Near-death experiences

What it is

Experiences reported by people who have been close to death — most often during cardiac arrest — with a recurring set of features.

The standard research instrument is Bruce Greyson's NDE Scale (1983), which scores sixteen elements. The commonest:

• A sense of peace and the absence of pain
• Separation from the body, sometimes with a view of it from outside
• Movement through darkness or a tunnel
• A light, frequently described as loving and as a presence rather than an object
• Meeting deceased relatives or unidentified beings
• A life review, sometimes experienced from the perspective of others affected
• A border or point of no return
• Return, often unwilling

Around ten to twenty per cent of cardiac arrest survivors report something of this kind.

Where it came from

The term was coined by Raymond Moody in Life After Life (1975), which collected anecdotes and sold enormously. Anecdote collected after the fact is weak evidence, and the serious work since has been prospective — identifying patients in advance, interviewing survivors systematically, and recording the clinical circumstances.

Pim van Lommel and colleagues published the first major prospective study in The Lancet in 2001: 344 cardiac arrest survivors across Dutch hospitals, of whom 18 per cent reported an NDE. Crucially, the reports did not correlate with duration of arrest, with medication, or with fear of death — which weakened several of the obvious physiological explanations.

Sam Parnia's AWARE study (2014) covered 2,060 cardiac arrests across fifteen hospitals in three countries. Of those interviewed, around nine per cent had NDE-type experiences and about two per cent reported explicit awareness with recall.

AWARE II (2023) added EEG monitoring during resuscitation, and reported bursts of near-normal brain activity — gamma, delta and theta — in some patients during CPR, in some cases up to an hour in, alongside recalled experiences.

How it is used

As the primary modern evidence in arguments for survival of death, and — from the other direction — as a well-defined target for neurological explanation.

What we can and cannot say

We can say the experiences are real, common and consequential. People have them, describe them consistently, and frequently report durable changes afterwards: reduced fear of death, altered priorities, and in some studies increased altruism. Those aftereffects are among the better documented findings in the field.

We can report the test that was designed to settle it, and what it found. The AWARE study placed shelves near the ceiling in resuscitation areas, bearing images visible only from above. If patients were genuinely observing the room from a position near the ceiling, some should have seen them.

Of the very small number of patients who both had an out-of-body experience and were in a room with a shelf, none identified an image. The sample is too small to be decisive and the study's authors say so — most arrests happened in rooms without shelves — but it is the cleanest attempt anyone has made, and it came back empty.

One case is cited constantly and deserves accurate handling. A patient in AWARE reported auditory awareness during a period of arrest, describing sounds that appeared to correspond to automated defibrillator prompts, allowing a rough timing. It is a single case, self-reported after the event, and it is not nothing and it is not much.

We can say the naturalistic explanations are plausible and individually incomplete. Cerebral hypoxia; hypercapnia — one study found elevated blood CO₂ associated with NDE reports; REM intrusion into waking consciousness, argued by Kevin Nelson; ketamine and NMDA receptor effects; temporal lobe activity; and the surge of coordinated gamma activity in the dying brain documented by Jimo Borjigin's group first in rats and later in a small number of human patients.

Each accounts for some features. None accounts for all of them, and van Lommel's finding that reports do not track arrest duration or medication is an awkward result for the simplest versions.

And we can say the cross-cultural evidence cuts against the universalist reading, which is the most useful finding here. NDE content varies by culture in ways that a single underlying encounter struggles to explain. Tunnels are rare in Indian accounts. Indian NDEs frequently involve being taken by messengers to a figure who consults a record, discovers an administrative error, and sends the person back — a bureaucratic frame that appears in Indian reports and essentially nowhere else. Thai accounts differ again.

That is exactly the pattern constructivism predicts: the experience takes the shape the person's culture supplies.

We cannot say what the experiences are. What can be said is that the question has been taken seriously, prospectively, in hospitals, for twenty-five years, and that the one experiment designed to produce decisive evidence produced none.

Further reading

• van Lommel et al., "Near-death experience in survivors of cardiac arrest" (The Lancet, 2001).
• Parnia et al., AWARE (2014) and AWARE II (2023), in Resuscitation.
• Allan Kellehear's cross-cultural work on NDE content.