Ethical Aspects of Psychedelic-Assisted Treatments: An Overview.

This chapter surveys ethical issues in psychedelic-assisted treatments across clinical ethics, research ethics, and societal dimensions. In clinical settings, autonomy, shared decision-making, and informed consent are critical because patients in altered states are vulnerable, raising concerns about touch and suggestibility. The debate over hallucinogenic versus nonhallucinogenic psychedelics questions the necessity of altered states. Exceptional therapist training and end-of-life care contexts are also discussed. In research, inclusivity, equipoise, and expectation management are key, with unresolved questions about post-trial access. Finally, equitable access, justice for indigenous communities, and the effects of legalization and medicalization are pressing societal concerns amid the psychedelic renaissance.

Study at a glance

Abstract

In this chapter, we provide an overview of ethical aspects of psychedelic-assisted treatments in the areas of clinical ethics, research ethics, and at the intersection of psychedelic medicine and society. In contrast to earlier psychedelic research, nowadays medical ethics have been firmly established as a discipline regulating patient-physician relationships which highlight the importance of autonomy, shared decision-making and informed consent in clinical ethics. During and after altered states of consciousness, autonomy is particularly important as participants are in a vulnerable state. In this vulnerable state, both touch and suggestibility are central ethical concerns. In turn, the debate surrounding hallucinogenic and nonhallucinogenic psychedelic substances discusses the importance of altered states of consciousness in general. Of further concern are exceptional training requirements and competencies of psychedelic therapists, as well as the particular context of end-of-life care. Lastly, this section discusses how ethical integrity in clinical treatments can be supported through institutions. In research ethics, inclusivity, research equipoise, and expectation management are key issues in the participation and trials, while open question for the posttrial access to care after psychedelic trials remain. Finally, the chapter addresses the question of equitable access to psychedelic medicine. Furthermore, justice for indigenous communities using psychedelics and the impact of legalization and medicalization of psychedelic substances are pressing ethical concerns amidst the "psychedelic renaissance."