Posts

Posted on

Psychedelics vs Anti-Depressants

A note from our Guild President, Tom Carroll

We have covered the rapidly-evolving topic of psychedelics as medicine in previous posts. One problem with the (one might say, literally) incredible claims about the near-miraculous benefits of psychedelics for a variety of psychiatric conditions is that the psychedelic experience is so unmistakable. This means that the vast (>90%) of those who should be blinded to group assignment in studies, both participants and therapists, are able to correctly guess which group (placebo or active treatment) they were assigned to.*

This means that while study participants can be randomized, they cannot be effectively blinded, arguably making all randomized controlled trials (RCTs) not blinded (i.e., “open-label”). As a consequence, we cannot make a true cause-effect claim about psychedelics based on these trials. Additionally, any positive treatment effects are truly due to psychedelics are likely to be overestimated by these (effectively) open-label studies.

Interestingly, there is a new article our that took a very different approach. This article was just published:

Their results are interesting, including:

  1. Psychedelic Assisted Therapy (PAT) trials, most of which attempted blinding, showed PAT to be no more effective than antidepressants when tested in in open-label trials.
  2. Open-label trials of antidepressants showed better (apparent) treatment effects than blinded trials of antidepressants. Interestingly, the same was not true for PAT trials.

Their conclusions:

So, when the claim is made that psychedelics are the cure-all for X condition, we should keep in mind that they are incredibly difficult to study, thus far the data are confounded and, I would argue, we need to be very careful about drawing cause-effect conclusions from non-blinded studies.

More to come, I’m sure, so stay tuned!

—

* Bogenschutz, M. P., S. Ross, S. Bhatt, T. Baron, A. A. Forcehimes, E. Laska, S. E. Mennenga, K. O’Donnell, L. T. Owens, S. Podrebarac, J. Rotrosen, J. S. Tonigan and L. Worth (2022). “Percentage of Heavy Drinking Days Following Psilocybin-Assisted Psychotherapy vs Placebo in the Treatment of Adult Patients With Alcohol Use Disorder: A Randomized Clinical Trial.” JAMA Psychiatry 79(10): 953–962.

Posted on

scMAiD @ URMC Medicine Grand Rounds

Dr. Carroll, our Guild President, will be co-presenting at URMC Medicine Grand Rounds about so-called Medical Aid in Dying (scMAiD) with Dr. Rob Horowitz.

They will be discussing details about the scMAiD law and how to both talk to patients who ask about scMAiD, including how one who categorically disagrees with taking part in the intentional killing of innocent humans can reasonably navigate this issue with patients, colleagues, and the world generally.

Grand Rounds will be held in the Class of ’62 Auditorium at URMC on Tuesday, September 1, from noon to 1pm.

The video link is: https://urmc.zoom.us/j/96839946945?pwd=TLqcrUNR5lEMfpazo7ffTHKUj9MfvO.1

(please email FLGMedGuild@stbernards.edu for the meeting passcode)

To repeat the offer currently on our homepage…

FLG Statement…and Offer

The Finger Lakes Guild of the Catholic Medical Association is comprised of a dedicated group of Catholic physicians and healthcare professionals committed to upholding the dignity of every human life. In response to the legalization of so-called Medical Aid in Dying (scMAiD) in New York State, we publicly affirm that under no circumstances will we participate in or support this practice. Guided by our Catholic faith and traditional, time-tested, medical ethics, we remain steadfast in providing compassionate, life-affirming care, respecting the inherent dignity of every patient entrusted to us.

We invite individuals, healthcare providers, faith communities, and organizations to partner with/contact us as we work to address the profound ethical and practical challenges posed by Governor Hochul’s decision to sign physician-assisted suicide into law. Together, we can ensure ongoing support, education, and compassionate alternatives that protect vulnerable patients and uphold the true purpose of medicine: healing and hope.

Posted on

Summer Soiree 2026

Thank you to everyone who joined this year for the FLG Summer Soiree. As special thanks to Bishop Bonnici for joining us! We are extremely fortunate to have such a wonderfully supportive Shepard!

Posted on

Organ Donation Registry

In light of our recent Journal Club discussion on organ donation after circulatory death and normothermic regional perfusion (original post and follow-up), we wanted to make mention of two things.

First, the Catechism provides guidance regarding organ donation:

2296 Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good that is sought for the recipient. Organ donation after death is a noble and meritorious act and is to be encouraged as an expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent. Moreover, it is not morally admissible directly to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons.

There is a lot here to be unpacked here. For our purposes, the important phrase is “after death.” One concern that has been raised in the literature, and was discussed during Journal Club, is whether or not we can have moral certainty of a person is (truly) dead under the conditions that allow for legal organ retrieval. There is reason to be concerned that many/most state laws do NOT allow for that moral certainty of death for either donation after circulatory death (DCD) or after death by neurologic criteria (commonly called “brain death”). This is, to say the least, troubling.

Add to this is extremely disturbing details of normothermic regional perfusion (NRP), especially the clamping of the carotid and vertebral arteries before the heart is restarted to avoid “accidentally” brining the (so-called) dead person back to life(?) by reprofusing the brain…and the situation becomes only more troubling.

Second, the FAQ on the NYS Donate Life Registry website is very clear that the little heart on NYS driver licenses (including very likely on yours) carries quite a bit of legal weight:

What if I am a registered donor, but my family is opposed?
If you are 18 or older enrolled in the Registry, your decision to donate must be honored if medically possible.

  • State and federal laws support your rights to be an organ, eye and tissue donor.
  • If you are in the Registry, your family will be told of your decision, and given information about the process, but their permission is not needed for the donation to proceed.
  • Most families of registered donors are happy to know their loved one made this decision. They follow their wishes.
  • If you are 16 or 17 at the time of your death, your parents or legal guardians can revoke your decision to be a donor. The consent to donate for people enrolled in the Registry that are 18 years of age or older can only be revoked by the enrollee themselves.

So we have a very unfortunate combination of: 1) organ donation is, in principle “a noble and meritorious act,” 2) there is legitimate worry that living humans are (at least possibly in some cases and not intentionally) being killed by having their organs removed, 3) having checked the “organ donor” consent box when we first received our license (likely at age 16 or 17) can legally override a family’s opposition to having their loved one under organ donation of circulatory or brain (so-called) death.

Navigating this is truly a challenge. There are people alive today because of organ donation…and…we have to look a very difficult question in the face and answer it honestly: “Are we (even inadvertently) killing people for their organs.”