Meet the Lawyer Leading the Federal Fight to Reschedule Psilocybin

As seen in The Other Magazine

For nearly four decades, attorney Kathryn Tucker has been one of the most influential voices in end-of-life rights in America. She helped build the legal framework for medical aid in dying, argued landmark cases before the United States Supreme Court, and spent her career pushing medicine and law to better serve people at the end of their lives.

Tucker has now turned her attention to another pivotal issue. As the federal government reconsiders whether psilocybin should remain a Schedule I substance alongside drugs like heroin, she is leading the legal effort on behalf of terminally ill patients and the clinicians who treat them. The reason? Psychedelic therapy works. Clinical research shows that a single guided psilocybin session can produce rapid and sustained reductions in anxiety and depression among people with advanced illness. For patients with only weeks or months left, access to that kind of relief is urgent.

In this conversation, Tucker explains the legal strategy behind the push to reschedule psilocybin, what the Ninth Circuit’s ruling has set in motion, and why she believes the next phase of palliative care must include psychedelic therapy. 

1) You’ve been called the architect of modern medical-rights law. How do you describe what you actually do?

For 37 years, I have engaged in advocacy to protect and expand the rights of people with terminal illness. When I first came into the field, my work focused on expanding end-of-life liberty to include the choice for a more peaceful death through medical aid in dying. That meant litigation, including taking cases to the United States Supreme Court, as well as extensive work in state legislatures. I also worked on improving pain and symptom management, ensuring patients are informed about all their options, and expanding those options. My work has always lived at the intersection of law and medicine at the end of life.

2) What led you to focus on psilocybin, and what did you see in the clinical research that convinced you it belonged in palliative care?

Even after decades of progress, I knew the palliative care toolbox was missing a crucial element: relief for non-physical suffering. When I saw the early clinical trial results showing that a single guided psilocybin session could bring immediate, substantial, and sustained relief from anxiety and depression in people with cancer, it was clear this was the tool we had been missing. The data showed both significant benefit and no evidence of risk to medically fragile patients. The therapy was very safe and very effective, and for people at the end of life, that is exactly what we need. That recognition led me to support the Oregon Psilocybin Services Act, but even if Oregon succeeded, federal prohibition would remain. So I began looking for a federal path to safe access.

3) What is Right to Try, and why did you recognize it as a pathway for psilocybin access? 

Right to Try laws recognize that dying people cannot wait for the long FDA drug-approval timeline. These laws allow access to certain investigational drugs before approval, as long as the drug has an IND at the FDA, has completed a Phase I trial, and remains under investigation. Psilocybin meets those criteria. I connected with Dr. Sunil Aggarwal, a respected hospice and palliative care physician who wanted to bring this tool to his patients. Together, beginning around 2020–2021, we approached the DEA to ask how it would accommodate Right to Try access. The DEA refused, which led us to sue.

4) What were you and Dr. Aggarwal hoping to achieve? 

I had known Dr. Aggarwal from previous work, and he was deeply engaged in exploring psychedelic-assisted therapy for his patients. He is exactly the kind of clinician who should be providing this therapy. Our goal was to safely bring psilocybin-assisted therapy to dying patients suffering from debilitating anxiety and depression. These are some of the most medically fragile patients, and they deserve expert care. The idea that a facilitator with only a high school diploma could serve these patients, as Oregon law permits, is inappropriate. This care belongs in the hands of trained palliative clinicians working within a medical treatment team.

5) You’ve sued the DEA several times. What did those lawsuits reveal about the agency’s handling of psilocybin? 

The DEA has consistently obstructed and delayed. Our first Right to Try lawsuit sought to require the agency to accommodate the law. Along the way, the DEA suggested that if Dr. Aggarwal wanted access, he could seek to move psilocybin off Schedule I, so we filed a rescheduling petition in 2022. We supported the petition with strong evidence, including the Johns Hopkins study explaining why psilocybin does not belong on Schedule I. The DEA summarily denied it. We challenged that denial in our third lawsuit, and the Ninth Circuit ruled that the DEA had acted improperly and remanded the petition to the agency. Still, the DEA delayed for months, which harms people with terminal illness who may die without receiving relief. After pressure and the threat of Freedom of Information Act litigation, the DEA finally confirmed in August 2025 that it had sent the petition to the Department of Health and Human Services (HHS).

6) Why does this shift matter? 

Because the DEA is a law-enforcement agency, it has no medical or scientific expertise. Under federal law, the DEA must send such petitions to HHS and the Food and Drug Administration for scientific and medical review. Those agencies have already made their views clear. The FDA has twice granted breakthrough therapy designation to psilocybin, a status given only when the agency determines that a therapy shows substantial improvement over existing treatments. Leaders at the FDA, HHS, the National Institutes of Health, the Office of the Surgeon General, and the Department of Veterans Affairs have all said publicly that opening access to psychedelic therapy is important and should be done as quickly as possible. This petition gives them a direct pathway to act.

7) How quickly could rescheduling happen?

President Biden requested a review in October 2022, and HHS issued its recommendation in August 2023, which took about ten months. The DEA did not issue a proposed rule until May 2024, followed by a 60-day comment period. That process is still not resolved. Psilocybin could move faster than cannabis because it already has two breakthrough therapy designations. But delay is deadly for people with terminal illness. Every month matters. 

8) If psilocybin moves to Schedule II, what would that mean for access and for clinicians treating dying patients? 

It would immediately allow access under Right to Try. Clinicians with Schedule II registrations could legally obtain psilocybin before FDA approval. The FDA already stated that it respects Right to Try, and sees its role as limited to modest data collection. Right now, Right to Try only applies to synthetic psilocybin because it is the form that has completed a Phase I trial. But a Phase I fungal trial led by Dr. Sue Sisley is underway. If completed, that form would also qualify. Rescheduling would finally allow clinicians to provide this therapy without risking their DEA registrations.

9) Ultimately, what is this fight about for you? 

I am a pragmatist. This work is about enabling clinicians like Dr. Aggarwal to access psilocybin for their dying patients so they can relieve debilitating anxiety and depression at the end of life. This therapy offers immediate relief. It belongs in the palliative care toolbox and should be provided by clinicians trained in palliative and hospice care. The goal is to ensure that no dying person endures suffering we now know how to relieve.