Why Psilocybin Should Be Rescheduled ASAP for EOL Care

What I share here might activate some big responses — that’s okay. I’m sharing my thoughts and experiences with the intention of just that — sharing my thoughts and experiences — hopefully in a way that feels gentle enough to be unbiasedly considered.

If Medical Aid in Dying, (the doctor prescribed medication to end the life of someone who is terminally ill) is legal in some states, so too should psilocybin assisted therapeutic modalities that may allow people to live a better life — while they are living. Though I do not take a formal stance for or against Medical Aid in Dying, as a death doula I have assisted with, and talked to, many families and individuals about the process and the options for end-of-life care. Also, as a holistic non-medical caregiver I help with all kinds of alternative therapeutic modalities (sounds, sensations, herbs, mantras, visualization practices) to help ease anxiety and existential stress and fears.

In an ideal society, death would be so much a part of living a healthy life that we would not be surprised or frightened when “our time” came. Of course many, or most, do not want to die and it doesn’t feel good to have to do something we don’t want to do. Imagine a society where the dying are not hidden away as if something were wrong with them that needed to be fixed, or at least kept out of view so that the regular speed of production could continue, dying, and deathing, could be embraced and perhaps even considered a rite of passage to look forward to. In this society, we would grieve in community, in the open, which would serve to demystify the wholeness of how deaths impact our society — not just individuals.

We are far from this imaginary death-literate, grief-embracing society.

Often people will feel ashamed or embarrassed by a particular diagnosis. Many choose not to make end-of-life arrangements — not just avoiding doing paperwork for organizing records — but also putting off saying “I’m sorry” or “I forgive you” or “I’m proud of you.” For some, going through menopause can feel like they’re being kicked to the curb — out of the pool of the “young and hot” or at least fertile. Becoming urinary or fecal incontinent is not something we like to freely talk about — working in residential care it was not uncommon for residents to be shocked that others in the facility were also incontinent! Often we don’t want to admit that we’re going grey and go to great measures to hide this sign of age. In short, many of us do not age well publicly, we don’t go through the dying process publicly but we can’t really help it when we die. Our names go in the paper and then the whispers of “illness” and “hospice” become regular volume and our death “comes out” (though, maybe not the cause of death.) At which time, the norm is to grieve within an appropriate amount of time before “moving on.” (Not to say all things should be made public — but it sure feels nice to feel less alone.)

What is missing, so blatantly, is everything else. And I do mean, everything else. The wind, the trees, the earth, the solar system, the raw elements of existence. We are so caught up in how we look, how we present ourselves, the level of our productivity and the sharpness of our memory, that we reduce ourselves to mere flesh factories — depriving ourselves of being anything beyond mundane humans. We think not of our purpose, our inspirations, that the very iron in our blood came from the stars and of all the things that we don’t know. Instead we take comfort in only a + b = c.

For these reasons, the idea of dying knocks the wind out of us. We feel abandoned- like life no longer wants us. We are petrified of where we will “go.” And, it doesn’t feel like there is anyone to talk to about our thoughts and feelings.

For some, religion will offer a degree of, or total comfort. Others report after near death experience a feeling of great oneness, love, unity, and comfort. Those who work with the dying sometimes say that the one dying has visitations from deceased relatives, talks about angels and that helpful beings are assisting them “across.” These anecdotes are often downplayed by scientists and skeptics who report that the stories are simply results of the brain malfunctioning or shutting down. Still, those that report NDEs often say they are “changed for life” for the better.

In an ideal society, we would not need to come close to death or be actively dying in order to feel a comfort of Oneness. We could relate openly to the wholeness of the life-death continuum.

