Journey to Narayama: Cultural Complexities, Psychedelics and Dementia

Abstract

In their target article, Peterson et al. discuss the intriguing prospect of using psychedelics as a treatment for patients with Alzheimer’s Disease and Related Dementias (AD/ADRD) (Peterson et al. 2023). They provide a helpful analysis of ethical issues that may arise in research or clinical use. However, while they mention the use of psychedelics in indigenous spiritual practices, Peterson et al.’s analysis largely draws on a Western bioethical lens. In this commentary, drawing on Japanese experience, we highlight some important cultural complexities that an ethics research agenda will need to attend to. Some cultural factors will make this sort of research much more challenging. Other factors may be more hospitable, and may even defuse some of the ethical problems that Peterson and colleagues identify.