Transient or transformative? Psychedelics, agency and informed consent

The transformative potential of psychedelic experiences raises ethical concerns about informed consent in psychedelic-assisted therapy, because an altered state of consciousness might shift a person's values in ways they cannot foresee. This argument, however, overemphasizes the power of the psychedelic experience itself. In most cases, the altered state is only the start; lasting change requires a sober, authentic agential process afterward. This two-step view of transformation alleviates the pressure on informed consent, suggesting that consent before the experience can still be valid.

Study at a glance

Abstract

The literature on psychedelic experiences often highlights their transformative potential. This raises ethical questions about informed consent in psychedelic-assisted therapy: if the altered state of consciousness induced by psychedelic drugs can profoundly alter a person's value system in ways that are epistemically inaccessible to them beforehand, it is unclear whether their informed consent before the experience can be considered valid. I argue that this view stems from a simplistic understanding of psychedelic-mediated transformation, which overemphasises the power of the psychedelic experience in driving change. In most psychedelic-mediated changes, the experience of an altered state of consciousness is only the beginning of the transformative process: a lasting transformation requires patients to undertake a sober, authentic agential process following the psychedelic experience. I suggest that this two-step view of psychedelic transformation alleviates the pressure on informed consent.