Therapists, social workers, grief counselors, chaplains, hospice workers, death doulas work with individuals who are dying to help reduce their anxiety and existential dread. All kinds of therapies and tools are used. One of the most recent on the block is psilocybin for cancer patients. Although the medicinal and ceremonial usage of it is ancient, the clinical application is new. These studies differ from the parties and festivals where mushroom trips were somewhat common before 1970 and instead are carefully weighed and analyzed in therapeutic settings. There are certain factors that eliminate one from being able to partake in therapeutic psilocybin such as a family history of schizophrenia or current use of SSRIs, but these factors along with intention, proper dosage and setting are carefully measured by professionals. The results are staggering. Dr Anthony Bossis who is a front seat spokesperson and researcher on therapeutic psilocybin in EOL care reports that participants in the studies are using phrases like, “I’m not afraid to die anymore” and “I can feel my family’s love — it’s not just that I love them, I can feel them loving me.”

Studies are actively being conducted in Universities across the United States such as Johns Hopkins and NYU in an effort to bring psychedelic assisted therapy into the therapeutic rotation because of its great success. Although, it seems years away from being legalized as a form of end-of-life care for those experiencing anxiety, I don’t think it’s a wild idea to imagine it becoming mainstream much sooner. Because this therapeutic modality is only available to those who have a six month or less diagnosis, the studies should move much faster. Unlike use of MDMA in therapy for trauma which is due to be rescheduled as a therapeutic drug by the end of 2023, in end-of-life care, we do not need long term results from studies. With end-of-life care, time is of the essence — the sooner the individual can feel relief from anxiety and feel they are safe in their dying process, the better. In fact, I think this should have been made legal in end-of-life care yesterday.

In Vermont Medical Aid in Dying was made a viable option to “hasten death” in 2013. (Some do not agree with the phrase “hastening death.” For me, I feel it is what it is.) Today, in the United States there are ten states and the District of Colombia where this is an option. It remains controversial. If MAiD is available to those who are privileged enough to have access to this concoction to end their life, then why would people not have access to something that is proven to greatly enhance the quality of living life? It begs the question, would those who wish to end their lives because of anxiety or a desire to be in control, benefit more greatly from alleviation of the anxiety and therefore not partake in the life-ending medication? Not to say that all who are privileged enough to get the medication ingest it — sometimes, just having the option feels like a bit of control and comfort. But Trusting is part of what is also experienced in psilocybin assisted therapy sessions. Psilocybin (and around the world other forms of psychedelics) has been used for healing delusions of separation (what so often causes us suffering and anxiety at end of life) as far back as history has been recorded.

I have a great many hesitations and questions around legal entities and doctors having say and control over matters involving one’s own life and death. But many of us agree that people deserve access to medicine that has the ability to improve quality of life — in this case, a medicine that often times with only one therapeutic dose can heal decades of trauma and, it chemically impossible to become addicted to. Psilocybin has fewer negative side effects than any doctor prescribed anti-depressant and anti-anxiety medication. In fact, with proper screening, dosage and setting, there are no drawbacks appearing in the studies.

From a whole-system, healthy society viewpoint, when one individual forgives, or apologizes or speaks something painful exposing a vulnerability, it can spark another to do the same, thus improving our society’s understanding of shared grief and pain. When people are dying, they are confronted with the opportunity to gain and share tremendous insight if they can see and feel past their anxiety or trauma and before they lose the ability to communicate. Psilocybin as a therapeutic modality can allow the terminally ill to heal themselves on a level beyond what we are able to fix or mask with modern medicine, with the possibility of healing others in their family and community.


I have so much more to say as each one of these points could spider web into many other subjects. For now, this should be enough to start some conversations. Don’t stop here! Check out the links below.





Author of Death Nesting and Ancient Death Doula Series. Feeding Your Demons Facilitator. Community Deathcare teacher. Mama of three. www.annemariekeppel.com

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Anne-Marie Keppel

Anne-Marie Keppel

Author of Death Nesting and Ancient Death Doula Series. Feeding Your Demons Facilitator. Community Deathcare teacher. Mama of three. www.annemariekeppel.com

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