Near Death Experiences: A Medical Commentary​
Joseph W. Bergeron, M.D.
Near death experiences (NDEs) are more common than one might think, with a prevalence of 4% reported in the general population.[1] This suggests that millions of people worldwide have had experiences that could be classified as NDEs. Claims of near death experiencers can be astonishing and thought provoking.
NDEs and out-of-body experiences (OBEs) have not escaped the attention of the medical community. Some researchers propose that NDEs are neuropsychological symptoms stemming from brain malfunction. Yet, such hypotheses are unsatisfactory and unable to explain heightened perception and detailed descriptions reported by near death experiencers during clinical death. Medical studies have provided important observations. Still, many NDE features defy scientific explanation. This article will explore evidence that NDEs appear to be more than symptoms of brain malfunction during a near fatal event.
What are NDEs?
NDEs are unusual experiences that occur at the brink of death. NDEs share many common features. Reassuring descriptions include: Feeling peace, altered sense of time, being surrounded by light, being separated from the body, being in another world, having a life review, meeting deceased friends and relatives, among other descriptions.[2]
Negative NDEs also occur. Descriptions include: threatening apparitions, threats, screams, danger, threat of violence or torture, feeling cold, and sensing Hell.[3] The reported prevalence of negative NDEs among near death experiencers varies from 12% to 60%. What accounts for this variation among studies? Underreporting may explain the disparity. Negative near death experiencers are notoriously reluctant to talk.[4]
Medical causes for NDEs include: illness, suicide attempt, traumatic injury, cardiac arrest, child birth, dialysis, and overdose among other causes. Non-physiological factors may contribute to eliciting NDEs. Fear of death has caused NDEs in some reports, for example.[5]
NDE Theories
Some researchers believe NDEs are from physiological causes, such as the effects of cerebral anoxia or the psychological after effects of a death experience. Physician researcher and theologian Michael Marsh, believes NDEs and OBEs are neurophysiologically determined and are best explained as phenomena of a malfunctioning brain. Acknowledging that NDEs and OBEs often produce lasting transformative positive life-changes, Marsh feels this is not significant noting that changes in life priorities also occur in non-experiencers over time. Marsh correctly observes that the majority of cardiac arrest patients do not report NDE or OBE experiences, an observation he feels best fits a neurophysiological explanation rather than non-physiological hypotheses.[6]
Gary Habermas disagrees, “Marsh’s physiological explanations are incapable in themselves of building sufficient groundwork that automatically nullifies or eliminates any actual veridical evidence for NDEs”.[7] Near death experiencers often describe details they could not know by natural means. For example, during an OBE some describe details of their resuscitation, objects and activities far from their body, meet deceased friends and family, plus experience lifelong transformation of character and change of priorities. A sick-brain hypothesis fails to offer satisfactory insights for the many reports of this kind. Habermas observes that Marsh’s proposed explanations and criticisms are dismissive of the hundreds of NDEs that cannot be explained as Marsh theorizes.[8]
Concordant with Habermas’s critique, physician and NDE researcher Bruce Greyson notes:
…some NDErs report having encountered deceased relatives and friends, and some child NDErs describe meeting persons whom they did not know at the time of the NDE but later identified as deceased relatives from family portraits they had never seen before. Other experiencers report having encountered recently deceased persons of whose death they had no knowledge, making expectation a highly implausible explanation. These aspects of NDEs present us with data that are difficult to explain by current physiological or psychological models or by cultural or religious expectations.[9]
The Accuracy of Out-of-Body Experiences
OBEs during NDEs defy conventional scientific explanation. Dutch cardiologist and NDE researcher Pim van Lommel reported the OBE case of a comatose patient who accurately described medical staff performing cardiopulmonary resuscitation (CPR), details of the hospital room, and individuals present even though he remained unconscious during treatment.
