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Special Communication
´¡±è°ù¾±±ôÌý10, 2024

Essentials of Informed Consent to Psychedelic Medicine

Author Affiliations
  • 1Project on Psychedelics Law and Regulation (POPLAR), Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics, Harvard Law School, Cambridge, Massachusetts
  • 2Florida State University College of Law, Tallahassee, Florida
  • 3Center for Bioethics, Harvard Medical School, Boston, Massachusetts
  • 4Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, Massachusetts
JAMA Psychiatry. Published online April 10, 2024. doi:10.1001/jamapsychiatry.2024.0184
Abstract

ImportanceÌý Interest in administering psychedelic agents as mental health treatment is growing rapidly. As drugmakers invest in developing psychedelic medicines for several psychiatric indications, lawmakers are enacting legal reforms to speed access globally, and health agencies are preparing to approve these treatments. Meanwhile, US states, such as Oregon and Colorado, are making psychedelics available for supervised use outside the conventional health care system.

ObservationsÌý Despite legal change and potentially imminent regulatory approval in some countries, standards for integrating psychedelics into health care have lagged, including norms for designing and implementing informed consent processes. Informed consent is complicated by the unique features of psychedelics and their means of administration. Because no governments have approved any classic psychedelics for general medical or psychiatric use, only clinical researchers have obtained informed consent from trial participants. Accordingly, there is an unmet need for informed consent processes tailored to the challenges of administering psychedelics in nonresearch settings.

Conclusions and RelevanceÌý Analysis of the challenges of designing and implementing psychedelic informed consent practices revealed 7 essential components, including the possibility of short- and long-term perceptual disturbances, potential personality changes and altered metaphysical beliefs, the limited role of reassuring physical touch, the potential for patient abuse or coercion, the role and risks of data collection, relevant practitioner disclosures, and interactive patient education and comprehension assessment. Because publicly available informed consent documents for psychedelic clinical trials often overlook or underemphasize these essential elements, sample language and procedures to fill the gap are proposed.

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