Ethics and Influence of Psilocybin Use in Palliative Care for Anxiety About Morality on Patient-Clinical Decision Making

Ms. Vipusaayini Sivanesanathan1

1Queen’s University, Canada

Palliative care aims to improve the quality of life of patients with serious and often life-threatening diagnoses by addressing (and hopefully alleviating) the physical, psychosocial and spiritual symptoms of patients. While modern medicine can easily aid in the management of physical suffering, addressing the psychosocial and spiritual suffering of patients has proven to be significantly more complex. As patients approach End of Life, the anxieties and existential dread produced by the fear of dying intensifies psychosocial and spiritual suffering. However, researchers have found that Psilocybin, a naturally occurring hallucinogen, can be utilized to address the psychosocial and spiritual suffering of EOL patients. While research on how psilocybin brings about such transformative experiences is still in progress, some studies now show psilocybin is able to chemically alter brain function in way that affects a person’s ego or sense of self and can lead to a phenomenon called ‘Ego Death’ or Ego Dissolution. In this project, I explore the transformative effects of psilocybin on one’s ego and concept of self to determine its implications on free will and decision making in clinical contexts. With particular focus on instances of psilocybin therapy and medical assistance in dying, I argue that current clinical research on psilocybin therapy for palliative care overlooks the possible problematic implications to may have on patient decision making.  Further, I offer directives to create more ethical guidelines to be utilized when determining candidacy for psilocybin therapy.


Vipusaayini Sivanesanathan (Vipushi) is a MA Candidate in the department of Philosophy at Queen’s University. Her main research focuses include a range of topics in bioethics, specifically philosophy of psychiatry, health equity, the role of religious belief in medicine and the ethics of the doctor-patient therapeutic alliance.

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