The Attorney Leading the Fight to Bring Psychedelics to the Dying
Kathryn Tucker, the nation’s leading end-of-life rights attorney, keeps a figurine of a distraught jester on her desk. Each time a federal agency finds a way to stall her pursuit of bringing psychedelics to the dying, she turns its face of theatrical despair toward whoever she’s speaking to. The gesture is both comic and tragic—the humor of a woman who has spent nearly forty years negotiating with bureaucracy. In her world, delay is never neutral. It is measured in suffering.
“The Drug Enforcement Administration (DEA) obstructs and delays,” she said. “But my clients don’t have the luxury of time.”
For Tucker, delay is mortal. Her clients are terminally ill, people in hospice care, often weeks from death, seeking legal access to psilocybin, the psychoactive compound in “magic mushrooms.” In tightly controlled studies at Johns Hopkins and New York University, a single guided session with psilocybin has brought what Tucker calls “immediate, substantial, and sustained relief” from the anxiety, depression, and existential terror that shadow the end of life. Yet under federal law, psilocybin remains a Schedule I substance, defined in the Controlled Substances Act as having “no currently accepted medical use in treatment in the United States.”
The absurdity of that contradiction—“absurd” being the word used by Johns Hopkins researcher Matthew Johnson—has made Tucker the unlikely general of a moral legal revolution. She is suing the federal government, again, not to secure a right to die but a right to peace before death. In the process, she has exposed a deeper flaw in the system: a government built to deliberate without a mechanism for mercy when time itself becomes a patient’s most finite resource.
“When you are talking about people with terminal illness, they only have a short time to live,” she says. “The delay means that people are left with debilitating anxiety and depression. They don’t get relief, and they die when they could have had relief. It is justice delayed; it is justice forever denied for that population.”
This is the axis of Tucker’s life: a belief that the law should serve mercy, and that time itself must be treated as a form of justice.
The Architect of Medical Rights Law
Tucker is one of the most influential end-of-life litigators in the United States. For nearly four decades, she has been defining what medicine can and cannot do for the dying.
“For thirty-seven years, I have engaged in advocacy to protect and expand the rights of people with terminal illness,” she told me. “All of that was right at the intersection of law and medicine at the end of life.”
Her resume reads like a modern history of death rights. For two decades, she led legal advocacy at Compassion & Choices, the nation’s largest end-of-life care organization. She served as lead counsel in Washington v. Glucksberg and Vacco v. Quill, the twin 1997 Supreme Court cases that asked whether a dying person’s choice for a peaceful death could be considered a constitutionally protected liberty. The Court said no, but it left the door open: states could decide for themselves. Through that opening came Oregon, then Washington, then California, and now nearly a dozen others that have legalized what became known as “death with dignity.”
In 2001, Tucker won Bergman v. Chin, a California jury verdict that found a physician’s failure to treat a dying patient’s pain adequately constituted elder abuse. In its aftermath, she drafted and helped enact Assembly Bill 487, a landmark California law requiring physicians to complete training in pain management and end-of-life care—a model later replicated in other states. In the process, she built an entire subfield of law—end-of-life liberty—that scarcely existed before her.
Yet after decades of progress, she saw what the law still could not touch. “We had improved pain care, improved choice,” she said. “But in palliative care, medicine that focuses on improving quality of life for people with terminal illnesses, there was still a gap. What was missing was a tool to relieve non-physical suffering.”
That gap is what ultimately led her to psilocybin.
The Missing Tool
Starting in the mid-2010s, clinical research on psychedelics and mental health began to reemerge after decades of dormancy. During a pioneering clinical trial at Johns Hopkins, patients with advanced cancer received a single guided session with psilocybin. The findings surprised even the researchers: immediate drops in anxiety and depression, with effects that lasted for months.
Tucker recognized a clinical breakthrough. “The results are incredible,” she said. “And that’s why we’re working so hard to bring it to the bedside.”
She calls psilocybin the “missing tool” in end-of-life care, because it changes how people meet death. Psilocybin softens the existential fear of dying that morphine can’t touch.
After years spent securing the right to die, she turned toward a new frontier: the right to live one’s final days with peace of mind. “I’m a pragmatist,” said Tucker. “This multi-pronged, multidimensional advocacy has all been driving toward one objective: allowing expert clinicians to access psilocybin to relieve debilitating anxiety and depression in patients who are dying of cancer. This care should be fully integrated into the medical treatment of people with advanced illness.”
From State Progress to Federal Prohibition
In 2020, Oregon became the first state to legalize psilocybin services under Measure 109, an initiative Tucker helped shape by bringing voices from the hospice and palliative care community into the campaign. Even as she celebrated the victory, she knew it was not enough.
“It is a federal crime,” she says, “to manufacture, possess, distribute, or touch psilocybin outside of tightly controlled research.” State laws can only reach so far; they cannot neutralize federal prohibition.
