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Attorney Kathryn Tucker.

Lucid News writes

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.