Psychological Medicine
January 1, 2025
Chiara Caporuscio, Christopher Poppe, Astrid Gieselmann et al.
9 citations
A scoping review of ethical issues in psychedelic-assisted therapy identifies seven key themes: safety and patient well-being, therapeutic relationships, informed consent, equity and access, research ethics, special contexts, and societal and cultural implications. The review systematically searched multiple databases for peer-reviewed studies on human participants and psychiatric patients, covering publications up to June 2025. The findings aim to inform further discussion and research to support safer and more ethical implementation of psychedelic-assisted treatments as they approach clinical use.
Philosophy and the Mind Sciences
January 25, 2022
Chiara Caporuscio
9 citations
A commentary argues that Chris Letheby's defense of psychedelic therapy insufficiently supports the claim that insights about the self are epistemically superior to those about the external world. The author contends that a key underexplored element is the capacity of self-related beliefs to become self-fulfilling prophecies. Recognizing the psychedelic experience and subsequent integration as opportunities not only to apprehend facts about the self but also to actively shape and redetermine those facts is crucial for understanding the epistemic differences between insights about the self and the external world.
Curr Top Behav Neurosci
November 2, 2024
Chiara Caporuscio, Sascha Benjamin Fink
7 citations
Belief change is central to therapeutic benefit in psychedelic-assisted therapy, but it poses unique challenges. Psychedelics can cause drastic belief shifts faster than in regular therapy, leading to confusion and disorientation. Hallucinatory experiences often carry a high degree of confidence and noetic certainty despite not necessarily being connected to reality. Telling a patient which beliefs are true is beyond a therapist's competence and risks abuse of authority, especially given the power imbalance and patient suggestibility during altered states. This chapter explores, through a philosophical and epistemological lens, how therapists can help patients navigate epistemic uncertainty around psychedelic insights while preserving autonomy. It argues that dynamically adapting strategies to individual patient needs can significantly reduce epistemic risks.
Philosophy and the Mind Sciences
May 2, 2022
Chiara Caporuscio, Sascha Benjamin Fink
1 citation
A book symposium on Chris Letheby's Philosophy of Psychedelics (2021) examines the tension between psychedelic therapy and philosophical naturalism. The special issue opens with an introduction by Matthew Johnson, followed by Letheby's overview of his main arguments. Seven contributions either critique or expand on Letheby's proposed mechanism for psychedelic therapy or discuss its epistemic implications. The symposium concludes with Letheby's responses to the commentaries.
Journal of Medical Ethics
March 10, 2026
Chiara Caporuscio
The transformative potential of psychedelic experiences raises ethical concerns about informed consent in psychedelic-assisted therapy, because an altered state of consciousness might shift a person's values in ways they cannot foresee. This argument, however, overemphasizes the power of the psychedelic experience itself. In most cases, the altered state is only the start; lasting change requires a sober, authentic agential process afterward. This two-step view of transformation alleviates the pressure on informed consent, suggesting that consent before the experience can still be valid.