Experts in the fields of psychedelics, healthcare and bioethics gathered virtually to discuss the ethical implications of psychedelic-assisted therapy during a webinar hosted by the Petrie-Flom Center at Harvard Law School on Thursday .
The event, which examined the ethical and legal considerations involved in the administration of psychedelics, approached the topic from an experimental and clinical perspective. Panelists discussed issues of informed consent, experimental standardization and the potential for abuse.
The event was part of the Center’s first project on Psychedelics Law and Regulation – a three-year program launched in July that aims to “advance evidence-based psychedelics law and policy.”
At the start of the discussion, Holly Fernandez Lynch, professor of medical ethics at the University of Pennsylvania, said it was important to ensure that participants in psychedelic research could give “adequate informed consent.”
“When it comes to the desperation of some patients in these populations, this can raise challenges to ensure that they understand what they are getting themselves into and that they have realistic expectations,” said Fernandez Lynch. “They may not have good treatment options outside of the scope of research.”
Regarding underground psychedelic therapy, William R. Smith, another UPenn researcher, said there was “a lot of variability” that needs to be overcome between groups.
“One of the difficulties moving forward is that there are different standards in the practice of different communities,” Smith said. “What you can expect depends on where you are and who you are talking to. “
Karin Gagnon, a psychotherapy researcher at Oregon Health Sciences University, said if she could pick one focus it would be “education, education, education.”
“Education is more important than policies or laws,” said Gagnon. “Who has this qualified information?” How do we distribute it? Who finances it?
Gagnon added that the use of words like psychedelics or drugs is “limiting” and “harmful” to research.
“Having a precise common language as we deploy this from the research sector is really important,” she said.
An important ethical dilemma discussed during the event was the possibility of boundary violations while a patient is in an impaired condition.
Alissa Bazinet, clinical psychologist with the Oregon Psilocybin Advisory Board, said “power differentials” could be exacerbated by psychedelics, as well as by transference – the process by which emotions are redirected during therapy to the therapist.
“The lines can be blurred between a therapist and a client in a non-ordinary state of consciousness, which can sometimes lead to the impression that the client and the therapist are friends or love each other,” Bazinet said.
She added that traditional therapeutic boundaries could be further complicated by the “touch element” of psychedelic-assisted therapy, such as holding a client’s hand, which Bazinet said could be “an integral part of their recovery.” .
In an email, Carmel D. Shachar, executive director of the Petrie-Flom Center, wrote that the webinar was “the kind of conversation we hope to foster in the future.”
“There is so much fermentation and change going on in the field of psychedelics,” Shachar wrote. “Having space to reflect on the ethical and regulatory challenges and opportunities raised by the increased interest and use of psychedelics is vital. “
Bazinet concluded the webinar with the example of Oregon – where possession of all controlled substances has been decriminalized – as a model for the future.
“It’s been a really exciting challenge to think about how we can maybe try to do it all,” Bazinet said. “It sounds like a great experience, but I hope we can figure it out.”