Human cultures have used classic psychedelics for healing purposes for millennia, emphasizing their subjective effects. In the 21st century, research has been revived to investigate the therapeutic effects of these substances. These substances show promising results in the treatment of various mental-related disorders such as depression, post-traumatic stress disorder, and others, necessitating ethical considerations and guidelines for researchers, psychotherapists, and policymakers. The subjective effects of the psychedelic experience that these substances evoke, such as the feeling of oneness and interconnectedness, infallibility, the sense of reduced one's self-importance, the encounter with the "ultimate" reality or with God, radically distinguish them from typical psychiatric medications such as selective serotonin reuptake inhibitors (SSRIs). In their essay "Ethics and Ego Dissolution: the Case of Psilocybin", William R. Smith and Dominic Sisti argue that the special properties of psychedelics entail certain novel risks that warrant "enhanced" informed consent that is "one that is more comprehensive than what may be typical for other psychiatric medications". They emphasize the unique effects of these substances, including 1) the potential for significant personality changes, 2) the short duration of treatment, and 3) the potential for profound and transformative experiences. They highlight the importance of explicitly addressing these potential changes as part of the informed consent process to ensure patient understanding, autonomy, and well-being. This current paper substantially complements Smith and Sisti's work by discussing in more detail the differences between psychedelics and typical psychiatric medications with respect to informed consent. I first support their arguments and then further argue that there are three other critical reasons why psychedelics should not be treated like other psychiatric medications that should be considered when discussing the enhancement of informed consent and disclosure. 1) potential changes in ethical values, 2) set and setting, and 3) suggestibility. To clarify my argument, I propose a distinction between changes in worldview and ethical values induced by the psychedelic experience and emphasize their differential impact on individuals undergoing psychedelic therapy. I introduce the term "ethical limbo", characterized as a state of uncertainty or ambiguity regarding the ethical implications or consequences of a particular action, decision, or situation due to conflicting ethical values, to highlight a potential risk of the psychedelic experience that should be considered in informed consent. Finally, I address potential objections to my arguments before concluding the paper and addressing some limitations of the research.

Interest in psychedelic science is increasing in society. From ritual traditions to today's therapeutic use, psychedelic substances have played a role in healing, self-exploration, and spiritual understanding. Increased research activity as well as the introduction of university courses on psychedelic science at institutions such as Karolinska Institutet and Lund University also indicate an increased interest within the Swedish academy. This integrative literature review highlights the historical, scientific, and cultural dimensions of psychedelic science. The overview results in four themes; Historical background, Psychedelic assisted therapy, Challenges and risks and Ontological perspectives; the biomedical meets the spiritual. Within these themes appears a theoretical debate regarding the medical and social perspective in treatment within the field of psychedelic science, which in turn affects and mirrors the field of social work. Positive results in treatment of depression, anxiety and addictive disorders are presented, as well as methodological challenges and a complex cultural and spiritual significance. Finally, the relevance of psychedelic science in social work is discussed, where psychedelics can potentially offer new therapeutic approaches to complex mental health problems as well as highlight existential questions in a field in need of comprehensive perspectives. / Intresset kring psykedelisk vetenskap ökar i samhället. Från rituella traditioner till dagens terapeutiska användning har psykedeliska substanser spelat en roll i läkning, självutforskning och andlig förståelse. Ökad forskningsaktivitet samt införandet av universitetskurser om psykedelisk vetenskap på institutioner som Karolinska institutet och Lunds Universitet indikerar även ett ökat intresse inom den svenska akademin. Denna integrativa litteraturöversikt belyser psykedelisk vetenskap ur historiska, vetenskapliga och kulturella dimensioner. Översikten resulterar i fyra teman; Historisk bakgrund, Psykedeliskt assisterad terapi, Utmaningar och risker samt Ontologiska perspektiv; det biomedicinska möter det andliga. Positiva resultat vid behandling av depression, ångest och beroendesjukdomar presenteras, likväl metodologiska utmaningar och en komplex kulturell och spirituell signifikans. Genomgående i dessa teman framkommer en teoretisk debatt inom forskningsfältet gällande det medicinska och sociala perspektivet på behandling, som även speglas i det sociala arbetet. Slutligen diskuteras relevansen av psykedelisk vetenskap inom socialt arbete, där psykadelika potentiellt kan erbjuda nya terapeutiska tillvägagångssätt för komplexa psykiska hälsoproblem samt lyfta fram existentiella frågor i ett fält vid behov av omfattande perspektiv.