van Lommel removed the upper dentures from a 44 year old man who was in a coma upon arrival to the emergency department. He placed the patient’s dentures in a cart. After 1.5 hours of resuscitation efforts the patient was stabilized and transferred to the intensive care unit. He remained comatose during treatment and for more than a week afterwards. Upon becoming conscious the patient told van Lommel while pointing to a nurse, “Oh, that nurse knows where my dentures are”. The patient reported having an out-of-body experience. He told van Lommel he was in the room and saw his body lying on the hospital bed. He described the room, persons present and their efforts at CPR even though he was comatose. He told van Lommel, ‘Yes, you were there when I was brought into the hospital and you took my dentures out of my mouth and put them onto that cart, it had all these bottles on it and there was this sliding drawer underneath and there you put my teeth”. He also said that he was afraid they would stop CPR and desperately tried to communicate to the medical team that he was still alive and that they should not give up doing CPR, but he was unable to contact them. The patient recovered and left the hospital one month later in good health and no longer afraid to die.[10]
Another well-known out of body experience is the story of Maria. Maria suffered cardiac arrest and was resuscitated at Harbor View Medical Center in Seattle, Washington. Later in the Cardiac Care Unit, she told a social worker her story. Maria reported being out of her body, watching medical staff working to resuscitate her. Maria then found herself outside the hospital looking at the Emergency Room entrance. On a third story window ledge, Maria saw a shoe. With great detail Maria described a man’s blue tennis shoe with a scuff on the left side. Maria said the shoelace was under the heel. At Maria’s continued insistence, the social worker searched for a shoe on the third story window ledge and found it precisely as Maria had described it.[11]
OBEs have been reported to occur in 45% of NDEs by some surveys. Two large retrospective studies looked at the accuracy of descriptions during an OBE. In one study, 97.6% of study participants described their experience as completely realistic. Of those, 23% investigated their observations after recovering from their life threatening event yet found no inaccuracies. In another study 92% found their observations during an OBE to be completely accurate when later investigated.[12]
Many NDE studies are retrospective, meaning the study relies on information from the memories of experiencers about their NDE or OBE. Do NDE memories become distorted with the passage of time? This does not seem to be the case. Experiencers describe their NDE memories as more vivid than memories of other life events, and recollection of NDEs has been shown to be reliable and unchanged for decades.[13]
Studies of Cardiac Arrest Patients
Cardiac arrest is when the heart suddenly and unexpectantly stops beating. Several prospective studies have monitored cardiac arrest patients after their recovery. A prospective study is a powerful research method that monitors subjects through time and can provide insight about events, after effects and long-term sequela.
Pim van Lommel reported a 2001 prospective study following patients that survived cardiac arrest. 82% had no recollection of a NDE. The absence of reported NDEs in such a large cohort is not fully understood, however prolonged CPR can induce memory loss. NDEs were noted to be less common in patients older than age 60.
18% of study subjects recollected NDEs of varied acuity. Among those, 30% had a tunnel experience going to a heavenly landscape or meeting deceased relatives. 25% had an out-of-body experience and communication with “the Light”. 13% had a life review, and 8% experienced the presence of a border from which they could not return if crossed. A minority described lucidity and the sensation of being outside their body observing medical staff working.[14] All patients in van Lommel’s study were noted to be clinically dead with no blood flow to the brain. In another prospective study of cardiac arrest patients, Parnia reported 9% of cardiac arrest patients had near death experiences with 13% among them described being separated from their bodies.[15]
Significantly, the duration of cardiac arrest, religious background, education, medication, physiological, psychological, and demographic factors were not found to be predictive for having an NDE.
