Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees
October 1, 2022
David B. Yaden, Brian D. Earp, Roland R. Griffiths
31 citations
Psychedelics partly achieve their therapeutic effects through the subjective experiences they produce and how individuals interpret those experiences. Because these subjective effects can be disturbing for people with certain mental illnesses, researchers are developing 'nonsubjective' psychedelics that cause similar biological changes without the characteristic subjective effects. The authors broadly support creating such substances for scientific and clinical reasons but argue they should be reserved only for cases where subjective effects are specifically contraindicated. Classic psychedelics that produce subjective experiences should remain the default standard of care, as withholding typically positive, meaningful, and therapeutic experiences from most patients raises ethical concerns.
The American journal of bioethics : AJOB
January 1, 2025
Katherine Cheung, Brian D. Earp, Kyle Patch et al.
30 citations
The authors argue against the idea that psychedelics raise uniquely exceptional ethical issues in clinical medicine, comparing this position to earlier debates about genetic exceptionalism in bioethics. They contend that psychedelics share more commonalities with existing medical interventions than is often assumed, and that adopting a stance of "psychedelic ethical exceptionalism" carries risks. Instead, they propose that consistent ethical rules and evidentiary standards should apply across all relevant areas of clinical medicine. While changes to existing standards may be warranted, such changes should not be justified by appealing to the alleged uniqueness of psychedelics.
Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees
June 27, 2023
Katherine Cheung, Kyle Patch, Brian D. Earp et al.
27 citations
Psychedelics like psilocybin produce altered states of consciousness that change perception, cognition, and affect. They show promise as therapeutic agents combined with talk therapy for conditions such as major depression and substance use disorder. It remains unclear whether these acute subjective effects are necessary for therapeutic benefits. This uncertainty has sparked debate about whether psychedelics without subjective effects could still have therapeutic impact, or whether the subjective effects are essential for full therapeutic realization.
AJOB Neuroscience
February 5, 2024
Julian D. Sandbrink, Kyle Johnson, Maureen Gill et al.
13 citations
A nationally representative sample of 795 US Americans rated the moral status of psilocybin use in a licensed setting as morally positive for both treating a psychiatric condition and enhancing well-being, showing strong bipartisan support. These attitudes can inform policy-making around supervised psilocybin use. The study did not explore attitudes toward unsupervised or non-licensed use.
International Review of Psychiatry
June 5, 2024
Katherine Cheung, Caleigh Propes, Edward Jacobs et al.
11 citations
Psychedelic integration groups, offered in person or online, may attract individuals who feel disconnected or lonely after a psychedelic experience. These groups can provide community and shared coping strategies, but also carry risks. This essay explores both benefits and risks, offering preliminary guidelines for physicians, researchers, and individuals to assess and evaluate such groups.
Bioethics
March 1, 2025
Emma C. Gordon, Katherine Cheung, Julian Savulescu et al.
8 citations
A common objection to cognitive or athletic enhancement is that using drugs or technologies to improve performance 'cheapens' the resulting achievement. This paper extends that objection to moral enhancement—using biotechnology to become a morally better person. The authors argue that if the cheapened-achievement objection holds for cognitive or athletic enhancement, it can also apply to some forms of moral enhancement, but not all. Highly speculative or determinative technologies might diminish the value of moral self-improvement. However, more practical forms—where drugs or technologies play an adjunctive or facilitative role, such as psychedelics in moral learning, 'Socratic AI,' or empathy enhancement via virtual reality—largely evade the objection, assuming those technologies work as intended. The most promising forms of moral enhancement thus avoid a leading critique of other enhancements.
The Lancet Child & Adolescent Health
September 2, 2025
Khaleel Rajwani, Edward Jacobs, Lori Bruce et al.
6 citations
A scoping review of medical literature from 2000 to 2025 found no completed or published clinical trials testing psychedelic-assisted therapy in adolescents under 18, despite three trial registrations and one trial plan. The proposed studies would have investigated MDMA-assisted or psilocybin-assisted psychotherapy for adolescents with post-traumatic stress disorder, autism with social anxiety, or self-harm. Ethical approval and recruitment details were inconsistently reported. This absence of data represents a major evidence gap that could hinder informed care. The authors argue for cautious, ethically grounded research starting with older adolescents who have the highest foreseeable benefit-risk ratio due to special circumstances.
