Several disturbing trends in recent years seem to be endangering the future of bioethics book publishing. One striking feature of the last two meetings of the American Society for Bioethics and the...

As research therapists with hundreds of hours of clinical experience supporting adults with PTSD in Phase 3 trials of MDMA assisted-therapy (MAT), we appreciate the opportunity to respond to this s...

Psychedelic ethics is at a crossroads. Confronted with the undeniable harm wrought by a widespread embrace of exceptionalism, many are approaching psychedelics not only in the context of urgent men...

The US Food and Drug Administration (2023) recently stated, “Psychedelic drugs have shown initial promise as potential treatments… However, these are still investigational products.” Indeed, there...

When used clinically, psychedelics may appear unusual or even unique when compared to more familiar or long-standing medical interventions, prompting some to suggest that the ethical issues raised may likewise be exceptional. If that is correct, then perhaps psychedelics should be treated differently from other medical substances: for example, by being subjected to different ethical or evidentiary standards. Alternatively, it may be that psychedelics have more in common with various existing medical interventions than first meets the eye. We argue in (...) favor of the latter position, drawing on parallels from earlier debates around genetic exceptionalism in bioethics. We suggest there are risks to adopting a stance of “psychedelic ethical exceptionalism,” and propose that consistent ethical rules and evidentiary standards should be applied across all relevant areas of clinical medicine. Importantly, this does not preclude the possibility that changes to existing standards should be made; but if so, this should not be justified by appealing to the alleged uniqueness of psychedelics. (shrink)

We thank the authors of the OPCs for taking the time to respond to our article and for the thoughtful contributions which have re-energized our considerations of this important topic. This dialogue...

Research on psychedelic medicines is experiencing a revival. Some clinicians, scientists, and ethicists believe that psychedelics are so different from other treatments that they warrant special consideration in how they are researched, regulated, commercialized, and administered. Others argue that psychedelic medicines show clinical potential, but they should be treated like other medical interventions. In other words, identical standards should apply. This article analyzes whether psychedelic medicines warrant special consideration from a regulatory and ethical perspective.

In their article “Psychedelic Medicine Exceptionalism,” Cohen and Marks (2025) aim to chart a middle course between two extreme positions—the Scylla and Charybdis of psychedelic “exceptionalism” an...

In their contribution to the rapidly developing field of research on psychedelic medicine, Glenn Cohen and Mason Marks shed light on a frequently overlooked but critical aspect of ethical considera...

The resurgence of psychedelic research has brought with it unique ethical considerations, including the role of personal psychedelic experience among facilitators. Some have argued that personal ps...

On August 9, 2024, the U.S. Food and Drug Administration (FDA) declined to approve Lykos Therapeutics’ application for MDMA-assisted therapy (MDMA-AT), in alignment with the recommendation of its i...

As Cohen and Marks (2025) focus their discussion of psychedelic exceptionalism and ethics in the regulatory arena, they rightfully explain that psychedelic exceptionalism also appears in other cont...

“Nobody owns healing, you don’t own our culture. You can’t take it from us. We deserve respect.”-Angela Beers, a person of Indigenous Mexican (Zacatecas and Coahuila) heritage, speaking in protest...

Mind Lumen (a non-profit) is an ethics-focused education, research, and policy advocacy organization. We also create tools to make ethics observable, measurable, and auditable.As a neurodivergent I...

The integration of psychedelic substances into modern Western therapeutic practice has sparked a critical examination of many topics including: efficacy of psychedelics to treat mental health diagnoses without psychotherapeutic intervention, what models of therapy to use, and ethical implications related to altered states of consciousness. Of utmost concern are issues of power dynamics leading to incidents of sexual abuse. These issues underscore the importance of understanding therapeutic dynamics within the context of psychedelic-assisted therapy. This paper aims to explore these intersections, (...) addressing sexual abuse issues in Western psychedelic-assisted therapy while elucidating pathways towards ethical practice and regulatory frameworks. (shrink)

The role of touch in psychotherapy has been a topic of debate for several decades, now gaining renewed salience with the (re-)emergence of psychedelic-assisted therapy (P-AT), where altered states...

Cheung et al. (2025) rightly argue that psychedelics should be subject to ethical and evidentiary standards consistent with clinical medicine at large, rather than exceptionalism based on their uni...

The use of psychedelics has recently gained increased interest among bioethicists, as the articles published in this journal attest. Some of the recent scholarship suggests that psychedelic experie...

