Two hands exchanging a pill.

Let Go and Surrender: Considerations on MDMA Couples Therapy and Coercive Control

The Petrie-Flom Center Staff

By Kayla Greenstien

From 2016 – 2022, I worked in client-facing community support work, focusing on domestic abuse and sexual assault. Throughout this time, I regularly witnessed how the mental health system struggled to respond to non-physical violence in the form of coercive control — an insidious form of abuse that involves intimidation, threats, and manipulation to restrict the autonomy of another person. On countless occasions, I saw coercive and controlling behavior entirely attributed to mental illness, resulting in missed opportunities and devastating injustices. Outside of work, I also started to notice how little of the content in my psychology coursework discussed domestic abuse. Little (if any) content focused on the psychology of people who engage in abuse and coercive control. Despite more open discourse on domestic abuse, it seemed like the mental health system was still deeply reticent to talk about power and control.  

At the same time, a new wave of research on psychedelic and MDMA therapy was underway. In 2021, I signed up for a psychedelic therapist training program, and the next year I started a PhD in Australia, studying the theoretical underpinnings of psychedelic therapies. I saw psychedelic therapy as a “paradigm shift” in mental health care. I wanted to believe psychedelics could get rid of the patriarchy, just like Ben Sessa said it did at raves in the 1980s. (Sessa is now facing medical practitioners’ tribunal in the U.K. for an alleged relationship with a patient.) But as I learned more about the theories and practices accompanying clinical trials of psychedelics and MDMA, I found misogyny, queerphobia, and alt-right New Age spirituality woven throughout. When multiple reports of sexual abuse emerged from underground, ceremonial, and clinical trial settings, I heard the same tropes that are used to discredit women in court: “It was a consensual relationship…She has BPD and manipulated him…This is all about a scorned woman seeking and revenge…”. Slowly, I started to see how historic and contemporary discussions on psychedelic and MDMA research largely ignored theories on power, control, and abusive interpersonal relationships, particularly in couples therapy.   

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cell with pipette and needle.

Are Embryos Children? The Alabama Supreme Court Says Yes

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By Joelle Boxer

This month, the Alabama Supreme Court held that the term “children” in a state statute includes embryos, or “extrauterine children.”

As fertility treatments like in vitro fertilization (IVF) involve the creation of multiple embryos, not all of which are implanted, the implications of this ruling could be far-reaching. Four million births each year in the U.S. are via IVF, an important pathway to parenthood for couples with infertility, LGBTQ couples, and single parents.

This article will examine the Alabama Supreme Court’s decision in LePage v. Mobile Infirmary Clinic and its consequences for Americans building their families through fertility services.

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Birmingham, Alabama - February 8, 2020: University of Alabama at Birmingham UAB Hospital title and logo on brick facade.

The Beginning of a Bad TRIP – Alabama’s Embryonic Personhood Decision and Targeted Restrictions on IVF Provision

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By Katherine L. Kraschel

Last week, the Alabama Supreme Court called frozen embryos created via in vitro fertilization (IVF) “extrauterine children” and referred to the cryotanks where they are stored as  “cryogenic nurser(ies).” The Court sided with couples who claim the accidental destruction of frozen embryos created through IVF and cryopreserved ought to be treated equally to the death of a child. 

The case, LePage v. Center for Reproductive Medicine, involves plaintiffs seeking punitive damages from an Alabama fertility clinic for the “wrongful death” of their embryos that were destroyed when a patient in the hospital where they were stored removed them from the cryotank. While the lower Alabama Courts concluded that the cryopreserved embryos were not a person or child under the state’s law, the Alabama Supreme Court disagreed and held that the state’s Wrongful Death of a Minor Act “applies to all unborn children, regardless of their location,” and that the  plaintiff’s wrongful death claims could proceed. 