Perspectives in biology and medicine
January 1, 2024
Katherine Cheung, Brian D. Earp, David B. Yaden
5 citations
A psychedelic experience might be valuable in itself, not just for its lasting therapeutic benefits. Using the concept of psychological richness and ideas from aesthetics and enhancement philosophy, this essay argues that the acute subjective experience can be a source of value independent of any persisting positive effects.
Philosophy, psychiatry & psychology
January 1, 2021
Brian D. Earp, David B. Yaden
4 citations
Psychedelic research must be studied across cultures and disciplines, and a recent medical anthropology contribution by Noorani (2021) explores how psychedelics challenge conventional boundaries like treatment versus enhancement or medical versus recreational. The authors agree with Noorani's emphasis on the therapeutic setting as a 'container' for experiences and his critical look at background conditions, including the values and assumptions of scientists and institutions. They note that science is shaped by omitted voices, often those of women and people of color. Noorani draws on his training at Johns Hopkins and ethnography with the 'psychedelic community,' but the authors criticize his vague definition of community, which lumps together researchers, therapists, neo-shamanic healers, hippies, and others without clear coherence.
Philosophical Psychology
September 8, 2025
Mina Caraccio, Katherine Cheung, Sebastian Porsdam Mann et al.
3 citations
As interest in psychedelics like psilocybin, ketamine, and MDMA revives and their legal status changes in many places, ethical guidelines are urgently needed for both medical and non-medical use. This paper argues that focusing only on medical applications neglects potentially valuable uses in other contexts and raises ethical issues including hype, exceptionalism, informed consent, therapeutic touch, data collection, and balancing access with safety. The authors call for renewed attention to the treatment-versus-enhancement distinction from bioethics and stress that guidelines should be flexible and context-sensitive. They recommend incorporating diverse stakeholder perspectives and cross-sector collaboration in future research and policy for psychedelic bioethics.
Wellcome Open Research
July 8, 2025
Khaleel Rajwani, Melanie Almonte, F. Feroz et al.
2 citations
A protocol describes a planned scoping review to determine whether any controlled clinical research involving psychedelic drug administration to adolescents under 18 has been conducted since 2000. The review will follow established methodological guidelines, searching multiple databases and trial registers for interventional studies from 2000 to the present. Two independent raters will assess articles, with a third resolving disagreements. The protocol notes that while historical studies from 1959 to 1974 exist, they do not meet modern standards, and no recent controlled clinical research with adolescents is known.
Wellcome Open Res
January 13, 2025
Samuel Streicher, Christopher Register, Xiu Lim et al.
2 citations
A protocol is described for a scoping review that will map ethical arguments for and against the voluntary use of psychedelics as moral bioenhancers. The review will follow the Joanna Briggs Institute methodology, searching multiple databases for published and unpublished sources that present explicit ethical arguments. Sources focused primarily on clinical treatment or unavailable in English will be excluded. Two independent raters will assess eligibility, with disagreements resolved by a third reviewer. Data will be charted and analyzed following PRISMA-ScR guidelines.
Accountability in research
May 1, 2026
Katherine Cheung, Rebecca Ehrenkranz, Brian D. Earp et al.
Several proposals across fields suggest including independent actors in research to manage bias, such as independent auditors for adverse events in psychedelic science or independent researchers in trial teams. However, the concept of independence is often undefined. While introducing independent actors seems beneficial for reducing bias and improving rigor, it may also have significant drawbacks. The authors argue that the implicit sense of independence is freedom from influences that could reduce the trustworthiness or accuracy of findings. They explore whether such actors can be identified without trade-offs with other scientific goals, like expertise. Two models from law and science are offered to guide incorporation of independent actors.
American Journal of Bioethics
January 1, 2026
Katherine Cheung, Brian D. Earp, Kyle Patch et al.
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