Responding to existential distress at the end of life: Psychedelics and psychedelic experiences and/ as medicine

Psychedelic medicine is re-emerging as a therapeutic modality, particularly for terminally ill patients experiencing existential distress near the end of life. This distress involves demoralization and a sense of meaninglessness, impairing one's ability to create or realize meaning. Psychedelic experiences, in contrast, often produce profound and lasting meaning. The essay examines whether meaning is a proper concern for healthcare and highlights implications of psychedelic medicine. It concludes by urging bioethics to recognize itself as a meaningful cultural discourse shaping the future of medicine, psychedelics, and what it means to be human.

Study at a glance

Abstract

Abstract This essay engages with the (re)emergence of psychedelic medicine and the idea of psychedelics drugs and the experiences they induce as a developing therapeutic modality. It does so in the context of the provision of psychedelics to terminally ill patients experiencing existential distress as they approach the end of their lives. Reflecting on such suggestions facilitates an examination of a specific aspect of psychedelics and/ as medicine (or palliative care), namely questions of meaning and meaninglessness. Understood as impacting one’s ability to make or realise meaning in life, existential distress commonly entails a degree of demoralisation. In some cases, individuals can be thought of as inhabiting (and being inhabited by) a sense of meaninglessness. In contrast, the experiences psychedelics seem to induce are often imbued with a great deal of meaning, a sense of which seems to continue long after the psychoactive effects of such drugs have ceased. Whilst briefly considering whether or not meaning can properly be thought of as a matter for healthcare or a medical concern, this paper seeks to highlight some of the implications that the advent of psychedelic medicine might have. By way of a conclusion, I enjoin bioethics in recognising itself as a meaningful cultural discourse that is implicated in the future(s) of medicine, psychedelics and being human.