes that informed consent should address patient concerns and that both patients and clinicians should have the option to opt out. Further bioethical analysis and qualitative research on recording practices in psychedelic-assisted therapy are needed.
Excluding people with personal or family histories of psychosis from psychedelic therapy research raises serious ethical concerns. The historical entanglement and separation of psychedelic and psychosis research in Western psychiatry is reviewed. Clinical and sociocultural reasons for this standard exclusion are examined. While caution is warranted, such exclusion causes significant harms to safety, accessibility, autonomy, and equity. Drawing parallels to the exclusion of pregnant people from drug research, a protectionist and exclusionary approach redistributes harms rather than preventing them.