Thoughtful scholars have argued that existing state laws do not sufficiently redress mistakes and accidents that occur in the process of fertility care, pregnancy, and birth. However, the ends do not justify the means in this case; likening frozen embryos to children is not a legally sound mechanism to hold fertility clinics accountable for negligently storing embryos. It illustrates how sympathetic stories can be used to further the agendas of those who seek to equate embryos and fetuses  to “people” under the law and undercut the critical role modern fertility care plays in (re)defining the bonds that create families, and particularly, many LGBTQ+ and single parent families. 

Specifically, lawmaking in fertility care stands to fuel the movement to create fetal personhood rights and a federal abortion ban. It may also signify an inflection point in regulating assisted reproduction reminiscent of pre-Dobbs targeted restrictions on abortion provider (TRAP) laws that sought to limit abortion provision by imposing restrictions. TRAP laws’ new sibling – targeted restrictions on IVF Provision – or TRIP laws, as I call them, stand to rob patients of their ability to build their families by compelling physicians to provide less effective, more expensive care. TRIP laws will erect barriers and exacerbate long standing racial disparities in accessing fertility care, and they will disproportionately impact members of the LGBTQ+ community who wish to build families through fertility treatments.  The Alabama decision is severe, but it should serve as a warning to state legislators with a new responsibility to safeguard reproductive health care without the floor of Roe’s protections – proceed with extreme care and regard for “unintended” consequences of regulating fertility care.  Read More

baby feet

If You Give a Law Student a Baby

Bobby Stroup Leave a comment

Editor’s Note: Congratulations, Bobby, and welcome to the world, baby Stroup!

By Bobby Stroup

If you give a law student a baby, they’re going to look for legal risk. And if they live in the Bay State, they’re going to want a class on ‘MILK’ (Massachusetts Infant Legal Knowhow). 

Then, after learning about the relevant law and policy, they’re probably going to want to write a legal blog post. They’ll need to do additional research to see how they can legally imitate a popular children’s book. Their research will show that “fair use” allows them to parody the book series by exaggerating its format in a new story.  Read More

Healthcare concept of professional psychologist doctor consult in psychotherapy session or counsel diagnosis health.

Should a Psychedelic Therapist Be Able to Continue Therapy for Their Patients Beyond Formal Integration Sessions?

The Petrie-Flom Center Staff Leave a comment

By Samuel Hatfield

Psilocybin and MDMA were recently rescheduled in Australia for clinical use, leading many mental health professionals to question how psychedelic therapy will work in practice. As part of a research team at the University of Sydney, I recently interviewed as number of experts in the field, with the aim of developing a comprehensive taxonomy of matters relating to psychedelic therapy that are or could be regulated. We also sought to identify where there was uncertainty or disagreement about the implementation of these matters. One point of contention was the provision of ongoing psychotherapy by the psychedelic therapist beyond the formal integration phase — which, given the vulnerability and suggestibility of patients undergoing psychedelic therapy, may give rise to important ethical considerations. With practitioners from a range of professions likely to act in the role of psychedelic therapist, this is an issue with cross-disciplinary relevance.

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A Brief Political Economy of Hype

The Petrie-Flom Center Staff Leave a comment

By Maxim Tvorun-Dunn

Silicon Valley depends on boom-and-bust cycles, manufacturing a new wave of investments every few months by promising grand technological revolutions, whether through AI, cryptocurrency, metaverses, or any other buzzword of the tech industry. These bubbles are furnished by media narratives and tech journalism. Through uncritical reporting of press releases and overexaggerating claims, news outlets help tech industrialists inflate their stock portfolios, while regularly ignoring the politics of privatization and automation. Reporting on psychedelics has followed similar trends, regularly positioning research on psychedelic therapy or drug manufacturing as Silicon Valley’s latest panacea.

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Beyond the Psychedelic Competitive Moat: Chasing the Patent Dragon

The Petrie-Flom Center Staff Leave a comment

By Amanda Rose Pratt and Shahin Shams

In the last five years, the granting of overly broad psychedelic patents led to the creation of the nonprofit online psychedelic prior art library Porta Sophia. As Porta Sophia-affiliated researchers with expertise in psychedelic science, patent law, archival history, and rhetoric, we have come face to face with the way psychedelic hype manifests within the world of psychedelic patent documents.

