Easing End-of-Life Distress: Should Psychedelic Therapy Be Part of Palliative Care in the UK?
By Professor Joanna Neill, Dr Laura Downey, and Professor Muireann Quigley
Facing a terminal diagnosis is one of life’s most difficult challenges. Beyond the physical burden of illness, patients often experience anxiety, depression, insomnia, and existential distress – a sense of suffering that touches mind and body alike. These mental health struggles are common but often hard to manage in palliative care, leaving some patients struggling to cope with the emotional realities of the end of life.
In recent years, a novel form of therapy has shown promise in addressing this distress: psychedelic-assisted psychotherapy (PAP). This approach combines psychedelics – such as psilocybin, the active compound in ‘magic’ mushrooms – with structured psychological support. The therapy works by encouraging neuroplasticity, enabling the brain to rewire itself and helping patients achieve breakthroughs in understanding and processing their emotions. Early clinical studies suggest that PAP can improve mood and quality of life in some patients facing terminal illnesses.
Traditional options for managing existential distress, such as antidepressants, psychotherapy, and mindfulness practices, often leave patients wanting. Research from The University of Manchester, currently under review, highlights that some patients experience delays of up to three months to access treatments. Others describe conventional approaches as insufficient – they may numb symptoms but do not help patients come to terms with their diagnosis or find meaning in the time they have left. For these patients, psychedelic-assisted therapy may help patients approach the end of life with greater acceptance and peace.
Across the globe, some countries have already recognised the potential of PAP in palliative care. Since 2022, Canada has allowed patients with serious or life-threatening conditions to access psilocybin through its Special Access Programme. Australia has legalised certain uses of psychedelics for mental health conditions, while Germany and the Czech Republic have approved compassionate use for treatment-resistant depression and medical psilocybin, respectively. The European Union has invested over €6.5 million to study psychedelic therapy for people with progressive, incurable illnesses. Public opinion in the UK also reflects strong support: 68% of respondents in a recent survey back legal change to allow terminally ill patients access to PAP.
Despite this evidence and international momentum, the UK remains restrictive. Research is tightly controlled, and the Misuse of Drugs Act classifies psychedelics in a way that makes therapeutic access almost impossible, leaving patients without additional options that could help manage their distress.
The Terminally Ill Adults (End of Life) Bill, currently progressing through Parliament, has sparked wider debate about the quality and scope of palliative care. While the Bill itself focuses narrowly on doctors’ duties, it prompts us to ask how well the UK addresses the psychological and existential needs of terminal patients. There is now an opportunity to consider whether psychedelic-assisted therapies should be integrated into palliative care, offering patients additional, evidence-based options for easing distress.
Several key questions arise as the Bill moves forward: Should terminal patients be offered treatments such as PAP that have demonstrated benefits in clinical trials? Why does the UK lag behind Canada, Australia, Germany, the Czech Republic, and EU initiatives in providing compassionate access? Can the government justify keeping promising therapies out of reach because of the Misuse of Drugs Act? Are current palliative care services sufficient to tackle existential distress? And should the UK establish a pathway for compassionate access, aligning policy with public support and international examples?
Importantly, introducing PAP would not be about replacing existing treatments. Antidepressants, counselling, and mindfulness would continue to play a role, but PAP could fill a critical gap – addressing the emotional and spiritual suffering that traditional care sometimes misses. For some, it could mean facing the end of life with acceptance, perspective, and even fulfilment, rather than fear and anxiety.
Evidence, international experience, and public sentiment suggest that the UK is at a crossroads. Parliament has an opportunity to modernise palliative care and give doctors the tools to support patients in every dimension of their suffering – mind, body, and spirit. By exploring PAP as part of end-of-life care, the UK could offer terminal patients therapies that truly matter and bring care in line with the compassion and dignity patients deserve.
As discussions continue around the Terminally Ill Adults Bill, the challenge is clear: ensure that patients can access every available, evidence-based therapy to ease their distress. Psychedelic-assisted psychotherapy may not be a magic cure – but for many facing the end of life, it could be the difference between despair and a final chapter lived with peace, clarity, and humanity.
