What is stopping psychedelic therapy in China? Jennifer Docherty on clinicians, family decision-making, and end-of-life care

Psychedelic therapy in mainland China and Hong Kong faces limited public knowledge, strict drug controls, stigma, and major cultural and clinical barriers, according to medical ethicist Jennifer Docherty. Her interviews with Hong Kong clinicians examine whether psilocybin-assisted care could eventually be used for end-of-life distress. Clinicians appeared more open to this application than to treatment-resistant depression because dying patients were perceived as less vulnerable to addiction and depression remains highly stigmatized. Docherty also found that family approval could be essential, particularly for elderly patients whose care decisions may be deferred to younger relatives. Limited palliative care infrastructure adds another challenge. Although esketamine is medically legal, psychedelics remain heavily restricted, and knowledge about them is low. Docherty suggests that Chinese cultural ideas about death, family authority, and possible references to psychoactive mushrooms in Daoist texts could shape future debates, but emphasizes that evidence from Chinese psychedelic use remains scarce.