artwork by Daiara Tukano
by Daiara Tukano and Maria Fernanda Gebara
Last June, we had the honor of speaking at “Law and Policy of Psychedelic Medicine,” the 2024 Annual Conference hosted by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School. You can watch our panel here.
Part I of this post highlighted the ethical considerations surrounding the use of Indigenous medicines. Part II considers paths forward to true ethical engagement.
Part II: Towards ethical integration
The globalization of ayahuasca presents numerous challenges for diverse Indigenous peoples (there are more than 160 nations that use ayahuasca), each with distinct histories facing systemic prejudice. Discrimination persists, with examples in Brazil including the burning of Indigenous prayer houses by fundamentalist groups and violence against shamans. Addressing mental health is critical, as suicide rates among Indigenous peoples are more than 20 times higher than in other populations. To ethically approach psychedelics, we must prioritize those who need mental health care but face significant barriers. Indigenous peoples encounter obstacles such as fragmented care, geographic isolation, discrimination from providers, and lack of culturally safe services or native-language support. These issues are especially severe in resource-limited and conflict settings, where mental health services are often inadequate, underfunded, or absent.
Many claim that psychedelics like ayahuasca could save humanity, but this places immense responsibility on these medicines. Addressing mental health and humanity’s future requires understanding the root causes of suffering. Issues such as depression and suicide are linked to cycles of violence, colonization, labor exploitation, capitalist values, systemic racism, marginalization, identity denial, and the rejection of traditional knowledge — all contributing to a crisis among Indigenous peoples.
Indigenous economist Winona LaDuke emphasizes that colonization is akin to digesting one culture by another through various mechanisms, which has deeply impacted ecosystems, Indigenous lands, minds, and spiritual beliefs. Religious institutions and colonialism reinforced this, stripping Indigenous peoples of their identities and cultural practices. To heal, we must embrace a process of decolonization akin to a deep purging — an embodied unlearning of colonizing beliefs. Medicines like ayahuasca may aid this transformation, but genuine decolonization requires systemic and individual change, involving cultural relevance, consultation, and reparative justice.
Neşe Devenot, another speaker at the Conference, warned against the “psychedelic hype” that inflates benefits while minimizing risks, perpetuating colonial ideologies and inequality. The current hype around psychedelics parallels trends in artificial intelligence, with investments often serving elite interests rather than addressing the real needs of marginalized communities. The commodification of sacred medicines transforms them into capitalist products, perpetuating historical injustices and altering cultural motivations, particularly for Indigenous youth, who increasingly engage in these traditions for economic gain rather than cultural learning and spiritual connection.
Ethics involves examining moral phenomena, including the principles that shape our understanding of morality, values, behavior, and institutions. It addresses our obligations — what is right or wrong, good or harmful — and how we can live harmoniously with all beings, including other-than-human beings. However, ethics can also be viewed as an institution — another metaphor that may serve a function different from what it appears. A feminist might see it as an instrument of patriarchal oppression, a Marxist as a tool for class domination, a Nietzschean as a consolation for those unable to seize life fully, and a Foucauldian as a diffuse mechanism of power and control. In any case, ethics must be critically examined and “unblinded.”
When it comes to psychedelics, ethical debates must reassess the underlying onto-epistemological beliefs that have led to our current health and environmental crises. Ethics shaped by colonial perspectives often overlook Indigenous rights, failing to acknowledge the value of traditional knowledge. A true ethical engagement should prioritize Indigenous leadership in both policymaking and discourse, fostering collaborative methodologies that respect and uplift diverse knowledge systems.
Healing is about more than substances — it requires abandoning extractive mindsets and acknowledging the sophistication of Indigenous medicines and knowledge, which have evolved over centuries. The urgency to preserve Indigenous wisdom underscores the need for ethical frameworks that respect these traditions, moving away from exploitative practices. We already possess solutions for environmental and health crises, but they require profound paradigm shifts — away from viewing marketable products as the sole solution and towards integrated, respectful approaches. Believing that a pill or medicine is the cure is not only misguided but is itself a symptom of the underlying crisis. For these solutions to be effective, they must be integrated within an entirely different economic, cultural and social context than the one in which we currently operate.
Daiara Tukano is a Tukano Indigenous artist, activist, human rights defender, and educator.
Maria Fernanda Gebara is a mother, writer, lawyer/anthropologist, and lecturer from Brazil.
