HOPE Declaration

The Hopkins-Oxford Psychedelics Ethics (HOPE) Workshop Consensus Statement

The first Hopkins-Oxford Psychedelic Ethics (HOPE) workshop convened to discuss ethical matters relating to psychedelics in August of 2023 at the University of Oxford. The organizers (BDE, DBY, EJ) aimed for a diversity of participant backgrounds and perspectives. The keynotes were given by an Indigenous scholar and a psychiatrist; other attendees included lawyers and ethicists, psychedelic scientists, anthropologists, philosophers, entrepreneurs and harm reduction actors.

The workshop was organized out of a recognition that the field of psychedelics is at a pivotal point in its history: research, clinical applications, and policy initiatives are quickly scaling up. The use of psychedelics is expanding, and the development of new systems governing their use is already underway. These changes are happening while substantial uncertainty remains, both about the effects of psychedelics and about the ethical dimensions surrounding their use. We recognize that there is a significant risk of harms as well as potential benefits. Participants at the workshop discussed the ethical aspects of psychedelics, including research methods, clinical practices, history, law and society, spirituality, community, culture and politics that arise in relation to psychedelics.

Despite the value of these discussions, the group remains mindful that relatively few voices could be included compared to the scope of those thinking about psychedelics, and those who will be impacted by psychedelics in the coming years. Participants resolved that improving outcomes will require us to make special efforts to further increase the diversity of participant perspectives and backgrounds at future events, including patients and users (not only those who have been benefited by psychedelics, but also those who have been harmed), biopharmaceutical companies, Indigenous communities with established histories of psychedelic use, and law and policy makers.

Workshop participants discussed a draft of the current document. This document is intended to summarize our shared understanding of some of the central ethical considerations relating to psychedelics and a few recommendations to the field. Of course, on some points, there is no consensus yet, and there may never be. Further, there are matters on which the group was agnostic, matters which split the room, and matters which we agreed required more evidence and more discussion between the full breadth of stakeholders. Nonetheless, the signatories endorse the sentiments below and believe they are worth conveying to the field at large. More broadly, we hope that this statement is a useful contribution: to those who work with, research, or use psychedelics, as well as anyone interested in the field.


The push towards developing psychedelic drugs into licensed medicines over recent years has led to a growing recognition of the importance of carefully laying out best research, clinical, and policy practice for regulating their clinical use. Specifically, best practices should be developed and implemented to minimize risks to patients and promote benefits. There are social justice issues to address as well, such as promoting equitable access and providing appropriate benefit-sharing with certain Indigenous communities with long histories of practice with psychedelic plants.

Currently, clinical applications may dominate discourse about engagement with psychedelics, However, the roles that psychedelics have played in society have always transcended the biomedical domain — and likely will continue to do so. Recent legislative shifts have removed criminal penalties for personal use of psychedelics in some jurisdictions, while others have moved to permit and license ’supported adult use’ outside of a medical context. Alongside these shifts, interest is increasing in less-formalized uses of psychedelics in spiritual, self-developmental, wellbeing-enhancement and other contexts. Such uses remain prohibited in many jurisdictions, and while nothing in this statement should be taken as an endorsement of illegal behavior, such practices remain deserving of serious attention and consideration.

We welcome recent analysis of psychedelics within clinical ethics, as well as from legal and regulatory standpoints, but we also acknowledge the need to consider the broader ethical implications of psychedelic use at multiple levels of analysis. Historical ethical transgressions around psychedelics - including MK Ultra, abuses of psychiatric patients and prisoners, sexual abuse and boundary violations by guides, and appropriative practices towards Indigenous communities - must neither be forgotten nor repeated.

The ethics of psychedelics is complex: psychedelic experiences can have profound - sometimes transformative - psychosocial or spiritual impacts on some users and these experiences are influenced by social and cultural factors. A comprehensive assessment of risks and benefits requires seeing things not only at the level of the individual user, but also at the socio-historical, political, public health and cultural levels. Even though we know much more about psychedelic compounds than we did 15 years ago, there is still much for us to learn and continued research is absolutely essential.

