If you respect someone, let them go? Personal autonomy and physical safety in psychedelic treatments

Abstract

Psychedelic treatments hold significant therapeutic promise for various psychiatric conditions. However, their unique therapeutic setting with psychedelic substance dosing sessions presents a particular ethical issue concerning patient autonomy. This article explores the ethics of limiting personal autonomy and freedom of movement during dosing sessions due to concerns for physical safety. After outlining normative reasons guiding clinical decision-making to uphold personal autonomy and physical safety in other medical contexts, we propose that containment during psychedelic dosing sessions should be justified under weak paternalism, implemented using the least restrictive means and operationalised through enhanced informed consent rather than blanket requirements to remain on-site.