The Ethics of Regulation

The New York Times just ran a fairly lengthy article that reported the use of psilocybin, a hallucinogenic drug, in a controlled experiment aimed at reducing anxiety and depression in cancer patients. (http://www.nytimes.com/2016/12/01/health/hallucinogenic-mushrooms-psilocybin-cancer-anxiety-depression.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=first-column-region&region=top-news&WT.nav=top-news)

A few days earlier the New York Times ran a story on trials using MDMA (i.e., ecstasy) to treat post traumatic stress disorder. (http://www.nytimes.com/2016/11/29/us/ptsd-mdma-ecstasy.html)

Why are these stories news?

First, because not only are these scientific studies using illegal drugs: the drugs worked. Mainstream society demonizes drug use, at least in part out of fear of the negative consequences of drug use and abuse. The fact that illegal drugs may be beneficial in certain settings is thus surprising and unexpected.

Second, because the manifest risk of the use of illegal drugs seems in tension with the deployment of these drugs in controlled studies aimed at therapeutic benefits. The tension is manifestly ethical. Are the patients aware of the risks of drug use? If the drugs are beneficial in certain settings, should we reconsider the laws that make them illegal? Or should we react in a different way – is it somehow wrong, or a step along a slippery slope, to publicize positive benefits of a very dangerous substance?

If some activity (like ingesting a substance) enhances one’s well-being and costs others nothing or nothing worth mentioning, a humane society ought not prevent that activity. Maybe a humane society ought to make that activity available to its citizens. There are costs associated with making dangerous substances available – we know that already from all the damage related to the ready availability of tobacco, alcohol, and sugar. But given evidence that MDMA and psilocybin enhance well-being in at least some circumstances, it’s worth thinking about how the law ought to regulate the availability and use of such substances.

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