As some of you know from our newsletters, we have been engaged this past year, since we paused programming, in a process with ethicists Lori Bruce and Brian Earp whereby we have sought their professional expertise in providing a subjective audit for The Center for Consciousness Medicine. We brought them on at a point in our own evolution where we had made the decision to slow down and re-examine the approaches and programs we offered as we further individuated ourselves from 2 of our former founders. Our small remaining operational team has had numerous meetings familiarizing Lori and Brian with ourselves and the organization as well as making all of our written materials, programming structure and educational framework available to them to look at through an ethical lens with the hopes of helping determine if the infrastructure of our programs are accountable to our own ethos and also to the wellbeing of those that are in relationship with us. Beyond that, we wanted to ensure that as an organization we are moving forward with as few blind spots as possible in the largely unregulated field of psychedelic therapy. We wish for our unique contribution to the field of psychedelic healing work to be ethically sound, effective and safe. This ethics initiative has been a meaningful journey for the organization. We feel grateful for Brian and Lori’s impassioned pursuit of clarity, enlivened by the work we have done together and more confident than ever about creating an ethical framework that is necessary to carry this work forward into the world.
We appreciate that this initiative has deepened and nuanced what ethics means to us and how it has emphasized how critical a comprehensive ethics infrastructure is to our own accountability to our community and our values. We are excited to bring this new infrastructure to life. With that being said, we wish to affirm that while our values and framework of ethics may be more expansive than in some professions we are first and foremost committed to the safety and well being of our students and those that our decisions and actions directly impact. We wish to restate that 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 is 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 restate that we stand in full support of victims of abuse and wish 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.
The process of working with Brian and Lori on this ethics initiative has been generative and fruitful for the operational team at CCM on many levels and specifically has been highly informative as we restructure and redesign our programs. As we wrap up Phase 3 of our ethicist initiative, we wanted to offer you a brief overview of the project (detailed below) as well as offer an update on the process so far from the ethicist’s perspective.
The following text comes directly from ethicists, Brian Earp and Lori Bruce, and is written in their voices:
“Our approach has been to evaluate CCM 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 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 we have focused on areas where we see a potential divergence between CCM’s approach and wider cultural expectations. Identification of these areas does not necessarily imply a need to revise or abandon CCM’s approach wholesale, that is, in favor of dominant norms. We understand that part of CCM’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 further its healing mission.
We understand CCM’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 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 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 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 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 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 below) 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 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 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 CCM 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 CCM.
Phase 6:
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.
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. We are excited to bring this work to life in our future programming and for it to help inform the level of discernment we intend to have around the admissions process. Feel free to direct any questions to ccm-team@centerforcm.com
Brian D. Earp, PhD, 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 CCM 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.