Here, we examine hype in the context of a perennial tension at the heart of patenting communication: between advertising innovation and keeping it secret. Given the fact that innovators cannot disclose their technological innovations if they hope to gain patent rights over them, and that they simultaneously need to attract investors—often on the merits of their intellectual property portfolios—what public communication strategies emerge? We look closely at the patenting strategies of the psychedelic biotech company MindMed here because their case reveals important insights about the rhetorical dynamics related to tensions around public psychedelic patent communication.

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Photo of Alicia Ely Yamin doing fieldwork courtesy of Marion Brown.

Q&A with PFC Director of Global Health and Rights Project, Alicia Ely Yamin

The Petrie-Flom Center Staff Leave a comment

Alicia Ely Yamin J.D. (1991), M.P.H. (1996), Ph.D. is a Lecturer on Law and the Director of the Global Health and Rights Project at the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics (PFC) at Harvard Law School; Adjunct Senior Lecturer on Health Policy and Management at the Harvard TH Chan School of Public Health; and Senior Adviser on Human Rights and Health Policy at the global health justice organization, Partners In Health.

Frequently labelled a scholar-activist, she combines academic research and scholarship that bridges law, development, and public health with grassroots work and policy advocacy. She has lived in seven countries on four continents, and worked with and for local advocacy organizations, including co-founding a program on health and human rights in the Asociación Pro Derechos Humanos (Lima, Peru; 1999).

In the interview below, she shares more about her career and life.

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Person examining psilocybin mushrooms in lab.

When the Promises of a Policy Do Not Meet the Reality of Its Practice: Ethical Issues Within Oregon’s Measure 109

The Petrie-Flom Center Staff Leave a comment

By Tahlia Harrison

As a practicing therapist in Oregon working with complex trauma survivors, I was optimistic at first about the passage in 2020 of Measure 109 and its promise of legalizing psilocybin-assisted therapy. Psilocybin has been shown in small samples to be an effective intervention for many challenges my clients face; I was excited about this option to further support their healing. As a bioethicist and researcher examining topics related to psychedelic-assisted therapy, and a former faculty member at one of the psilocybin facilitation programs, Measure 109 also brought feelings of trepidation and a flood of questions such as: Would my national associations be amenable to this intervention? Would my liability insurance provide coverage? What about the ethics of engaging clients in a treatment involving a federally illegal substance? What about informed consent and other ethical issues? While the current informed consent form used by facilitators does address some aspects of concern (like the use of touch, 333-333-5040 (9)), it does not address other aspects like suggestibility or power dynamics within the facilitator/client relationship. Additionally, the form states “I understand that psilocybin services do not require medical diagnosis or referral and that psilocybin services are not a medical or clinical treatment,” yet it is reported that many are still seeking this as part of treatment for a medical diagnosis. How do multiple licensures apply to understanding scope of practice? Three years later, many of these questions remain unanswered, and the option of offering psilocybin-assisted therapy remains illegal and off the table.

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satanic ritual altar, pentagram with candles beside it.

The Satanic Temple Asserts Medication Abortion is a Religious Right

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By Katherine Drabiak

In February 2023, The Satanic Temple (TST) opened a telehealth clinic that offers free screening, virtual appointments, and medication abortion prescriptions by mail for pregnant women seeking an abortion. Currently, TST offers the services only to patients in New Mexico, but it plans to expand into other states.

Over the past several years, TST has filed lawsuits in multiple states, including Texas, Indiana, and Idaho, directly challenging those state laws that restrict abortion. TST is an IRS-recognized religion that denies the authority of God and describes its mission using seemingly benevolent and unassuming terms. TST alleges that abortion restrictions in certain states interfere with the ability to obtain a medication abortion and argues that abortion is a protected religious right.

Is there any merit to this argument? This is a complex legal area involving telehealth, abortion laws, and determining what actions fall under religious freedoms.

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