This presentation was part of the “Psychedelics in Context: Politics, Epistemics, and Ethics” conference, held in November 2024 at Harvard Divinity School. Here I analyze the ethical complexities surrounding the use of Indigenous medicines, focusing on power dynamics and epistemic hierarchies that shape their integration into Western frameworks. Drawing on Foucault’s concept of power and the notion of epistemicide proposed by Boaventura de Souza Santos, I analyze how Indigenous peoples perceive ethical practices and their different cosmologies concerning medicinal traditions, contrasting these with Western commodification. The discussion critically examines who holds authority over these sacred knowledge systems and who benefits from their use and commercialization. It also shows how Indigenous cosmologies offer alternative paradigms for understanding and engaging with these medicines. The focus is on advocating for approaches that respect Indigenous sovereignty, protect traditional knowledge, and promote equitable benefit-sharing and reparative justice.