Ethical challenges in the therapeutic application of classical psychedelics for pediatric health conditions: A comprehensive review

Abstract

Classical psychedelics encompass psilocybin, lysergic acid diethylamide (LSD), N, N-dimethyltryptamine (DMT), and mescaline and are psychoactive substances that primarily function as agonists at the serotonin 5-hydroxytryptamine receptors (5-HT). In the immediate term, they modify perception, cognition, emotional state, social processing, and introspection, leading to a subjective mystical encounter. They also yield enduring effects by mediating neural plasticity. A renaissance in the potential benefits of using psychedelics, especially for psychiatric disorders, has led to clinical trials with adults. When considering a possible equivalent application of classical psychedelics for pediatric conditions, autonomy, beneficence, non-maleficence, and justice have to be contemplated, following the framework of Beauchamp and Childress. The purpose of this study was to provide a comprehensive review of the use of classical psychedelics, hence providing a balanced evaluation of the ethical considerations surrounding the administration of psychedelic compounds to pediatric populations. We summarized evidence indicating that classical psychedelics have shown efficacy in treating various disorders in adults, with ongoing research exploring their potential for additional conditions. While this suggests they could offer benefits for children, the current research remains preliminary, with uncertain outcomes and significant limitations. These factors highlight the ethical and practical challenges of applying such treatments to children, a particularly vulnerable population.