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

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. CLICK TO REVIEW