In Oregon, Psychedelics Regulators Confront Conflicts of Interest
February 25, 2022This past Wednesday, February 23, Oregon’s Psilocybin Advisory Board voted unanimously that each member would disclose their personal and financial conflicts of interest during its next meeting in March. The Board is made up of people who were appointed by the governor to create recommendations for the rules for the state’s legal psilocybin services, which begin in January 2023.
Rachel Knox, a clinical endocannabinologist and the board member who put forward the motion, said in the meeting that the equity subcommittee had received a “considerable number” of calls for members of the board to declare their conflicts of interest, including conflicts that extend beyond financial or business interests, and veer into the personal.
“It is unclear what exactly prompted the request for clearer disclosure requirements,” wrote journalist Tess Riski in Willamette Week.
Knox didn’t respond to an interview request, so no assumptions should be made about what prompted her actions. But Motherboard has learned of a personal relationship that comes squarely under the parameters of the new motion: one between the chairman of the psilocybin advisory board, Tom Eckert, who also co-led the campaign to pass Measure 109, and Rachel Aidan, the CEO of Synthesis Institute, a Dutch psychedelic retreat company with interests in Oregon. (A disclosure of my own: I went to Synthesis in 2019 for a 3-day retreat.)
Multiple sources in the psychedelic community confirmed they were aware of a relationship between Eckert and Aidan, and expressed concerns about it not being disclosed more explicitly. Synthesis will ultimately have to adhere to the rules set by the Oregon Health Authority (OHA), and Eckert has a prominent role in creating the recommendations that will inform those rules. In the last year, Eckert has also brought in Synthesis employees to speak to members of the board and provide guidance on facilitating psilocybin experiences, according to public recordings of those meetings.
“It’s the same way that you would disclose a relationship inside of a workplace,” said one source. “Not that it’s not permitted, right? But that it’s a thing your co-workers should be reasonably aware of.”
When asked directly about the motion to disclose conflicts of a personal nature, like her relationship with Eckert, Aidan said in an email, “I think it is best practice to disclose any potential conflicts of interest,” and that her disclosures have “occurred in accordance with the policy of my organization, Synthesis.”
Eckert, when reached for comment, said in an email, “I supported the motion. The Advisory Board unanimously decided to refine language in its bylaws relating to publicly disclosing conflicts of interest or potential conflicts of interest each calendar year. A year has now passed since the Board took shape and disclosures were first made publicly, so we will take time in the next meeting to make relevant public disclosures again. My expectation is that Board members will continue to stay in compliance with the bylaws.”
Declaring conflicts of interest is already an important obligation in other fields, like academic research. This practice started after corporate funding of research in the 1950s by the tobacco industry led to studies that skewed in favor of their funders’ interests. In 2009, a report by the Institute of Medicine defined a conflict as any “set of circumstances that creates a risk that professional judgment or actions regarding a primary interest will be unduly influenced by a secondary interest,” though disclosures often center around financial interests.
The motion, whether about Eckert and Aidan or not, gestures at a larger shift in the psychedelic space: One side effect of having regulated access to psychedelics, whether through legal or medical means, is that rather than operating as an underground economy, the field will operate as a more or less normal one, imposing new obligations on people in positions of power, like the disclosure of personal business where it potentially affects the public’s business.
For a field that has existed underground for a long time, this kind of bureaucracy will be new, but necessary. The psychedelic community is still a relatively small one, with people who are serving multiple roles—as business owners, regulatory advisors, training program leaders, and advocates. Part of the growing pains for legal psychedelics will be determining exactly which conflicts should be disclosed and what ripple effects those disclosures will have. Eyes are on Oregon as a model for how legal access to psilocybin might work in the rest of the country, and people are closely watching to see how it navigates these ethical questions.
At the meeting earlier this month, Knox introduced new conflict of interest language that could be potentially added to the board’s bylaws, pending a vote.
Knox raised the issue of personal conflicts of interest multiple times, even though it’s not mentioned directly in the proposed language. “What’s not reflected here is this concern for personal interest,” she said. Knox also said that an annual declaration of broad conflicts of interest wouldn’t replace the ethical obligations that are already in place under state law, but would be in addition to them.
Riski previously wrote about how board members who plan to operate psilocybin businesses in Oregon have a role in creating the rules those businesses will adhere to. (Though the board makes recommendations to the Oregon Health Authority, the OHA will make the final decisions.)
