Legal and Ethics Concerns of Psilocybin as Medicine

Preliminary research shows the psychedelic psilocybin to be a promising potential treatment for psychiatric illnesses. Recent U.S. government legislation and policy indicate that access to psilocybin, which remains illegal on the federal level despite increasing efforts to decriminalize it at the state and local levels, will be expanded to enable further research into its treatment potential. It remains unclear how psilocybin will be regulated and who will have access to this new treatment, raising important legal and ethics questions psychiatrists must consider. This article reviews the current legal regulation of psilocybin and matters related to standard of care, right to effective treatment, and the respectable minority doctrine. It concludes with a discussion of the ethics matters surrounding the use of psilocybin as medicine, including provider bias, the interpersonal dynamic between providers and patients, informed consent, and equity and access.