At Gather Well Psychedelics we take client care very seriously. With this in mind, and because there are no established infrastructures of accountability in the realm of psychedelic healing yet, we sought out the expert guidance of professional ethicists. We feel bringing in guidance from individuals outside of the organization will serve to strengthen our program offerings and organization as a whole. After a challenging search to find individuals who have both the professional expertise and caliber required for such an undertaking, who are also comfortable consulting in this new and emergent field of psychedelic healing, we are grateful to have found them and are pleased to have been working with them over the last 9 months. We introduce them below.
We appreciate that this initiative has nuanced what ethics means to us. Further, it has made us aware of how important an ethics infrastructure is to our own accountability to all we serve. While our values and framework of ethics may be more expansive than in some professions, we are no less committed to the safety and well being of our students and those they may impact as a result of taking our training. We firmly stand in opposition to therapeutic abuse or abuse of any kind. Abuse of power is the absolute antithesis to the healing and liberating purpose the organization has been created to serve. None of our programs or approaches, have ever, or will in the future, involve touch of any sexually associated parts of the body and our students are never advised or permitted to do so with their clients.
We also wish to state that we stand in full support of victims of abuse and want wholeheartedly for them to feel supported, safe and find healing. With hearts and minds toward Transformative Justice, we advocate that those inflicting harm receive the help they need to come into accountability and grow for their own wellbeing and most importantly so that future harms may be prevented. We are committed to creating an ethics infrastructure for the organization that is robust and effective in taking all possible measures for the safety of those who come to us and in supporting both those who experience harm and those who cause it.
As an entity, we wish for Gather Well Psychedelics to be independently reviewed in order to gain crucial input and implementation from expert recommendations regarding our approaches, assumptions, policies and procedures. We are excited to have begun the process of creating a working ethics committee within the organization. Because there are no regulatory committees, supervising or governing boards yet that ensure safe practices within the field of psychedelic-assisted therapy, we feel hiring this team of ethicists will help us move forward confidently in a meaningful and integrous way.
During the second half of 2022, the ethicists performed a high level review of the organization’s activity since its incorporation in 2020 and focused on any challenges the organization and its graduates have faced. The ethicists are also reviewed for projected challenges that students or graduates might face and if there are any concerns about the quality of care clients might get as it relates specifically to the quality of training of their guide. These assessments included a consideration of the nature of the work itself, Gather Well’s particular philosophies and approaches, the techniques it is teaching, as well as the vulnerabilities of clients and the positional power of the guide within the approach. The ethicists had access to training materials, policies, protocols, institutional accountability structures, communications issued, student and staff feedback and conducted relevant interviews with stakeholders and leadership. Additionally, these ethicists will help Gather Well to develop the early stages and ongoing structures for implementing an ethics committee for the organization. This committee would be able to develop and maintain standardized and confidential procedures for reporting client grievances, and for conducting future ethical review of the organization’s programs, policies and procedures.
We wish for the body of this work to be beneficial to the field overall. We believe no one is exempt from the human propensity to project one’s shadow/unconscious material, out into the world, and specifically toward individuals with whom we have close contact. We strive to do our best to create safe spaces to heal, and acknowledge that there is no such thing as absolute safety. We hope to bring further awareness to our own shadows as individuals, as an organization and to understand in which ways our efforts might carry with it collective shadow. We feel it is essential for us to commit to this process in striving to educate psychedelic guides who are self-aware, self-reflective, and accountable for the impact they will inevitably have on their clients.
The ethicists will produce reports of their findings, indicating recommendations for necessary changes to the approach, programs or policies from the lens of ethics. We intend to make this shareable with the wider community, other teaching institutions, and the public. In addition, the ethicists will provide a reflection of overall findings on ethics within psychedelic training programs and within psychedelic-assisted therapy approaches. We are grateful to have found these two individuals and would like to offer some introductions.
