Emmerich Nathan, Humphries Bryce
School of Medicine and Psychology, Australian National University, Florey Building, Acton, Australian Capital Territory, Australia.
Camb Q Healthc Ethics. 2023 Mar 2:1-10. doi: 10.1017/S0963180123000099.
Recent research offers good reason to think that various psychedelic drugs-including psilocybin, ayahuasca, ketamine, MDMA, and LSD-may have significant therapeutic potential in the treatment of various mental health conditions, including post-traumatic stress disorder, depression, existential distress, and addiction. Although the use of psychoactive drugs, such as Diazepam or Ritalin, is well established, psychedelics arguably represent a therapeutic step change. As therapies, their value would seem to lie in the subjective experiences they induce. As it is the only way for trainee psychedelic therapists to fully understand their subjective effects, some have suggested that firsthand experience of psychedelics should form part of training programs. We question this notion. First, we consider whether the epistemic benefits offered by drug-induced psychedelic experience are as unique as is supposed. We then reflect on the value it might have in regard to the training of psychedelic therapists. We conclude that, absent stronger evidence of the contribution drug-induced experiences make to the training of psychedelic therapists, trainees to take psychedelic drugs does not seem ethically legitimate. However, given the potential for epistemic benefit cannot be entirely ruled out, permitting trainees who wish to gain first-hand experience of psychedelics may be permissible.
近期的研究提供了充分的理由让人认为,包括裸盖菇素、死藤水、氯胺酮、摇头丸和麦角酸二乙酰胺(LSD)在内的各种迷幻药物,在治疗包括创伤后应激障碍、抑郁症、存在性困扰和成瘾在内的各种心理健康状况方面可能具有显著的治疗潜力。尽管使用精神活性药物,如地西泮或利他林,已被广泛认可,但迷幻药物可以说是治疗上的一个重大转变。作为治疗方法,它们的价值似乎在于它们所引发的主观体验。由于这是实习迷幻治疗师充分理解其主观效果的唯一途径,一些人建议迷幻药物的亲身经历应成为培训项目的一部分。我们对这一观点提出质疑。首先,我们思考药物引发的迷幻体验所带来的认知益处是否如人们所认为的那样独特。然后,我们思考它在迷幻治疗师培训方面可能具有的价值。我们得出结论,在没有更强有力的证据证明药物引发的体验对迷幻治疗师培训有贡献的情况下,让实习生服用迷幻药物在伦理上似乎是不合理的。然而,鉴于不能完全排除认知益处的可能性,允许希望获得迷幻药物亲身经历的实习生可能是可行的。