March 2023

“Popularly Enthralling and Ethically Disquieting”: As Psychedelics Research and Medicine Goes Mainstream, Greenwall Faculty Scholars Weigh In

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After a half-century of relative dormancy, there has been a recent, tremendous surge in the clinical use and research of psychedelics like ketamine and psilocybin. The legal and cultural prohibitions on psychedelic research—and the speed of the growth in interest in the topic—have left considerable gaps in understanding the bioethics questions raised when studying these substances. 

In the 1960s, the prominent and controversial Timothy Leary engaged in notorious experiments with LSD that led to his ouster from academia. Among other factors, these experiments also led to the criminalization of psychedelics. Greenwall Faculty Scholar Brent. M. Kious, MD, PhD, invoked this history in a Journal of Psychopharmacology paper, Should We be Leery of Being Leary? Concerns About Psychedelic Use by Psychedelic Researchers. Leary’s blurring of the lines between advocate for and researcher of psychedelics is reflected in some more contemporary bioethics concerns around researchers’ bias, Dr. Kious and coauthors note, as their paper grapples with “whether the possibility that psychedelic use can directly and positively affect investigators’ enthusiasm about psychedelics themselves raises concerns about bias and scientific integrity.”

It’s not only clinicians and researchers who can potentially overestimate psychedelics’ potential. Patients can too, which Faculty Scholar Alum Holly Fernandez Lynch, JD, referred to as the “hype/hope dyad associated with…psychedelics.” But this hype is not the only bioethics problem the substances present. Andrew Peterson, PhD, a Faculty Scholar Alum and philosopher who studies consciousness, noted in a recent paper the popular allure of psychedelics’ “paradigm-shifting capacities” to deliver “deeper insight into the mysteries of human consciousness.” In Journeying to Ixtlan: Ethics of Psychedelic Medicine and Research for Alzheimer’s Disease and Related Dementias, published in AJOB Neuroscience—alongside Faculty Scholar Emily A. Largent, PhD, RN, Alums Prof. Fernandez Lynch and Jason Karlawish, MD, and their coauthor Dominic Sisti, PhD—the authors propose a series of essential research questions for studying the ethics of psychedelic medicine and research involving those with Alzheimer’s disease and related dementias. These questions include how to deal with “ego dissolution,” the degree to which the substances undermine autonomy and consent, and more.

Beyond these ethical gray areas, too, are legal gray areas, a result of the rapid rise in popularity of psychedelic research and treatment. Prof. Fernandez Lynch has noted concerning areas where ketamine administration, in particular, has outstripped the legal safeguards for its use:

The substances’ current status as federally prohibited but increasingly legal in states and other jurisdictions also complicates research on and use of psychedelics in ways that policymakers will need to unravel. Early in 2023, Faculty Scholars Program Committee Chair and Alum Amy L. McGuire, JD, PhD joined 2022 Stubing Lecture moderator Meghna Chakrabarti on WBUR’s On Point, and noted “there is this tension between…the federal government and the gatekeeping role that they have over these sorts of substances and the states and…their desire to act independently.”

And amid a relatively unsettled patent landscape, notes Faculty Scholars Program Committee Member and Alum I. Glenn Cohen, JD, and coauthor Mason Marks, MD, JD, in Patents on Psychedelics: The Next Legal Battlefront of Drug Development, psychedelic substances “raise unique concerns raise unique concerns associated with their unusual qualities, history, and regulation.” One such concern is that they’ve been used by a broad range of populations for millennia, as Jon Oliver points out, citing Prof. Cohen in an episode of Last Week Tonight:

Booming interest in psychedelics suggests that their use and research won’t dissipate in the near future—nor will the bioethics questions that go along with them. As members of the Faculty Scholars community have taken up questions of consciousness, researcher bias, and accessibility, among others, still more remains to be explored. As ever, bioethics —and the Greenwall community—will be at the forefront of these explorations.


More from The Greenwall Foundation community on bioethics and psychedelics research and medicine:

* Quotation in title comes from Journeying to Ixtlan: Ethics of Psychedelic Medicine and Research for Alzheimer’s Disease and Related Dementias, by A. Peterson, et. al.