Informed Consent to Psychedelic-Assisted Psychotherapy: Ethical Considerations
Research Article
Andrew Lee, Daniel Rosenbaum, Daniel Z. Buchman
The Canadian Journal of Psychiatry, 17 January 2024
Excerpt
…Given that psychedelics can induce powerful nonordinary states of consciousness and increase suggestibility, challenges surrounding the informed consent process in [Psychedelic-Assisted Psychotherapy] PAP have begun to receive attention. For example, Smith and Sisti suggest that a process of “enhanced consent” be undertaken prior to PAP, characterized by special attention to the shifts in personality and values that can follow a psychedelic experience, the possible mental health side effects of psychedelics, and the possible use of therapeutic touch during treatment. However, Jacobs argues that owing to the particular effects of psychedelics—namely, mystical and ego-dissolution experiences which can occur acutely after administration and longer-term shifts in identity and values—the typical standards for informed consent may not be feasible.
Issues of capacity and consent during the psychedelic experience have received less attention. Individuals using psychedelics often experience profound acute changes to their sensorium along with alterations in mood, detachment from the body, and distortions of their sense of self, time, and reality. Consequently, it may be difficult for patients to appreciate the risks and benefits of terminating the session during the psychedelic experience. It may also be difficult for observers to predict or interpret the internal process and distress of patients during sessions, as their observable behaviour may not be representative of their inner experience…
Center for Informed Consent Integrity 