Features of NDEs
Clear sensorium and lucidity are common features of NDEs. van Lommel poses the question:
how can an extremely lucid consciousness be experienced outside the body at a time when the brain has a transient loss of all functions during a period of clinical death, even with a flat EEG?[16]
An American study by physician and NDE researcher Bruce Greyson had similar findings to van Lommel’s Dutch study. 15% of cardiac arrest patients reported NDEs. Greyson notes:
no one physiological or psychological model by itself could explain all the common features of an NDE. The paradoxical occurrence of a heightened, lucid awareness, and logical thought processes during a period of impaired cerebral perfusion raises particular perplexing questions for our current understanding of consciousness and its relation to brain function. A clear sensorium and complex perceptual processes during a period of apparent clinical death challenge the concept that consciousness is localized exclusively in the brain.[17]
Concurring with van Lommel, Greyson concludes:
These features and the occurrence of heightened mental functioning when the brain is severely impaired, such as under general anesthesia and in cardiac arrest, challenge the common assumption in neuroscience that consciousness is solely the product of brain processes, or that mind is merely the subjective concomitant of neurological events.[18]
In a UK study, Parnia and Fenwick found 11% of cardiac arrest patients reported NDEs. Similar to the Dutch and American studies, lucidity and heightened sensorium were reported among experiencers during clinical death. In another UK prospective study 28% of cardiac arrest patients reported NDEs. Researcher Penny Sartori states: “according to mainstream science, it is quite impossible to find a scientific explanation for the NDE as long as we ‘believe’ that consciousness is only a side effect of a functioning brain.”[19]
NDEs in the Blind
Blind experiencers can see during NDEs. They describe intact sight with heightened visual acuity they may find challenging to describe.
Marta, a five year old blind girl described this experience after walking into a lake:
I slowly breathed in the water and became unconscious. A beautiful lady dressed in bright white light pulled me out. The lady looked into my eyes asked me what I wanted. I was unable to think of anything until it occurred to me to travel around the lake. As I did so, I saw detail that I would not have seen in “real” life. I could go anywhere, even to the tops of trees, simply by my intending to go there. I was legally blind. For the first time I was able to see leaves on trees, bird’s feathers, bird’s eyes, details on telephone poles and what was in people’s back yards. I was seeing far better than 20/20 vision.[20]
NDEs among the blind are comparable to NDEs among the sighted. Blind near death experiencers report: seeing lighted areas, colors, and deceased relatives for example.
NDE Investigators Ring and Cooper note:
as a whole our interviews with both NDErs and OBErs offered abundant testimony that reports of visual perception among the blind are common, that their impressions concern both things of this world and otherworldly domains, and that they are often clear and detailed, even in narratives furnished by those who have been blind from birth.[21]
Ring and Cooper emphasize the commonality of visual perception reports among the blind during NDEs and OBEs, suggesting that these experiences transcend the physical limitation of blindness.
NDE After Effects
At two and eight year follow up in van Lommel’s study, cardiac arrest near death experiencers had increased sense of purpose, love, and forgiveness. van Lommel notes of study participants:
We saw in them a greater interest in spirituality and questions about the purpose of life, as well as a greater acceptance of, and love for, oneself and others. The conversations also revealed that people had acquired enhanced intuitive feelings after a NDE, along with a strong sense of connectedness with others and with nature.
Changes of attitude appear to be permanent. In one study, Greyson followed near death experiencers for 20.5 years using a NDE research questionnaire called the Life Change Inventory (LCI).[22] Regarding LCI scores, Greyson notes:
Respondents reported increases after their NDEs in their appreciation for death, appreciation for life, spirituality, concern for others, quest for meaning or sense of purpose, self-acceptance, religiosity, and concern for social or planetary issues, and decreases in their concern for worldly achievement.
Greyson found no statistical difference in individual LCI scores after more than two decades.[23]
The Implications of NDEs
NDEs offer evidence of continuing individual consciousness after physical death. Drawing definitive theological conclusions from NDEs seems premature, however.
Physicians struggle with the spiritual implications of NDEs. van Lommel, for example, postulates an eternal consciousness external to the body but stops short of suggesting a specific religious corollary.[24]
It is noteworthy that NDEs have been described in the religious and cultural cosmology of many faith traditions. Hindus and Thai Buddhists report NDEs concordant with their respective cultures and religions, for example. NDEs in other cultures have many common aspects reported in Western NDEs, but may differ in some respects and emphasis. Tunnel experiences seem more common in Western reports of NDEs than in some cultures, for example.[25]
It is noteworthy that NDEs are fleeting interruptions in the death process. As such, NDEs neither provide full understanding of life after death nor provide a theological compass.
