A psychedelic renaissance is currently taking place in mental healthcare. The number of psychedelic-assisted therapy trials is growing steadily, and some countries already grant psychiatrists special permission to use psychedelics in non-research contexts under certain conditions. These clinical advances must be accompanied by ethical inquiry. One pressing ethical question involves whether patients can even give informed consent to psychedelic-assisted therapy: the treatment’s transformative nature seems to block its assessment, suggesting that patients are unable to understand what undergoing psychedelic-assisted therapy actually (...) means for them and whether it aligns with their values. The present paper argues that patients often have sufficient knowledge to give informed consent because they know that they want to change their negative status quo and that psychedelic-assisted therapy offers an effective way to do so. Accordingly, patients can understand what the transformative nature of psychedelic-assisted therapy means for them and a make a value-aligned choice even if they are unable to anticipate the manifestation of a psychedelic experience. (shrink)

Peterson et al. (2023) present a range of ethical issues that arise when considering the use of psychedelic substances within medicine. But psychedelics are, by their nature, boundary-dissolving, a...

Peterson et al. (2023) identify important ethical issues that are relevant to psychedelic therapy and research in various clinical populations and contexts. This is certainly the case in palliative...

Well-trained, competent therapists are crucial for safe and effective psychedelic-assisted therapy (PAT). The question whether PAT training programs should require aspiring therapists to undergo their own PAT—commonly referred to as “experiential training”—has received much attention within the field. In this article, we analyze the potential benefits of experiential training in PAT by applying the framework developed by Rolf Sandell et al. concerning the functions of any training therapy (the therapeutic, modeling, empathic, persuasive, and theoretical functions). We then explore six key (...) domains in which risks could arise through mandatory experiential training: physical and psychological risks; negative impact on therapeutic skill; justice, equity, diversity, and inclusion; dual relationships; privacy and confidentiality; and undue pressure. Ultimately, we argue that experiential training in PAT should not be mandatory. Because many PAT training programs already incorporate experiential training methods, our exploration of potential harms and benefits may be used to generate comprehensive risk-mitigation strategies. (shrink)

According to L.A. Paul, undergoing an experience is transformative if we learn something we cannot learn without having the experience and if it substantially changes our point of view. While the implications of transformative experiences have primarily been discussed in the context of rational choice, their underlying concept has also proven fruitful in the context of unchosen occurrences. The present paper examines mental disorder and its treatment from a transformative experiential perspective, using major depressive disorder as an exemplary case. It (...) shows that developing a mental disorder typically requires a transformative experience since the two popular mental disorder classification systems primarily classify such disorders on an experiential basis. This provides an explanation for the lack of understanding mentally disordered people often face: their experiential state is epistemically inaccessible for those who have not experienced a similar state before. Furthermore, successful treatment of mental disorder again requires a (personally) transformative experience that results in the disorder’s overcoming. The paper examines pharmacological, psychological, and psychedelic-assisted treatment and reveals that each of them uses a different transformative route to recovery: a finding relevant, for example, to ongoing debates in medical ethics about informed consent. (shrink)

This essay engages with the (re)emergence of psychedelic medicine and the idea of psychedelics drugs and the experiences they induce as a developing therapeutic modality. It does so in the context of the provision of psychedelics to terminally ill patients experiencing existential distress as they approach the end of their lives. Reflecting on such suggestions facilitates an examination of a specific aspect of psychedelics and/ as medicine (or palliative care), namely questions of meaning and meaninglessness. Understood as impacting one’s ability (...) to make or _realise_ meaning in life, existential distress commonly entails a degree of demoralisation. In some cases, individuals can be thought of as inhabiting (and being inhabited by) a sense of meaninglessness. In contrast, the experiences psychedelics seem to induce are often imbued with a great deal of meaning, a sense of which seems to continue long after the psychoactive effects of such drugs have ceased. Whilst briefly considering whether or not meaning can properly be thought of as a matter for healthcare or a medical concern, this paper seeks to highlight some of the implications that the advent of psychedelic medicine might have. By way of a conclusion, I enjoin bioethics in recognising itself as a meaningful cultural discourse that is implicated in the future(s) of medicine, psychedelics and being human. (shrink)

This special issue of AJOB Neuroscience explores a number of ethical questions emerging from some of the most recent results of research on consciousness, including its moral interpretation, its te...

Peterson et al. (2023) identify two potential uses of psychedelic drugs in Alzheimer’s disease and related disorders (AD/ADRD). The first is to treat depression and anxiety that commonly occur afte...

Peterson et al. (2023) outline a broad ethics agenda for imminent research on psychedelic agents for Alzheimer’s disease and related dementias (AD/ADRD) by acknowledging the therapeutic promise of...

In their target article, Peterson et al. discuss the intriguing prospect of using psychedelics as a treatment for patients with Alzheimer’s Disease and Related Dementias (AD/ADRD) (Peterson et al....

While the developers of the “Ixtlan Basic Kit” promise a curative treatment taking advantage of increased neuroplasticity for targeting the underlying neurological causes of Alzheimer's disease and...

Dementia is an ever-growing public health concern with significant impact on the quality of life of older adults and their families (Aranda et al. 2021). Research continues to investigate treatment...

People crossing the border into the United States or Canada may find their electronic devices subject to search. Border agents can require travelers to unlock their devices, and then browse through...

Peterson et al. (2023) write that there’s “a rich philosophical debate on the nature of authenticity in dementia” involving the relationship of identity and autonomy. I explore this with Jaworska’s...

In “Journeying to Ixtlan,” Peterson and colleagues (2023) evaluate some of the potential ethical implications of treating Alzheimer’s disease (AD) with psychedelic medicines. In this commentary, I...