Are Psychedelic Experiences Transformative? Can We Consent to Them?

Psychedelic substances hold promise for treating many conditions, but some argue that informed consent for their use may be impossible because psychedelic experiences can be transformative in the sense defined by L. A. Paul—involving knowledge that cannot be obtained otherwise or changes in the self. This article argues that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and they may not differ in transformative features from other common medical experiences where informed consent is clearly possible. Even if psychedelic experiences can be transformative, informed consent remains possible. The article closes with recommendations for how informed consent processes should reflect the distinct features of psychedelic experiences.

Study at a glance

Abstract

Psychedelic substances have great promise for the treatment of many conditions, and they are the subject of intensive research. As with other medical treatments, both research and clinical use of psychedelics depend on our ability to ensure informed consent by patients and research participants. However, some have argued that informed consent for psychedelic use may be impossible, because psychedelic experiences can be transformative in the sense articulated by L. A. Paul (2014). For Paul, transformative experiences involve either the acquisition of knowledge that cannot be obtained in any other way or changes in the self. Either of these characteristics may appear to undermine informed consent. This article argues, however, that there is limited evidence that psychedelic experiences are transformative in Paul's sense, and that they may not differ in their transformative features from other common medical experiences for which informed consent is clearly possible. Further, even if psychedelic experiences can be transformative, informed consent is still possible. Because psychedelic experiences are importantly different in several respects from other medical experiences, this article closes with recommendations for how these differences should be reflected in informed consent processes.