Tucker then turned her attention to Washington, D.C., and the web of agencies that control the legal fate of medicine. The Food and Drug Administration (FDA) had already recognized psilocybin’s promise, granting it Breakthrough Therapy Designation twice for treatment-resistant depression. The designation is reserved for experimental treatments that demonstrate substantial improvement over existing options, a signal that the agency views the drug as both safe and potentially transformative. The DEA, however, continues to classify psilocybin alongside heroin as a substance with “no accepted medical use.”
That contradiction became her next battleground.
Right to Try
The opening came through a law with a humane promise: the Right to Try Act, passed by Congress in 2018. The act allows terminally ill patients to access investigational drugs that have cleared initial safety trials but have not yet received full FDA approval.
“Dying people don’t have the time to wait for new drug approval to wend its way to completion,” Tucker explains. “These laws are about respecting the reality that this population should be allowed access to investigational drugs before it is too late.”
Nothing in the statute excludes Schedule I substances, and psilocybin meets every requirement. On paper, patients should already have been able to try it.
In 2021, Tucker and Seattle palliative care physician Dr. Sunil Aggarwal petitioned the DEA for a legal pathway allowing dying patients to receive psilocybin under the Right to Try Act. The DEA denied the request that same year, asserting it could not authorize access while psilocybin remained a Schedule I substance.
In early 2022, Tucker then did what she has always done when the law stalls. She sued, then sued again.
“Some of the leading scientists in the field have said that placing psilocybin on Schedule I is absurd,” she said. “Yet here we are, having to sue the DEA several times just to make it follow its own process.”
For Tucker, the cases were never just about psilocybin. They were about the fault line between compassion and control. Who gets to decide how suffering is relieved—the physician or law enforcement?
The Distance Between Law and Mercy
The first court dismissed her petition on procedural grounds. The judges said the DEA had not yet made a “final” decision. Tucker regrouped. She filed Freedom of Information Act (FOIA) requests, resubmitted evidence, and began building a coalition of physicians, ethicists, and attorneys general from several states.
“The DEA has several behaviors we’ve observed,” she says dryly. “One is to obstruct, and the other is to delay. We shouldn’t have needed to sue the DEA. We should not have needed to threaten FOIA as a prod. But this could be a very seismic moment in drug policy reform.”
Persistence has always been Tucker’s method. In February 2022, she filed a petition to reschedule psilocybin under the Controlled Substances Act. The DEA summarily denied it, prompting another lawsuit. In October 2023, the Ninth Circuit Court of Appeals ruled that the agency had mishandled the petition and ordered it to reconsider. The victory was procedural, but symbolically it marked the first federal acknowledgment that the government’s treatment of psilocybin might be irrational.
In August 2025, the DEA confirmed that her petition had been transmitted to the Department of Health and Human Services (HHS) and the FDA for scientific and medical evaluation—the step required before any formal change in classification can occur. For the first time, psilocybin’s fate rested with scientists rather than law enforcement.
The Right to Peace
Tucker has watched clients die while waiting for answers, and each loss becomes part of her case file. Each loss, she says, is a reminder that the system moves more slowly than the people it serves.
“Nobody wants to imagine a dying person living with unrelieved emotional suffering,” she adds. “Everyone can agree that good relief of symptoms is essential. And this tool, psilocybin-assisted therapy, relieves anxiety and depression with immediate, substantial, and sustained effect.”
In Tucker’s view, autonomy is not only the freedom to end life but the freedom to face death without fear.
The Long Road to Mercy
Tucker believes rescheduling will happen—perhaps within a year or two. When it does, psilocybin would likely move to Schedule II, alongside morphine and fentanyl. Physicians with the appropriate license could prescribe it, and under Right to Try, terminally ill patients could access it even before full FDA approval. It would mark the first time a psychedelic entered mainstream medical use in the United States since the 1960s.
It would also vindicate Tucker’s argument: that the law can evolve toward compassion if someone keeps litigating the moral truth of suffering.
“We may not need to resort to litigation again,” she says. “It is possible that we will smoothly transit the proper course here, and that the DEA will take the next step of issuing a notice of proposed rulemaking. That’s the moment we are preparing for, and it’s really exciting.”
The Waiting Room
Tucker lives in Washington State, near the mountains and rivers she loves. Much of her psilocybin litigation has been pro bono, and the rest low bono, sustained by philanthropists who give through the National Psychedelics Association Foundation, the fiscal sponsor for this work. When I asked what keeps her going, she laughed softly. “Probably stubbornness,” she said. “And maybe a sense of justice that never goes away.”
She hopes she will not have to hold the jester up again. Yet she keeps it close, just in case.
Tucker’s efforts now rest with federal health officials. The FDA and DEA review could take months, possibly longer, but it represents the furthest advance yet in her years-long campaign to bring psilocybin into legitimate medical practice. For Tucker, the possibility is enough: “We’re getting closer,” she said. “This isn’t theoretical anymore. It’s within reach.”