Eckert has already disclosed a financial conflict of interest: His facilitator-training business InnerTrek. “Eckert’s business venture means he is simultaneously leading the government advisory board that is crafting the rules surrounding psilocybin legalization and starting a company that will profit from that new marketplace,” Riski wrote.
Board member Mason Marks, the project lead at The Project on Psychedelics Law and Regulation, said in the meeting that Knox’s new motion could prompt two separate kinds of conflict disclosures: One would be an annual, general disclosure of all existing and potential conflicts, and then there would be a case-by-case disclosure for individual matters that come up for vote.
Board member Barb Hansen, a registered nurse and CEO of the Oregon Hospice and Palliative Care Association, suggested in the meeting that the language could be amended to include when a person should recuse themselves from a vote, if it’s involving a matter that they have a conflict of interest around.
Marks agreed that the disclosures should extend beyond financial: “It should be financial, professional, and personal, which is sort of the same standard that we're holding facilitators to,” he said in the meeting.
In the meeting, Eckert said that he’s been transparent about his training program and that there were many “gray areas” around conflict of interest, since members of the board were often chosen because of their expertise in the same areas that might prompt to them wanting to be involved in psilocybin services. “Where is that line? It's going to be tricky, and I'm very open in defining that a little bit more,” he said.
Knox again brought up conflicts outside of financial ties: “Personal relationships might not be, as defined here, a member of your household or you yourself, but might be influencing our recommendation as board members,” she said.
She added: “I think we need to make sure that we're not limiting this to financial or business interests and or employment interests of, necessarily, an Oregon-based company. There might be other organizations that are ancillary or even have an interest in the state that you're tied to outside of the state. All of those things have to be considered, especially considering how many people from out of Oregon are wanting and planning to come into Oregon to conduct business.”
When board member Todd Korthuis, a general internist doctor, asked Knox, “You mentioned a few times personal conflicts of interest, and Mason echoed that language just now. Can you be a little more specific?”
Knox responded, “No, I cannot be more specific. I don't think it's appropriate for me to be specific in this forum.”
There’s a reason to urge the disclosure of personal relationships, and it’s not about a desire to air people’s personal lives in front of the public. In the psychedelic community in Oregon, many businesses and people will have crossovers, both personally and financially. Disclosures of conflicts of interest are not an indictment, but simply a recognition that such overlaps exist. In this case, Eckert, who has substantial standing on the board, has personal ties to what will be a major player in both training and services, Synthesis.
According to property records, Synthesis purchased real estate in Oregon, a 124-acre property in Ashland that went for $3.6 million. ‘[N]estled among ancient oaks,” according to the Zillow listing, “the retreat center features a restored Lodge, 8 private rooms and commercial kitchen.” There are also “thirteen lovingly restored cottages, with Emigrant creek frontage, complemented with a circular garden, hiking trails connecting to old growth forests, and 1891 irrigation rights.”
Myles Katz, the co-founder of Synthesis, told Willamette Week that he plans to host training programs in Oregon as early as this year. Through a Public Records Law request, Motherboard obtained documents that show that Katz had applied to be on the Psilocybin Advisory Board, but was not selected.
Synthesis, and its employees, have previously been tapped for their expertise by the board. “[Synthesis has] been advisers in the sense that they have come in and shared protocols to the advisory board,” Nathan Howard, who assisted with the Measure 109 campaign, told Willamette Week. “They were on the ground floor, like a bunch of other people during the campaign.”
In June, an email obtained through a Public Records Law request showed that Eckert suggested a “Synthesis panel engaging with the full Advisory Board, as there are so many angles that their team of experts can speak to,” he wrote. Last September, two members of the Synthesis team visited the board. When Eckert introduced them, he said, “I really can't think of another group that's been more aligned and helpful to our effort in terms of sharing information with us helping to clarify the road ahead. Tons of appreciation for Synthesis.”
Aidan confirmed that Synthesis does plan to operate in Oregon, “both by conducting a training program for the state’s facilitator licensure as well as a service/retreat center.” When asked, Aidan said that for personal future relationships within the psychedelic community, it will be up to “each organization to decide how to best address disclosure and handling of conflicts,” and that “I trust that each organization (governing body. etc.) will design, implement and iterate on an appropriate set of guidelines for the communities that they serve.”
Disclosures of interest have multiple benefits. They assure the public that transparency is a priority, and that while some personal relationships can and do occur, those in positions of power will be open about what those are, and not let it—unconsciously or not—affect decision making or recommendations. For now, it will be up to the board to vote on the new conflict of interest language, and to verbally provide their disclosures at the next meeting, on March 23.
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