Why is nonconsensual, compulsory treatment widely accepted in mental healthcare? Why are many in the medical and bioethics community so certain that the “insane” are undoubtedly unfit to choose for themselves? Who is to say? Who is to decide what is the most whole/beautiful/meaningful/ “right” existence of another?
* Thinking specifically about nonconsensual electroconvulsive therapy (ECT) in schizophrenic patients, some who deny their diagnosis and treatment. See the case PBU & NJE v Mental Health Tribunal from 2018 in Victoria. Essentially, the patients won and were freed from forced treatment. For those on the side of patient advocacy and autonomy, this was good news. However, this ruling upset some psychiatrists and bioethicists.
Can the mentally ill, as certain medical systems see them, make rational, autonomous decisions for themselves? Do certain emotions halt capability to reason? Can anyone make autonomous decisions for themselves? Or are we all embedded in and influenced by altered/unaltered choice/default design?
Psychedelic researchers, advocates, and skeptics alike met on February 13th, 2019 in Melbourne for the Mind Medicine Australia launch. Fresh from San Francisco and eager to meet people in this city also interested in psychedelic medicine, I bought an early-bird ticket.
February 13th, 2019, 5:30 PM. At this point in life getting ready to go out involves more time bopping around with acid under my tongue than looking in the mirror. Microdosing quells my zapping nerves and oftentimes overactive mind, especially before larger gatherings.
So I took a small dose before biking to the University of Melbourne for the Mind Medicine launch. The bats weren’t out yet, but they would be soon, and the air was a perfect 23°C. I locked my bike, tried to tame my helmet hair, and entered the Sidney Myer Asia Centre. Immediately greeted, thick lashes ushered me to the left. More smiling eyes appeared around the corner, showing the way upstairs. I entered the full, bustling theater.
There were only a few seats left. Everyone was finding their space, finding their friends. I sat down in the back and observed the crowd. No matter if it’s in Melbourne, London, Berlin, or San Francisco, the general attitude and sense of psychedelic conferences remains the same: compassionate, curious, positive, and present. There’s this shared understanding, communicated with kind and sometimes cheeky glances that say: “We’ve seen a glimpse of the possible. That’s why we’re all here.” It’s usually a clash of characters, buttoned-up scientists, artists. The kind of people you might bond with at a music festival and never see again are there, anticipating a lineup of lectures.
Sound cultish? It really shouldn’t. People from all edges of the earth have been interested in psychedelic medicine and its potential for millennia. Many aboriginal people wonder what took us so long to make the connection. This goes beyond a Reddit thread.
“Hi neighbor,” the man next to me introduced himself. He was wearing a sheen suit and said he wanted a job.
9:10 am, waiting room. People rushing, apologizing for minutes. The parking lot was full. “I’d like to make an appointment.” “How about next month?” Holding time to cram us in. This mole is new and dark in the middle of my chest. From a pale pore to an odd shape. An island, collecting the sun of my life. Forming near my heart. Doctor, please see me.
Migration as a bioethics issue — not allowing people to migrate physically (from asylum seeking to relocation for better opportunity and simply travel) and mentally (with psychoactive substance or mind-altering experiences) is a bioethics issue. Regulations on migration, travel, and drug use serve some and harm many.
The ethics of psychiatric diagnosis/prescription vs. self-medication — the current psychiatric system also serves some, but hurts many, and moving from the doctor-patient power imbalance to patient empowerment could be a solution. This research would seek information about people who do not receive psychiatric treatment (for reasons from ability to financial), who do not benefit from current pharmaceuticals, and who already know which drugs they want to try — whether from their psychiatrist or from the street. Do you know people who go to the doctor knowing what they’ll be asking for? Isn’t this doctor-approved self-medication? Do you know people given drugs by doctors that they wouldn’t take on their own, that might even make them seem worse? (Thinking strictly re: psychiatric medicine, not for example, cancer treatment.) Is self-medication really the problem authorities should fight or should they provide wider education and harm reduction instead? Reference: Portugal. Will the information age cut out doctors as the middle men between patients and their preferred medicine? This would reference Our Right to Drugs by Thomas Szasz, among others.
It’s 7am on the uBahn. Eyes still puffy from the night before. A woman slowly nibbles her morning brötchen while staring into the static on the broken TV above. Everyone is silent. And in this crowd of straight faces, there I am: grinning like an idiot. Why? I have a little secret. There’s acid under my tongue.
This slightly mischievous feeling is familiar to me. I’ve taken 1P-LSD (a legal LSD analog in Germany) over 50 times in the last six months. Most doses have been small. So small that they’ve merely lifted my mood, generally speaking. But somehow each and every time still feels brand new.
These ritual doses have drastically improved my life and reshaped my perception, but what’s really been going on inside my head? It seems my brain has been especially malleable these last few months. I’ve been able to untangle the knots of thought that eclipsed my reality and made everything a little darker.