OPENurses Code of Ethics
Mission and Intention:
The intention of OPENurses is to advance the role of nurses in the therapeutic use of psychedelic medicines. We advocate for the central involvement of nurses in creating psychedelic policy, praxis, culture, education, and research.
Honoring Ancestral Traditions and Qualitative Knowledge:
OPENurses acknowledges that many psychedelic medicine traditions began before the era of modern medicinal chemistry. These medicines, and the understanding of how to use them, originated in indigenous cultures, were practiced by women and Black, Indigenous, and People of Color (BIPOC), and were embedded in a culture of storytelling and qualitative ways of knowing. When working with these medicines, we honor the history and the cultures from which they originated and acknowledge that we are borrowing and learning from these lineages and traditions. We encourage nurses to be mindful of appropriation and extractive practices when engaging with indigenous cultures. Other invaluable psychedelic medicines, and frameworks for their use, emerged from Western, qualitative, scientific methods, and we also honor that tradition of inquiry.
Nursing has a tradition of learning from skilled and systematic observation, the cataloging of clinical storytelling in the form of narrative knowledge, and qualitative inquiry that exists in tandem with quantitative ways of knowing. We see qualitative study as an essential and humanizing complement to quantitative methods of inquiry, and advocate for both methods of scholarship.
Nurses have always held the space for the patient to heal, often for extended periods of time, and through the rites of passage of birth, illness, and death. This intuitive and ineffable care supports the innate healing processes of the patient. We feel that these midwifery-type skills are well-suited to psychedelic therapy.
Adherence to law:
OPENurses does not encourage the use of substances currently ruled illegal under United States laws. While we acknowledge that personal use of these substances does occur, unsupervised use is not the focus of this organization.
We believe that criminalization of personal drug use has been a failure, and has led to innumerable human rights violations, particularly to economically disadvantaged communities and communities of color. However, we also acknowledge that these laws currently exist, and violation of them may be consequential. We recognize this paradox, and encourage nurses to actively explore the inherent conflicts between these positions.
We are aware that some people choose to travel to countries where these medicines are not subject to the same prohibitions. We strongly suggest that people who wish to explore this use do so in legally, ethically, and culturally-appropriate settings. For nurses licensed in the United States who choose to explore these medicines internationally, we encourage exercising the utmost discretion, caution, and mindfulness if they choose to share their experiences. While the discussion of cognitive liberty remains a robust point of debate, we acknowledge that many of these medicines remain Schedule 1 drugs under the United States Controlled Substance Act. Communications within this group, and on our platforms, are not privileged or confidential. It is important for licensed professionals to be aware that public discussion of the use of Schedule 1 medicines may be subject to sanction by state and federal licensing agencies. Licensed professionals are encouraged to be aware of these potential complexities. OPENurses does not provide legal advice or guidance and encourages members to seek their own legal counsel in these matters.
OPENurses, as a community of nurses, believes that the first and foremost role of the nurse in psychedelic therapy is to ensure safe and ethical treatment of patients.
Patients undergoing psychedelic therapy are inherently vulnerable, and it is the ethical duty of the nurse to protect patients under their care. Nursing practice should be trauma-informed. It is critical to acknowledge that, in most patient-provider interactions, and especially, during non-ordinary states of consciousness, there is a potential for significant power differences between provider and patient. Nurses should be aware of these dynamics, and always protect the vulnerability of the patient.
OPENurses encourages nurses to consider risk mitigation, benefit maximization, and harm reduction strategies if they encounter psychedelic use outside of therapeutic contexts.
It is the position of OPENurses that psychedelic therapies should be administered in a safe and therapeutic environment by experienced providers who have been adequately trained in the use of these medicines.
OPENurses believes that psychedelic-assisted therapy should always be confidential and adhere to all state and federal laws regarding the privacy of Protected Health Information (PHI). Disclosure of PHI should only be done with the explicit, written consent of the patient, or in specific circumstances as described in state laws regulating nursing practice (e.g. duty to warn, risk to self or others, or mandated reporting of child or dependent adult abuse).
OPENurses encourages nursing scholarship in the field of psychedelic therapies through publication and public sharing of findings. Qualitative inquiry is an important part of nursing scholarship, however, case studies about psychedelic-assisted therapy sessions should only be used with consent of the patient, and should be thoroughly de-identified in order to protect their privacy. Nurses should be aware of potential implied quid pro quo issues with a patient who has benefitted from psychedelic-assisted therapy, and this should be explicitly discussed with any patient who is being asked to consider publicly sharing their story.
OPENurses feels strongly that psychedelic medicines should never be given without explicit, informed consent of the recipient. Coercion, in any form, has no place in psychedelic therapy.
Any therapeutic touch used in a psychedelic session should be done only with prior consent provided by the patient before a psychedelic is introduced. Consent should be frequently renewed throughout the treatment session, and can be withdrawn at any time, without need for justification. Coercive, intimidating, or aggressive behavior towards a patient is never acceptable. Psychedelic medicine providers should never engage in sexual contact with their patients before, during, or after psychedelic therapy.
Collaboration and Representation:
OPENurses encourages the representation, inclusion, and leadership of nurses at all levels of psychedelic therapy and research. Nurses, and nursing practices, provide a unique perspective to patient care. We welcome collaboration and expect that our colleagues from other professions reciprocate by inviting nurses onto multidisciplinary teams.
OPENurses is a professional organization that seeks to uphold the highest standards for nurses working with psychedelic medicines. We encourage peer accountability and transparency between members. Clinical supervision is seen as an essential component of safe psychedelic practice. When ethical standards are breached, we invite a “calling in” of members who are practicing outside of these established parameters and urge the larger community to create an ethos of best practices that ensure the safety of patients undergoing psychedelic therapies.
Equity and Access:
OPENurses supports social justice, anti-racism, and economic equity. Our organization values the inclusion of a diversity of voices in our discourse and strives towards greater representation of nurses from diverse backgrounds in psychedelic-assisted therapy.
OPENurses believes access to healthcare is a human right, and that all patients who may benefit from psychedelic-assisted therapy should have access to it. We strongly encourage pharmaceutical developers, payors, and providers to be aware of the costs of treatment, and to help make these treatment modalities available to those with limited means.
The OPENurses code of ethics was influenced by and can be seen as a companion to the Council on Spiritual Practices Code of Ethics for Spiritual Guides and the American Nursing Association Code of Ethics. Last revised 8/20/20