Brian is a Senior Research Fellow in Practical Ethics at the University of Oxford, Associate Director of the Yale-Hastings Program in Ethics and Health Policy at Yale University and The Hastings Center, and Associate Editor of the Journal of Medical Ethics. Brian is co-author of the book Love Drugs: The Chemical Future of Relationships (Stanford University Press, 2020), which is the first book-length philosophical treatment of the social and clinical ethics of psychedelic-assisted couples therapy. The book was favorably reviewed in The Atlantic, New Scientist, The Guardian and other leading venues. Brian has also published widely on the ethics of bodily integrity, sexual autonomy, and consent, having previously served on the Sexual Harassment Grievance Board of Yale University.
Brian will be working closely with Gather Well and will also be consulting with Lori Bruce on specific action points throughout the process particularly around standing up an ethics committee within CCM.
Lori’s earliest work in bioethics was as a skeptical community member; she was asked by Harvard Medical School to evaluate policies from the lens of her grassroots work as a rape crisis counselor.
Lori now is Co-Director of the Adult Ethics Committee at Yale-New Haven Hospital; Associate Director, Interdisciplinary Center for Bioethics (ICB), Yale University, and Director of the Summer Institute in Bioethics at Yale’s ICB. She is the Founder & Chair of the Community Bioethics Forum co-sponsored by the ICB and Yale School of Medicine, and is also on faculty in the Bioethics Program at the Icahn School of Medicine at Mount Sinai. Lori has deep experience in organizational and clinical ethics, trauma-informed care, systems administration, issues around sex/gender/power, and setting up/leading ethics committees.
One of the earliest pioneers of the “community ethics” paradigm, Lori has amplified the voices and values of community members within scores of institutional and public health policies across the US on a wide range of subjects, including end-of-life, infant abandonment, consent for intimate exams, and so forth. She is also one of the earliest voices to bring trauma-informed care to ethics consultations and ethical policy design.
Lori has over 20 years of experience on ethics committees at Harvard and Yale and has helped to design and establish ethics committees at prominent locations across the US, promoting inclusion, transparency, and racial equity. She sits on several international ethics boards and lectures globally on policy and ethics topics. Her scholarship is cited in the New York Times and the New England Journal of Medicine and her work appears in prominent academic journals and popular media from the Hastings Center Report to The Huffington Post.
The following text comes directly from ethicists, Brian Earp and Lori Bruce, and is written in their voices: (Gather Well will be referred to as “CCM” as we were still using the name “The Center for Consciousness Medicine” when their work began)
“Our approach has been to evaluate CCM’s [now known as Gather Well Psychedelics (GW)] actions and materials with an open mind, seeking to learn about the embedded values, underlying assumptions, and rationales implied by its activities and documentation to date. We have also been mindful of the dominant norms and attitudes within the wider U.S. culture toward psychedelics, therapist-client relationships, organizational ethics, and other pertinent topics. We appreciate the need to think carefully about how best to pursue CCM’s[GW’s] goals in a way that is consistent with its own core values while also giving due weight to the aforementioned attitudes and norms. In our work with CCM[GW] we have focused on areas where we see a potential divergence between CCM’s[GW’s] approach and wider cultural expectations. Identification of these areas does not necessarily imply a need to revise or abandon CCM’s[GW’s] approach wholesale, that is, in favor of dominant norms. We understand that part of CCM’s[GW’s] mission is precisely to challenge certain mainstream ways of thinking, behaving, relating, and responding that reflect harmful or otherwise problematic histories, dynamics, and power structures (e.g., those that are racist, colonialist, retributive, non-restorative, etc., in nature). Instead, the areas we have focused on are those with potential for misinterpretations, misunderstanding, impairing of important relationships, impeding organizational progress, and harms, both to those within and outside of the organization. The next phases of this project will aim at building a strong organizational ethics framework to help mitigate these risks as far as possible while helping CCM[GW] further its healing mission.
We understand CCM’s[GW’s] goals as seeking to promote the healing power of psychedelics within a broader mainstream audience while maintaining respect for indigenous traditions and demonstrating integrity to an inclusive, anti-colonial, and non-hierarchical vision. We understand CCM’s[GW’s] values to be rich and multifactorial. They include balance and non-polarized/non-binary views; restorative and transformative conflict management; a commitment to inner and organizational ethics; harm reduction, beneficence (promoting good), and respect for indigenous cultures.
