As psychedelic therapy and integration become a legal option for millions of suffering people, nuanced consideration around the ethics of the growing practice is essential. Emerging scientific studies indicate that psychedelics consistently yield powerful therapeutic and transformative experiences, often imbued with profound mystical significance (Griffiths et al., 2008). These substances possess the unique capacity to reliably dissolve established personality structures, fostering heightened suggestibility while influencing spiritual and philosophical beliefs (Carhart-Harris, 2014; Timmermann, 2021), and providing therapeutic results. While medical, academic and commercial establishments take charge of the proliferating field of legal psychedelic therapy, there needs to be more thorough examination of the philosophical, spiritual and cultural biases and assumptions brought into the treatment room by practitioners and their affiliated institutions, especially when providing psychedelic therapy to minority populations. This essay explores the ethics of psychedelic therapy and integration through the lens of cognitive liberty and harm reduction, suggesting these guiding frameworks can safeguard individuals engaging with psychedelic therapy from the undesired imposition of philosophical, spiritual and cultural bias. Through the application of the lens of cognitive liberty and harm reduction to the practice of psychedelic therapy, clients are encouraged and empowered to retain autonomy over their process of self-discovery, healing and transformation.

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Psychedelic-assisted therapy may represent an upcoming paradigm shift in the treatment of mental health problems as recent clinical trials have demonstrated strong evidence of their therapeutic benefits. While psychedelics are currently prohibited substances in most countries, the growing popularity of their therapeutic potential is leading many people to use psychedelics on their own rather than waiting for legal medical access. Therapists therefore have an ethical duty to meet this need by providing support for clients using psychedelics. However, incorporating psychedelics into traditional psychotherapy poses some risk given their prohibited status and many therapists are unsure of how they might practice in this area. This paper explicates such risks and describes ways in which therapists can mitigate them and strive to practice within legal and ethical boundaries. A harm reduction approach will be emphasized as a useful framework for conducting therapy around clients' use of psychedelics. It is argued that therapists can meet with clients before and after their own personal psychedelic experiences in order to help clients minimize risk and maximize benefit.

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The academic discipline of bioethics is becoming a prominent arena for the discussion of ethics abuses in psychedelic therapy. With this being a relatively new topic of research for bioethics, it may be opportune to consider blind spots in the discipline’s own gaze and operations, which can otherwise hinder effective engagement with the issues at hand. We write in the wake of an extensive search by Gather Well Psychedelics, a psychedelic therapy training organization, to contract professional bioethicists to conduct an ethics audit of their organization. We ask, what challenges arise for bioethicists offering professional services when taking on commissions to work for organizations such as Gather Well that are emerging out of the psychedelic underground?

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