<p>Psychedelics are increasingly being studied and used in clinical and therapeutic contexts, prompting renewed ethical and regulatory debate. Claims of psychedelic exceptionalism—whether “negative,” portraying psychedelics as uniquely risky and thus requiring stricter oversight, or “positive,” portraying them as uniquely beneficial and thus exempt from ordinary ethical rules—have become common. In a recent article, we argued that while psychedelics may involve distinctive constellations of features, these do not justify fundamentally new ethical standards. In response, Daniel Villiger and, separately, Edward Jacobs, agreed that psychedelics should not be exempt from existing ethical standards (what Villiger calls Type A ethical exceptionalism) but suggested that their distinctive qualities may still warrant unique applications of those standards (Type B ethical exceptionalism). For example, Villiger argues that psychedelics possess certain features that do not, in his view, exist anywhere else in medicine, including the unpredictability and emotional intensity of the psychedelic experience, alongside a temporary lowering of psychological defences, leading to heightened suggestibility and sensitivity to context. He argues that such allegedly unique features call for exceptional policies around how existing ethical standards are to be applied—Type B exceptionalism. In this essay, we argue that the features Villiger identifies are only ethically significant insofar as they raise concerns about (<i>inter alia</i>) autonomy and vulnerability. But these concerns arise also in other medical settings. As such, policies addressing these issues would apply more broadly to other medical interventions raising similar concerns. Villiger thus fails to establish a genuine case for psychedelic ethical exceptionalism, even of the more modest, Type B variety.</p>