Is the hype around RFK Jr. and Matt Zorn justified? Where to start with ethical design? How does consent work in psychedelic therapy?

To shine a light on all of this, plus a story that is definitely not a love letter to capitalism, read on!

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Robert F. Kennedy Jr is famously (apparently) open to psychedelics and is Secretary of the US Department of Health and Human Services (HHS). His nominee for Surgeon General, Casey Means, has spoken openly of her belief in the healing power of mushrooms. Matt Zorn, a lawyer known for his pro-psychedelic work, has recently started work at the HHS.

The reaction from many of the loudest voices on social media, particularly LinkedIn, has been unalloyed enthusiasm and optimism. I’ve seen predictions range from the approval of MDMA-assisted therapy to outright re- or even de-scheduling of psychedelic substances.

Not everyone is buying into the hype, though. Here’s three reasons why caution is the right response:

Despite now being a public servant, RFK Jr is a politician at heart. You always have to consider he’s saying what he thinks people want to hear. His public support for childhood vaccinations, in light of his known anti-vax views is evidence he’s not always entirely honest or consistent in aligning his actions with his beliefs.

Although Casey Means is more of an influencer than politician, it will be a similar situation. Even if her enthusiasm for psychedelics is genuine, she’ll only get the chance to try if the Senate confirms her appointment.

Of the recent psychedelic-friendly appointments, Matt Zorn is the most junior, but also most interesting. He’s been upfront about wanting to use the chaos that’s unfolding in the HHS to push for reforms that could make approval of PAT easier. If you read his interviews carefully, though, you’ll see he’s much more cautious about saying whether or not it will happen.

And forget about ending prohibition through wholesale rescheduling or de-scheduling of psychedelics. Zorn himself correctly points out that this requires changing multiple federal laws, which is well beyond RFK’s influence.

There are two kinds of backlash coming in the next 3-4 years.

The first comes from inside the administration, when Trump inevitably scapegoats psychedelic allies to save his own skin (and if it comes down to it, he absolutely will.)

The second is that psychedelic business, particularly big organisations, become too closely associated with Republican politics. When the situation changes and power shifts away from Trump (and, therefore, RFK etc,) this association will become a massive liability.

For both forms of backlash, there’s a deeper lesson: Once you decide that you will do anything or work with anyone in order to achieve your goals, these risks radically increase. You’ve decided the great thing you’re working towards is worth all the negative things the government is doing. Apart from this kind of calculus being morally repugnant in itself, there's zero historical reason to assume the good will outweigh the bad.

We also have to consider how things will play out if our plucky psychonauts are successful.

Zorn has said he thinks psychedelic medicines should not have to show efficacy prior to approval. Lowering this bar might make it easier for MDMA therapy to get past the FDA. But, if this idea were applied more generally the flow on effects could be worse than current situation.

Zorn is suggesting that insurers can decide if a drug works after it's approved. This isn’t going to let the orange sunshine into therapeutic spaces. But it might create a corrupt patchwork system where science is (even more) overridden by marketing and vibes. Let’s be clear: The FDA has its problems. But would you want insurance CEOs, those well-known paragons of diligence and compassion, deciding if a new psychedelic treatment works?

Even if Zorn can influence all this, which is far from certain, his belief that it won’t be a disaster comes from faith that the ‘free market’ will save US consumers rather than screwing them over, again.

Sorry, but I’m just not buying it.

I’ve been going back over some of my work from a few years ago. One piece I liked, but never revisited, was when I tried to apply ethical design principles to psychedelic assisted therapy to see how it measured up.

This is what I assessed PAT against:

Even if my use of them could have been more nuanced, the principles themselves are good. These guidelines, lifted wholesale from Ethical by Design, by Matt Beard and Simon Longstaff of the Ethics Centre, set what should have been the gold standard for new products and services. (Clearly, Sam Altman wouldn’t agree.)

It’s not enough to have a great set of rules to measure against, though. If you’re biased or don’t have depth of knowledge to see how they apply, you could easily miss something. And if you can’t be honest with yourself about whether you truly respect people or just see them as cash cows, you will almost certainly screw this process up. Nonetheless, going through this list is a hell of a lot better than nothing.

And, not that I need to point it out, the price of ethical failure isn’t intangible. The Exxon Valdez, Deepwater Horizon oil, Enron, thalidomide crisis and Grenfell Tower fire are all examples where poor ethical choices led to horrific outcomes. When key decision-makers cut corners, people get hurt or die.

Even if you’re too callous or narcissistic to worry about hurting people, screwups of this magnitude will impact your bottom line. Just ask Rick Doblin. Inconvenient as this is for some people to accept, there were ethical failures during MAPS MDMA trials which led to people being harmed, and this was likely part of what impacted the FDA decision-making process. It wasn’t the whole reason for the rejection, but it really didn’t help.

Psychedelic experiences can be surprising, even for seasoned psychonauts. We can’t perfectly predict what a trip will be like. We also can’t predict if or how a psychedelic experience will change us. Any journey can be transformative, possibly changing how we view ourselves, our relationships, what we value, or how we think of reality as a whole.

When psychedelic therapy (or any psychedelic healing) seeks to harness this transformative potential, informed consent can get a little complicated, compared to more conventional therapy. This is particularly true for the issue of touch between therapist and client.

For a full discussion of why this is complex and how to best navigate it, check out my first piece for Chemical Collective: Psychedelic Ethics: How to Gain Consent in Psychedelic Therapy.

Consent in psychedelics isn’t just about touch. It’s about power, deep change, and real (but manageable) risks. Pretending otherwise is negligence, not healing.

My flash fiction, Bro, Do You Even Optimize?, is live at Joan Westenberg’s Slobstack

Read the full story here (but be warned, I was in a bad mood the day I wrote it.)

If you made it this far, thanks for reading! Getting this issue out has been interesting, not least because of the near miss with floodwaters last week.

All feedback, complaints and suggestions are welcome, and I promise* to not make you a comically evil character in my Harry Potter fanfic where Alexander Shulgin runs Hogwarts.

*Unless you’re unironically posting on r/shroomstocks.

PS:

Q: Why is Stan Grof so well-preserved for his age?

A: Because he’s Jung at heart!

Written on Worimi lands. Sovereignty was never ceded.

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