Journeying to Ixtlan: Ethics of Psychedelic Medicine and Research for Alzheimer’s Disease and Related Dementias

Introduction

Peterson and colleagues frame their paper by placing contemporary enthusiasm for psychedelic medicine in historical and cultural context, using Carlos Castaneda's Journey to Ixtlan as a cautionary parable about charismatic claims that outpace evidence. They note a renewed scientific and commercial interest in psychedelic compounds alongside lingering regulatory and ethical uncertainties, and emphasise that these uncertainties are especially salient when considering Alzheimer's disease and related dementias (AD/ADRD), disorders that progressively erode memory, cognition, and aspects of personal identity and for which disease‑modifying treatments are lacking. The paper sets out to survey the existing landscape of psychedelic research relevant to AD/ADRD and to propose an ethics research agenda. Rather than presenting new empirical data, the authors offer a preliminary analysis organised around six ethical issues they regard as unresolved or magnified in the AD/ADRD context: the effects of psychedelics on autonomy and consent (including concerns about authenticity), ego dissolution in people with pathologies of the self, impacts on caregiving relationships, the risk of exploiting patient desperation, institutional review board (IRB) expertise and protectionism, and strategies to mitigate inequity in research and access.