Overcoming epistemic injustices in the biomedical study of ayahuasca: Towards ethical and sustainable regulation

Abstract

After decades of biomedical research on ayahuasca's molecular compounds and their physiological effects, recent clinical trials show evidence of therapeutic potential for depression. However, indigenous peoples have been using ayahuasca therapeutically for a very long time, and thus we question the epistemic authority attributed to scientific studies, proposing that epistemic injustices were committed with practical, cultural, social, and legal consequences. We question epistemic authority based on the double-blind design, the molecularization discourse, and contextual issues about safety. We propose a new approach to foster epistemically fair research, outlining how to enforce indigenous rights, considering the Brazilian, Peruvian, and Colombian cases. Indigenous peoples have the right to maintain, control, protect, and develop their biocultural heritage, traditional knowledge, and cultural expressions, including traditional medicine practices. New regulations about ayahuasca must respect the free, prior, and informed consent of indigenous peoples according to the International Labor Organization Indigenous and Tribal Peoples Convention no. 169. The declaration of the ayahuasca complex as a national cultural heritage may prevent patenting from third parties, fostering the development of traditional medicine. When involving isolated compounds derived from traditional knowledge, benefit-sharing agreements are mandatory according to the United Nations’ Convention on Biological Diversity. Considering the extremely high demand to treat millions of depressed patients, the medicalization of ayahuasca without adequate regulation respectful of indigenous rights can be detrimental to indigenous peoples and their management of local environments, potentially harming the sustainability of the plants and of the Amazon itself, which is approaching its dieback tipping point.

Culture, context, and ethics in the therapeutic use of hallucinogens: Psychedelics as active super-placebos?

“…We are currently witnessing what has been called a “psychedelic renaissance” (Pollan, 2018). The biomedical appropriation of substances once embedded in rich traditional, cultural, ritual, and spiritual contexts, as pointed out by Schenberg and Gerber (2022a) for the study of ayahuasca, may result in epistemic injustice for Indigenous communities that pioneered their use but have their knowledge and experience ignored or discounted. Schenberg and Gerber (2022a, 2022b) have sought to address these injustices—which in their view also entail epistemological errors , as a correct understanding of psychedelic therapies cannot divorce them from cultural context—by studying the effects of psychedelic substances in their local context, with the collaboration of local experts.…”

“…The biomedical appropriation of substances once embedded in rich traditional, cultural, ritual, and spiritual contexts, as pointed out by Schenberg and Gerber (2022a) for the study of ayahuasca, may result in epistemic injustice for Indigenous communities that pioneered their use but have their knowledge and experience ignored or discounted. Schenberg and Gerber (2022a, 2022b) have sought to address these injustices—which in their view also entail epistemological errors , as a correct understanding of psychedelic therapies cannot divorce them from cultural context—by studying the effects of psychedelic substances in their local context, with the collaboration of local experts. As another potential compromise, some scholars have argued for the therapeutic mobilization of traditional psychedelic practices in the context of their respective medical systems, on the grounds of their demonstrated efficacy in randomized controlled trials (Ona et al, 2022).…”

On epistemic injustices, biomedical research with Indigenous people, and the legal regulation of ayahuasca in Brazil: The production of new injustices?

“…"Overcoming Epistemic Injustices" by Schenberg and Gerber (2022) is a valuable effort to deepen a much-needed discussion in the field of biomedical research on ayahuasca, and bravely focuses on the important issue of epistemic injustices fostered by biomedical research on psychedelics in relation to Indigenous people. The article presents relevant concerns and raises important questions regarding both the nature of biomedical research and the debate on the legal regulation of ayahuasca.…”

Access and benefit-sharing legislation: An ethnobiological approach to overcoming epistemic injustices through intercultural dialogue

“…Schenberg and Gerber’s (2022) article develops an important discussion on the relationship between Brazilian legislation on access to genetic heritage, protection of and access to associated traditional knowledge, and benefit-sharing for the conservation and sustainable use of biodiversity: the access and benefit-sharing (ABS) framework. However, there are some details that deserve further clarification.…”