Experts in palliative care, oncology, psychiatry, and psychedelic-assisted therapy identified special considerations for using psychedelics near the end of life. They emphasized a non-medicalized setting, the potential to reduce preparation time, and the importance of addressing anxiety, depression, and spiritual distress. Dosing flexibility was recommended: low-to-medium doses for relational issues, higher doses for transcendental experiences. Therapists need knowledge of mystical states, existential aspects of life-threatening illness, and their own inner work. The findings provide a first step toward specific treatment recommendations for psychedelic-assisted therapy in palliative care.
Clinicians frequently encounter end-of-life dreams and visions (ELDVs) in patients with serious or terminal illness, but they feel underprepared to respond. A survey of 247 health care professionals found that participants perceived positive effects of ELDVs on patients more often than negative effects. The most commonly reported clinical challenges were lack of institutional protocols and lack of standardized diagnostic criteria, both rated significantly higher than other challenges. Participants endorsed multidisciplinary involvement and formal policy implementation. There is a need for structured training and institutional protocols to address ELDVs in clinical care.