Lead author Eddie Jacobs, whose doctoral research at the Department of Psychiatry focuses on the ethics of psychedelic-assisted therapies, led the work, which has now been published in The American Journal of Bioethics.
Last August saw a multidisciplinary group, including psychedelic scientists, psychiatrists, ethicists, Indigenous scholars and others, convene at the University of Oxford to form the Hopkins-Oxford Psychedelic Ethics (HOPE) Working Group and discuss the ethical dimensions of psychedelics. Insightful presentations and the animated discussions that followed explored research methods and clinical practices, but also history, law and society, spirituality, community and culture. Over the following months, participants collaborated to develop the HOPE Consensus Statement, which seeks to distil the combined expertise and perspectives of stakeholders in the ‘psychedelic renaissance’ to highlight both the central and underappreciated risks, and the potential benefits, of psychedelics.
Signatories were keen to make sure that the statement did not singularly focus on clinical practice, because while these drugs will likely be licensed for medical use within a couple of years, the majority of psychedelic use globally always has, and always will, happen outside of the clinic. Any proper ethical analysis needs to consider not just the prospective patient at the individual level, but also what impacts psychedelics could have at socio-historical, political, and cultural levels.
The majority of psychedelic use globally always has, and always will, happen outside of the clinic.
Key facets of the statement include the recognition of the special position of the Indigenous communities who have a long history of using psychedelics, whose long-accumulated knowledge has informed modern clinical practice, but who remain at risk of extractive and unsustainable practices as Western science and society grow more interested in their ancestral medicines; the need for a precautionary approach to advance scientific understanding that generates real-world evidence about harms and harm reduction without straying into ‘psychedelic exceptionalism’; and the responsibility of researchers to provide impartial information, free of bias or hype, to the diverse groups who will directly or indirectly come into contact with psychedelics in the coming years.
Considering the use of psychedelics in research and medicine, our group acknowledged that “the unpredictable nature of psychedelic experiences presents particular challenges for securing adequate consent,” as well as pointing to the need to better understand the long-term and ‘non-standard’ potential risks of psychedelics (including changes in belief and outlook and relational harms), and the need for research and practice communities to actively develop not just codes of conduct and accountability structures, but cultures that actively engage with ethical challenges.
In line with the HOPE statement’s call to psychedelic researchers to make the outputs of their work as accessible as possible, the statement itself, as well as launching today in the American Journal of Bioethics, has been made available in six languages.
This year, Johns Hopkins University is hosting the HOPE Summit in Washington DC, with a wider range of participants, including representatives from the US Food and Drug Administration, in anticipation of the licensing of MDMA-assisted therapy for PTSD.