Ketamine-caused Dissociation as a Meaningful Sign, Not Just a Side Effect: How Context Guides Ethical Medical Responsibilities

Ketamine-induced dissociation may represent an ethically significant signal influenced by various contextual factors.

• Dissociation is framed as a context-dependent phenomenon rather than simply a side effect or therapeutic feature.
• Patient vulnerability, dosing, and interpersonal support shape the significance of dissociative experiences.
• Two distinct trajectories of dissociative experience are identified: dysphoric, associated with psychological harm, and integrative, linked to emotional reappraisal.
• The proposed dual-trajectory model emphasizes the role of clinical context in determining outcomes.
• This model suggests the need for proportionate safeguards in clinical practice rather than outright exclusion of dissociative experiences.

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