Developing an ethical framework for psychedelic clinical care

As government agencies around the globe contemplate approval of the first psychedelic medicines, many questions remain about their ethical integration into mainstream medical practice.

Andrew Peterson, assistant professor in George Mason University's Department of Philosophy and Institute for Philosophy and Public Policy, along with a team of bioethicists, clinicians, researchers, Indigenous groups, industry, philanthropy, veterans, retreat facilitators and training program leaders, worked to identify key ethics and policy issues related to the integration of psychedelic therapies into clinical practice and areas for further research and deliberation. 

The team recently published a paper in JAMA Network Open, after a two-day workshop held at the Banbury Center of Cold Spring Harbor Laboratory.

“Psychedelics are often thought of as garden variety recreational drugs, but they have real therapeutic potential for psychiatry. With this potential comes a need for ethical evaluation,” Peterson said. “We provide the first ethical framework to help researchers and lawmakers move forward in this new era of medicine.”

The authors note that many of the traditional frameworks of bioethics and drug policy may be out of date, and that policy makers must take seriously the challenges ahead, while not losing sight of the rich cultural histories and traditions from which contemporary medical uses of psychedelics have emerged.

In the paper, the team focuses on bioethics and regulatory issues in the United States, which may be generalized globally.

They also identify 20 points of consensus across five topics (reparations and reciprocity, equity, and respect; informed consent; professional boundaries and physical touch; personal experience; and gatekeeping).

“There will be novel ethical challenges that accompany the approved medical use of psychedelics, and we must understand the issues at hand, anticipate obstacles and work to surmount them quickly and efficiently so clinicians can focus on utilizing approved psychedelics to provide evidence-based care to patients,” said corresponding author Amy McGuire, Leon Jaworski Professor of Biomedical Ethics and director of the Center for Medical Ethics and Health Policy at Baylor University. “We hope this paper will inspire greater collaboration and action now so that when psychedelics are soon approved there is ethical and safe uptake.”

The workshop held at the Banbury Center of Cold Spring Harbor Laboratory was funded by the Project on Psychedelics Law and Regulation (POPLAR) at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, which is supported by the Saisei Foundation, Tim Ferriss and Matt Mullenweg, Baylor College of Medicine through the Ortus Foundation, and the Cold Spring Harbor Laboratory Corporate Sponsor Program. The meeting was organized by researchers from the Center for Medical Ethics and Health Policy at Baylor University, Petrie-Flom Center at Harvard Law School, and the University of Pennsylvania Perelman School of Medicine.