In line with our intention to convey some central issues in psychedelic ethics and a few recommendations to the field, we present the below as a ‘ground floor’ consensus. In each numbered section below, we present:

  1. our shared understanding of some of the major ethical considerations relating to psychedelics (while also acknowledging points of disagreement),
  2. our position relating to those features,
  3. and our suggestions to the field.

I. Recognition of the special position of communities with historical use of psychedelics

II. Precautionary approach to advancing scientific understanding

III. Recognition of legitimacy of diverse motivations to engage with psychedelics

IV. Need for education

VI. Equity

VII. Professional Conduct

VIII. Special vulnerabilities around psychedelic use and risks of abuse

IX. Importance of breadth of research to advancing understanding

X. Responsibility and ethics in communication


Edward Jacobs, Brian D. Earp, Paul Appelbaum, Lori Bruce, Ksenia Cassidy, Yuria Celidwen, Katherine Cheung, Sean Clancy, Neşe Devenot, Jules Evans, Holly Fernandez Lynch, Phoebe Friesen, Albert Garcia Romeu, Neil Gehani, Molly Maloof, Olivia Marcus, Ole Martin Moen, Mayli Mertens, Sandeep M. Nayak, Tehseen Noorani, Kyle Patch, Sebastian Porsdam-Mann, Gokul Raj, Khaleel Rajwani, Keisha Ray, William Smith, Daniel Villiger, Neil Levy, Roger Crisp, Julian Savulescu, Ilina Singh, David B. Yaden

To cite this report

Jacobs, E., Earp, B. D., Appelbaum, P., Bruce, L., Cassidy, K., Celidwen, Y., Cheung, K., Clancy, S., Devenot, N., Evans, J., Fernandez-Lynch, H., Friesen, P., Garcia-Romeu, A., Gehani, N., Maloof, M., Marcus, O., Moen, O. M., Mertens, M., Nayak, S. M., … Yaden, D. B. (2024) The Hopkins-Oxford Psychedelic Ethics (HOPE) Working Group Consensus Statement. American Journal of Bioethics.

The scope of ‘psychedelics’

We have in mind for this statement so-called ‘classic’ or paradigmatic psychedelics, defined as substances that are partial agonists of 5-HT2A receptors that produce substantially altered states of consciousness involving changes to affect, cognition, and perception. Notable examples include psilocybin, LSD, mescaline, and DMT. Some of these (e.g., psilocybin mushrooms, peyote mescaline) are found in nature, and have been used in select Indigenous communities for ceremonial and communal purposes, within the context of particular belief systems and traditions of use. Others (e.g., LSD, synthetic psilocybin) were developed by scientists within the past century and may have different associations within Western culture.

The term ‘psychedelic’ was coined by psychiatrist Humphrey Osmond in correspondence with author Aldous Huxley. Roughly, the term means “mind-manifesting”. In contemporary usage, ‘psychedelic’ has the character of a cluster concept, with paradigmatic examples at the center , and less paradigmatic examples toward the margins, with corresponding disagreement about whether the latter examples should be counted as ‘psychedelics’ at all.

Among these more contested examples are MDMA, ketamine, salvia, scopolamine, ibogaine, and cannabis. These substances, and various associated patterns of usage, have some things in common with the ‘classic’ psychedelics on which we are focusing in this article: they involve intensely altered states of consciousness lasting a few minutes to many hours, with the possibility of persisting effects lasting days, weeks, months, or even years.

However, these substances differ along a number of dimensions, such as their pharmacological mechanisms of actions, histories of use, and acute subjective effects. Thus, although some of the ethical points we raise likely will apply to these latter types of substances, we are not committing ourselves to any particular implications in those cases and instead see our statement as being primarily concerned with the paradigmatic examples of psychedelics (i.e., classic psychedelics such as psilocybin).