Pain, as Emily Dickinson aptly described, “has an element of blank.” It is perhaps the most universal human experience, yet even in its most visceral and all-consuming forms, pain defies descriptio...

Current research on psychedelic-assisted therapy (PAT) focuses on their potential to treat clinical psychiatric conditions such as treatment-resistant depression, anxiety, and PTSD. Presumably, if...

Drawing on comparisons to genetic exceptionalism, Cheung et al. (2025) reject psychedelic exceptionalism—that psychedelics raise unique concerns regarding increased vulnerability and diminished aut...

Neitzke-Spruill et al. (2025) offer an important overview of the ethical considerations around the use of touch within psychedelic assisted therapies (PAT) and MDMA-assisted therapy (MDMA-AT). Thei...

“Ethical exceptionalism” is often used as a pejorative shrouded in a superlative. The charge of wrongly treating similar things differently—for varying motives—has been leveled against exceptional...

In August 2024, The U.S. Food and Drug Administration rejected Lykos Therapeutics, Inc.'s new drug application for midomafetamine with psychological intervention (MDMA-AT) to treat post-traumatic stress disorder (PTSD). Among the many issues raised during review was concern about a highly publicized case of alleged sexual misconduct by an unlicensed therapist during a Phase 2 study of MDMA and the potential risk of future abuse. This incident of misconduct, along with several other publicized cases of misconduct by guides, facilitators, and shaman (...) offering psychedelic retreats, has raised the question of whether physical contact is ever appropriate during psychedelic-assisted therapy (PAT). Drawing on research about supportive touch in other clinical contexts and taking into consideration features of psychedelics that exacerbate the potential for harm associated with supportive touch, we advocate for a precautionary approach to harm-reduction while arguing that supportive touch ought not be thrown out whole-cloth. (shrink)

Increased interest in psychedelic treatments has raised concern regarding consent and whether it can be sufficiently informed. One source of concern is that psychedelic substances are prone to elic...

This correspondence piece responds to commentaries on the authors' survey of U.S. bioethicists. The authors address two key questions: the definition of a bioethicist and how bioethics should evolve. They identify four distinct roles bioethicists occupy: researchers, pedagogues, consultants, and advocates/activists. The article examines various aspects of inclusiveness in bioethics - demographic, viewpoint, methodological, and topical - while acknowledging inherent tensions and trade-offs between them. For example, including religiously or geographically diverse voices may conflict with other inclusivity goals. The authors (...) argue that while demographic inclusiveness is crucial, other forms of inclusiveness require careful consideration of trade-offs and empirical research to assess their impacts. They emphasize the need for systematic research on bioethicists' beliefs and reasoning, particularly regarding complex issues like disability and racial health disparities. The piece concludes by calling for continued dialogue and better funding for empirical research on ethical perspectives across different groups. (shrink)

Psychedelic researchers and therapists must contend with the fact that psychedelics are highly scrutinized to a degree that does appear to be problematically exceptional. That said, we believe ther...

Cohen and Marks (2025) discuss medical exceptionalism within the context of psychedelic access pathways, noting that the medical model is just one of many possible approaches to using, understandin...

Psychedelics are having a moment. This moment is a good time to assess the story of psychedelics. Psychedelic substances like psilocybin, LSD, and others are at the center of FDA regulation, spirit...

Exceptionalism in bioethics generally refers to the idea that a particular medical development or intervention warrants special consideration, either ethically or legally, given its unique features...

In their target article, Cohen and Marks (2025) argue that recognizing something as exceptional is a contextual matter. The authors consider the question of whether psychedelics are exceptional by...

This Special Issue on Psychedelic Ethics highlights that while psychedelic medicine may not be “exceptional” in its therapeutic value and risk (Cohen and Marks 2025), it is “distinctive” in that it...

In “Distinctive but not Exceptional: The Risks of Psychedelic Ethical Exceptionalism,” Cheung et al. (2025) elaborate the ways that psychedelics share individual ethical considerations with those o...

The presence of unusual features in psychedelic treatments has led to the argument that these treatments are exceptional within medicine and should therefore also be treated as exceptional when ana...

The recent surge in psychedelic-assisted therapy (PAT) research and anticipated Food and Drug Administration (FDA) approval of MDMA (methylenedioxymethamphetamine) and psilocybin treatments has bro...