Salus Populi: Training the Judiciary in the Social Drivers of Health

By Elaine Marshall, Isabel Geisler, L. Virginia Martinez, Krystal Abbott, and Katherine Hazen

Social drivers of health (SDOH), sometimes known as the social determinants of health, are factors in the social environment that shape individual and population health, including poverty, racism, housing, education, and employment. When judges decide cases that impact these social factors, their rulings can have important health implications. While cases impacting the SDOH can be landmark Supreme Court cases, such as the ruling on the CDC’s eviction moratorium during the COVID-19 pandemic, judges also make decisions on a daily basis that can affect the SDOH and thereby health. Take, for example, a child welfare case out of New York, In re Brittany T, 852 N.Y.S.2d 475 (N.Y. App. Div. 2008), where the issue before the judge was whether a family willfully and without just cause violated orders meant to support their child’s health through diet and exercise. The order required the family to use all resources available to ensure the well-being of the child, enroll the child at their own cost in a local gym and attend it at least 2-3 times a week, and actively and honestly participate in a nutrition program.

Read More

EU and US Regulatory Challenges Facing AI Health Care Innovator Firms

 

 

 

By Suzan Slijpen, Mauritz Kop & I. Glenn Cohen

 

 

 

1. Introduction: A Fragmented AI in Healthcare Regulatory Landscape

In the past few years, we have witnessed a surge in artificial intelligence-related research and diagnostics in the medical field. It is possible that in some fields of medicine in the future AI tools used in diagnostics will generally perform far better than a human clinician. Prime examples of this can be found in radiology, particularly in the detection -and even the prediction- of malignant tumors.

Although the actual development of a clinically usable, deployable deep-learning algorithm is a challenge in and of itself, we have moved from an early period where there was not enough guidance as to ethical and other issues to an era where many guidelines have proliferated. While one might ordinarily say “let a thousand flowers bloom,” the fact that they partially overlap, sometimes diverge, and are often written at different levels of generality make it difficult for well-meaning companies to keep up. This is specifically the case for innovative firms who aim to bring their product into the European market.

Read More

Yellow folder file with magnifying glass.

Bioethics, Psychedelic Therapy Abuse, and the Risk of Ethics Washing

By Tehseen Noorani and Neşe Devenot

Introduction

The academic discipline of bioethics is becoming a prominent arena for the discussion of ethics abuses in psychedelic therapy. With this being a relatively new topic of research for bioethics, it may be opportune to consider blind spots in the discipline’s own gaze and operations, which can otherwise hinder effective engagement with the issues at hand. We write in the wake of an extensive search by Gather Well Psychedelics, a psychedelic therapy training organization, to contract professional bioethicists to conduct an ethics audit of their organization. We ask, what challenges arise for bioethicists offering professional services when taking on commissions to work for organizations such as Gather Well that are emerging out of the psychedelic underground?

Read More

View on Namche Bazar, Khumbu district, Himalayas, Nepal.

Intersectionality, Indigeneity, and Disability Climate Justice in Nepal

By Pratima Gurung, Penelope J.S. Stein, and Michael Ashley Stein

The climate crisis disproportionately impacts marginalized populations experiencing multilayered   and intersecting oppression, such as Indigenous Peoples with disabilities. To achieve climate justice, it is imperative to understand how multiple layers of oppression — arising from forces that include ableism, colonialism, patriarchy, and capitalism — interact and cause distinctive forms of multiple and intersectional discrimination. Only by understanding these forces can we develop effective, inclusive climate solutions.

Read More

Person examining psilocybin mushrooms in lab.

Psychedelic Inequities and Unexplored Risk: Colonization, Commercialization, and Regulation

By Tegan M. Carr

As a researcher studying the psychedelic experiences of people of color in hopes of driving equitable psychedelic health care, I’m concerned about the ways in which Black, Brown, and Indigenous contributions have been excluded in the development of the psychedelic field and investigation of novel psychedelic therapies. By excluding diverse contributions to the psychedelic field, we risk establishing psychedelic practices that exacerbate racial health inequities (disparities) in which people of color experience worse health outcomes as compared to whites on a population level. These patterns are already emerging in therapeutic psychedelic outcomes.

This piece identifies three interrelated topics that warrant scrutiny as drivers of psychedelic racial health inequities: the colonization of psychedelics, psychedelic commercialization & rent-seeking, and regulatory processes.

Read More

Two hands exchanging a pill.

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

Note from Susannah Baruch, Petrie-Flom Center: Following this recent post in the Critical Psychedelic Studies symposium on the Bill of Health blog, two sets of researchers whose studies were described in the post expressed concerns that the post contained inaccuracies. As the Executive Director of the Petrie-Flom Center, which publishes Bill of Health, I made the decision to temporarily remove the original post to look at the issues carefully and to give the author and researchers more time and space for discussion. The original post is now back up [below] with an addendum from the author. My thanks to everyone involved for being helpful and patient while we gathered more information.

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.   

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?

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.

Read More

Collage with one hundred dollars banknote in surreal style.

A Brief Political Economy of Hype

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.

Read More