Malpractice without a Baseline: Tort Liability and the Structural Paradoxes of Psychedelic-assisted Therapy
Michael Palmieri
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper |
|---|---|
| Topics | Psychedelic-assisted therapy |
| Key points | Argues that psychedelic-assisted therapy poses structural challenges to traditional malpractice doctrine that require doctrinal adaptations rather than expecting resolution as the field matures. |
Abstract
Psychedelic-assisted therapy is advancing rapidly toward clinical legitimacy in the United States. The Food and Drug Administration has granted Breakthrough Therapy designations to psilocybin and MDMA, several states have established regulated access frameworks, and major research institutions have invested hundreds of millions of dollars in psychedelic science. Yet the legal infrastructure governing malpractice liability for this emerging treatment modality remains almost entirely undeveloped. This Article identifies three structural challenges that psychedelicassisted therapy poses for traditional malpractice doctrine. First, the standard-of-care inquiry confronts an emerging profession that lacks settled credentialing, licensing norms, and practice standards, making expert testimony unreliable and the custom-based standard largely indeterminate. Second, causation analysis breaks down when the treatment intentionally alters the patient's evaluative framework-the cognitive architecture through which the patient assesses whether an outcome constitutes harm. Third, the damages calculus faces a paradox when the alleged injury is identity transformation that the patient may, after the shift, regard as beneficial. This Article argues that these are not transitional problems that will resolve as the field matures; they are structural features of a therapy that deliberately modifies the baseline against which malpractice doctrine measures deviation, causation, and harm. The Article proposes doctrinal adaptations-including prospective consent architectures, tiered standard-of-care frameworks, and temporal damages models-that would allow tort law to govern psychedelic therapy without collapsing the doctrinal coherence that makes malpractice liability meaningful.
Comparable studies
Other theoretical and historical papers on psychedelic-assisted therapy, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Theorizing that Psychedelic Assisted Therapy May Play a Role in the Treatment of Trauma-Induced Personality Disorders. | 2024 | Theoretical or philosophical paper | |
| Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance | 2020 | Theoretical or philosophical paper | |
| Awe: a putative mechanism underlying the effects of classic psychedelic-assisted psychotherapy | 2018 | Theoretical or philosophical paper | |
| Ethical and legal issues in psychedelic harm reduction and integration therapy | 2021 | Theoretical or philosophical paper | |
| Towards psychedelic apprenticeship: Developing a gentle touch for the mediation and validation of psychedelic-induced insights and revelations. | 2022 | Theoretical or philosophical paper |