At the time of writing, CCM[GW] is beginning to emerge from a state of flux, with much of its prior organizational activity having been suspended and reconsidered. We understand that the training curriculum will continue to evolve over time, especially over the next several months as CCM[GW] continues to forge positive progress on their new identity, mission, and goals. We have observed sincere reflection, rethinking, and soul-searching among the current operational team, opening up avenues for radically different institutional structures, systems of accountability, approaches to recruitment and training, and responses to critical periods of change. We commend CCM[GW] for their careful work, their ability to pivot in the face of challenges, and their interest in seeking external guidance. We look forward to continuing our partnership with them in this important and impactful work following the hiring of a new CCM[GW] Executive Director, projected for the spring of 2023.”
-Lori Bruce and Brian Earp
Ethicist Initiative Phases and Details :
Background: In the autumn of 2021, The Center for Consciousness Medicine (CCM) began a search for ethicists to engage in a review of our organizational practices. After an extensive search, CCM contracted with Brian Earp and Lori Bruce (see bios above) to lead a six-phase analysis of the structure and nature of our organizational ethics. As currently defined, the initiative will produce several internal reports, a couple external reports and culminate in the creation of an organizational ethics framework for CCM.
Phase 1: Phase 1 involved the ethicists researching and meeting with CCM leadership to gain understanding of CCM as an entity in its structure and its values, recent ethical challenges, and CCM responsibilities related to those challenges.
Phase 2: Phase 2 sought to provide a high-level ethical review of CCM organizational structure and approaches through the identification of structural barriers and risks to CCM’s ethical goals, intentions, and aspirations. Ethicists flagged ethically sensitive areas where CCM diverges from mainstream norms It is meant to help guide future discussions and developments.
Phase 3: The purpose of Phase 3 was to reflect on how training materials could be enhanced to align with CCM’s mission, values, and ethics with an eye to identifying points of compatibility or tension with wider cultural norms and expectations. Areas of key ethical concerns were highlighted regarding the historical and current proposed approaches (emphasizing newer documents and practices, but also considering older/original training materials that are already in a state of revision by the organization). Ethicists provided a list of recommendations to address said concerns.
A note from the Ethicists on extending the project: “The original project’s timeline has been extended through the Spring as this ethical analysis – and creation of an ethics framework – is a transformative, collaborative, and inclusive effort. All parties are deeply interested in the development of actualizable “ethical guardrails” to guide and influence future action and address future ethical challenges. All are also deeply committed to the creation of an ethical framework that truly fits CCM’s [GW’s] distinct aspirations and goals – and demonstrates integrity and intentionality. A robust organizational ethics framework cannot be rushed. The 3 next phases will be most effective, and thus initiated, upon the hiring of a new Executive Director, which CCM[GW] projects for Spring 2023.”
Phase 4: The purpose of this phase is to devise a new, integrated ethical paradigm across the organization. Based on knowledge gained in Phases 1-3, ethicists will design a first draft of an organizational ethics framework, to include an explicit organizational ethics policy for the organization and clear guidelines for development and ongoing operational functioning of a standing ethics service or committee designed to support the size, goals, and culture of Gather Well Psychedelics while supporting ethical tenets of inclusion, transparency, respect for persons and cultures, beneficence (“doing good”), and nonmaleficence (minimizing harms). The ethics service or committee will offer a standardized confidential procedure for reporting, analyzing, and resolving ethical dilemmas.
Phase 5: Ethicists to revise and finalize organizational ethics framework with clear guidance for implementation of an organizational ethic. They will prepare a public-facing report summarizing the process and results of developing a new ethics framework for Gather Well Psychedelics.
Ethicists will author an externally facing report for the broader community of psychedelic therapists, to articulate a summary of ethical reflections on psychedelic-assisted therapy and psychedelic training programs.
Gather Well Psychedelics is pleased to have engaged two strong independent ethicists for this body of work and look forward to the process ahead. We are excited to bring this work to life in all facets of the organization, in our developing ethics casebook program and for it to help inform the level of discernment we intend to have around the admissions process. We are eternally grateful for the expertise and professionalism of Lori and Brian and for their ability to help us envision a clear path for putting our values into practice.