Ethical Considerations in Ibogaine Therapy

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Ethical Considerations in Ibogaine Therapy
Sandra Karpetas Iboga Therapy House Global
Ibogaine Therapy Alliance (GITA) 2nd
International Ibogaine Therapy Provider
Conference Barcelona, Spain 2010
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Why do we need ethical standards?

• Ethical insensitivity can contribute to
• Health and safety problems
• Dissatisfied clients/patients
• Public relations problems
• Financial problems
• Legal problems
• Organizational challenges

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How can ethics in therapy be helpful?

• Ethical Standards
• Increase the quality of care and services
  provided
• Increase transparency and accountability
• Help to protect clients and therapists from undue
  harm
• Foster greater recognition from the public domain
• Create conditions for maximizing therapeutic
  potential

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Ethical Guidelines

• Internationally Recognized Ethics in Therapy and
  Research
• Beneficence Promotion of well-being
• Non-malfeasance Avoid potential harms
• Dignity Respect for the person
• Informed Consent The person's right to
  information, to ask questions and to weigh the
  risks/benefits before making a decision
• Transparency Open communication about
  policies/procedures, disclosure of key
  information for client decision making
• Confidentiality Respect for privacy
• Feedback The right to provide feedback, whether
  positive and/or negative and to file a grievance
  or incident report

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Beneficence Promotion of well-being

• Ibogaine therapists should promote health in all
  aspects of their programming, procedures and
  policies.
• This includes key concepts such as health
  promotion, harm reduction
• and physical, psychological, emotional,
  spiritual and social well-being
• Foster knowledge, skills, attitudinal changes and
  supports needed to help people engage in safer
  and healthier lifestyles
• Avoid deficit thinking, build on strengths and
  support positive perspectives

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Non-malfeasance avoid potential harms

• There is an urgent ethical responsibility to
  decide whether the risk is too great for some
  participants, and thus to act to reduce or
  eliminate the risk even if that means stopping or
  modifying the therapy.
• Therapists also have a responsibility to
  continuously educate themselves and remain up to
  date on ibogaine safety related information.
  Neglect of this responsibility can be considered
  negligence and/or misconduct and may contribute
  to adverse events and/or death.

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Dignity Respect for the person

• Respect autonomy and support informed
  decision-making
• Accept and work with individual differences in
  client characteristics in both preventing and
  responding to potential challenges. These include
  unique risks associated with gender, age, sexual
  orientation, cultural/religious identity, etc...
• Recognize that the realities of poverty, class,
  racism, social isolation, past trauma,
  discrimination, labels, stigma and other social
  inequalities affect both people's vulnerability
  to and capacity for effectively dealing with self
  care.

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Informed Consent

• The client has a right to information, to ask
  questions and to weigh the risks and benefits
  before making a decision to undergo therapy
• Minimal Risk
• If potential subjects can reasonably be expected
  to regard the probability and magnitude of
  possible harms implied by participation in the
  research to be no greater than those encountered
  by the subject in those aspects of his/her
  everyday life that relate to the research, then
  the research can be regarded as within the range
  of minimal risk.
• -Tri Council Policy Statement 1998

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What does an ethical consent form consist of?

• A proper consent form should include
• Introduction/Background Information about
  ibogaine
• Ibogaine's Legal Status in the country where
  therapy takes place
• Therapeutic and Other Procedures from start to
  finish - in detail (include search, source of
  ibogaine, dosing, monitoring protocols,
  complementary/additional therapies, etc...)
• Ibogaine's Potential Effects, Side Effects and
  Risks
• Emergency Protocols (including specifics of what
  you would do in case of an adverse event, injury
  or death)
• 
  

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What does an ethical consent form consist of?

• Potential Benefits (including a disclosure
  regarding no guarantee that it will help)
• Quitting or Withdrawing from Participation in the
  Therapy - including your procedures and risks
  should someone decide to leave the site of
  therapy whilst under your care
• Data Collection, Publication and Communication of
  Results - disclose any plans to share information
  with others/public
• Confidentiality - handling and storage of
  personal info, files, medical info etc... plus
  staff/team confidentiality agreements

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What does an ethical consent form consist of?

• Alternative Sources of Therapy ibogaine therapy
  is not the only option and not necessarily the
  easiest/safest
• Incentives disclose any vested interests
  including financial
• Client Rights and Responsibilities - include DWF
  Bill of Rights, outline client responsibilities,
  the right to file incident or grievance reports
  and how to do so
• Who to contact for more information include
  contact info
• The actual Informed Consent statement page to be
  signed

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Elements of a consent form

• Each page should be numbered and have a space at
  the bottom for initials acknowledging the
  following statement
• I have read the contents of this page. I have had
  the opportunity to ask questions about it, and I
  understand what it says. Initials____
• The form should be written in an easy to
  understand manner (8th grade reading level).
  Complicated terms should be defined in an easy to
  understand way
• The actual informed consent statement page
  include a statement regarding minimal risk
• Space for date, signature of client and witness
  signature/date
• Note A copy should be available for client
  without extra charge

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Confidentiality

• Respect for privacy before, during and after care
• Handling and storage of sensitive information
• - keep all files/personal/medical info secure
  and locked
• - consider using a secure server w/ SSL
  certificate
• - do not use publicly-accessible computers
• Ask client how they prefer to be contacted and
  when
• Omit personally identifying info in
  publications/reports/discussions
• Each staff member should sign a confidentiality
  agreement

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Feedback

• Every client (regardless of whether they paid for
  the services or not) has the right to provide
  feedback, whether positive and/or negative and to
  file a grievance or incident report if they deem
  necessary.
• It is the responsibility of the therapy provider
  to provide information on how to do so.
• Ibogaine Incident or Grievance Report Form
• http//www.doraweiner.org/incident.html

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A few other considerations

• Compassion, empathy, strong interpersonal,
  listening, counseling and facilitation skills are
  of utmost importance. Individuals on the
  staff/team should possess the following
• Recognition of and respect for diversity
• Awareness of ones own learning process
• Ability to be attentive/good listening skills
• Trust in ones way of working
• Ability to work with authority
• Willingness to do ones own inner work
• Also Have a fair and just conflict resolution
  policy in place

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Sandra Karpetas sandra_k_at_ibogatherapyhouse.net
1 604 785 0924 www.ibogatherapyhouse.net Global
Ibogaine Therapy Alliance www..ibogainefederation.
org