Feuille de route pour un accès équitable et une utilisation responsable de la psychothérapie assistée par la psilocybine dans les soins palliatifs
Mots-clés :
Psilocybine, détresse existentielle, soins palliatifs, accessibilité, implantationRésumé
La psychothérapie assistée par psilocybine représente un ajout prometteur aux interventions de soins palliatifs, pouvant améliorer la qualité de vie en soulageant la détresse existentielle. Malgré sa sécurité et son efficacité, cette thérapie demeure limitée au Canada, soulignant la nécessité d’en améliorer l'accès pour atténuer la souffrance liée à des maladies potentiellement mortelles. Cependant, d'importantes questions subsistent quant à la manière d'intégrer la psychothérapie assistée par psilocybine dans les cadres de soins existants, de surmonter les défis réglementaires et d'assurer un accès équitable à tous les patients. Ces questions sans réponse mettent en lumière la complexité de l'élargissement de l'accès et la nécessité d'approches réfléchies et éclairées pour sa mise en œuvre. Pour y remédier, l'équipe P3A (Psilocybine en fin de vie : Audace, Acceptabilité, Accès) a organisé un Forum le 22 mars 2024 à Québec, afin d’explorer les étapes concrètes pour une utilisation responsable et un accès équitable à la psychothérapie assistée par psilocybine.
Au total, 57 personnes ayant des connaissances en soins palliatifs, dont des associations professionnelles et de patients, des patients, des professionnels de santé, des chercheurs et des décideurs politiques, ont assisté à l'événement, qui comprenait des séances plénières et des ateliers en petits groupes. Cet article propose seize recommandations sur six grands thèmes préalablement identifiés : 1) Admissibilité des patients et équité, 2) Encadrement réglementaire et respect de l'autonomie, 3) Aspects logistiques et organisationnels, 4) Éducation et formation professionnelle, 5) Sensibilisation et information du public, et 6) Recherche. Les éléments et recommandations discutés dans ce document peuvent offrir des perspectives pour élargir l'accès à la psychothérapie assistée par psilocybine dans d'autres pays, en particulier dans un contexte global où des barrières similaires à l'accès aux soins existent.
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© Michel Dorval, Sue-Ling Chang, Houman Farzin, Olivia Nguyen, Jean-François Stephan, Diane Tapp, Pierre Deschamps, Yann Joly, Florence Moureaux, Robert Foxman, Marianne Masse-Grenier, Jean-Sébastien Fallu 2026
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