Implications from Jaworska’s Account of Autonomy and Self for Dementia and Psychedelic Research

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This article refers to:

Journeying to Ixtlan: Ethics of Psychedelic Medicine and Research for Alzheimer’s Disease and Related Dementias

Notes

1 Jaworska develops her conception of autonomy while arguing against Dworkin’s. This dialectic is rich but, because of my purpose, I’ll put these arguments aside. See Jaworska (2017, 284–6) for her summary of, and challenges to, Dworkin’s account.

2 Dworkin understands autonomy in this more robust sense, thinking that one’s capacity for autonomy also includes the ability to enact one’s values on one’s own.

3 Since requiring assistance to enact one’s values does not imply that one lacks the capacity for autonomy, respecting the autonomy of a valuer who values participating in psychedelic research is not limited to merely allowing them to participate in such research; like Mrs. D, this individual may need help implementing their autonomy by, e.g., helping them find and enroll in psychedelic research studies. I’ll abbreviate this as “allow/assist.”

4 Even though cognitive complexity may not be a necessary condition for this, one plausible necessary condition is that the individual displays sufficient understanding of the possible effects they may experience while under the influence of psychedelics. That they can recall and recite them doesn’t seem a good proxy, for this may reflect their capacity for memory rather than understanding. However, that they understand the range of possible experiences seems crucial to whether they genuinely value participating in this particular kind of research.

5 See, e.g., her discussion of Julian (Jaworska, 2017, 287–8).

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