It is crucial to note that while NDE literature predominantly focuses on positive experiences, negative NDEs do occur, and are underreported by some estimates.[26]
Thomas Welch
Thomas Welch’s story is of particular significance. Welch is an outlier among near death experiencers because of his prolonged death. He was unequivocally dead and submersed under water for 45 minutes. Over 70 coworkers were eyewitnesses and participated in rescue efforts. Thomas Welch’s story is undeniable.
Thomas Welch was an atheist. He found himself in Hell standing next to the Lake of Fire. It was life-changing. Welch spent the rest of his life as a Christian evangelist telling others about what he saw while dead.
Conclusion
​
Physical illness, psychiatric illness, toxicity, anoxia, birth trauma, or psychological factors all fail to offer plausible explanations for NDEs. NDEs offer robust evidence of persisting human life after bodily death.
Thomas Welch’s story stands out among NDEs, being dead for 45 minutes. Moreover Welch’s story points to a biblical understanding of the death experience, specifically that Heaven and Hell do exist and that Jesus Christ is the only hope of salvation from eternal damnation.
From the Bible
For this is the way God loved the world: He gave his one and only Son [Jesus], so that everyone who believes in him will not perish but have eternal life. (John 3:16, NET)
For we know that when this earthly tent we live in is taken down (that is, when we die and leave this earthly body), we will have a house in heaven, an eternal body made for us by God himself and not by human hands. (II Corinthians 5:1, NLT)
Footnotes:​
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[1] van Lommel P. Getting Comfortable With Near-Death Experiences: Dutch Prospective Research on Near-Death Experiences During Cardiac Arrest. Mo Med. 2014 Mar-Apr;111(2):126-131. PMID: 30323518; PMCID: PMC6179502.
[2] Ibid, 27-29.
[3] Nancy Evans Bush, “Distressing Western Near-Death Experiences: Finding a Way through the Abyss,” in The Handbook of Near-Death Experiences, eds. Janice Miner Holden, Bruce Greyson, and Debbie James (Praeger Publishers, 2009), 69. see Table 4.1.
[4] Ibid, 66-70.
[5] Nancy Zingrone and Carlos Alvarado, “Pleasurable Western Adult Near-Death Experiences: Features, Circumstances, and Incidence,” in The Handbook of Near-Death Experiences, eds. Janice Miner Holden, Bruce Greyson, and Debbie James (Praeger Publishers, 2009), 20-25.
[6] Marsh, Michael N. 2016. "The Near-Death Experience: A Reality Check?" Humanities 5, no. 2: 18. https://doi.org/10.3390/h5020018
[7] Habermas, Gary R. “Evidential Near-Death Experiences.” In Minding the Brain: Models of the Mind, Information and Empirical Science. Edited by Angus Menuge, Brian Krouse and Robert Marks. Chapter 18. Seattle: Discovery Institute Press. Seattle. September 19, 2023. p. 230.
[8] Ibid, 228-229.
[9] Greyson B. Getting comfortable with near death experiences. An overview of near-death experiences. Mo Med. 2013 Nov-Dec;110(6):475-81. PMID: 24563994; PMCID: PMC6179792. 481.
[10] van Lommel P, van Wees R, Meyers V, Elfferich I. Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands. Lancet. 2001 Dec 15;358(9298):2039-45. doi: 10.1016/S0140-6736(01)07100-8. Erratum in: Lancet 2002 Apr 6;359(9313):1254. PMID: 11755611. 2041.
[11] Kimberly Clark Sharp, After the Light: What I Discovered on the Other Side of Life That Can Change Your World (iUniverse, Inc., 1995, 2003), 15-17. The shoe is seen in the reenactment as part of this news broadcast, Kim Clark Find the Tennis Shoe and Proves Near Death Experiences are Real. https://youtu.be/WPXK2Ls-xzQ?si=CsRuz9IkrN5CwZYm
[12]Long J. “Near-death experience. Evidence for their reality,” Mo Med. 2014 Sep-Oct;111(5):372-80. PMID: 25438351; PMCID: PMC6172100. 374.
[13] Ibid. 476.
[14] van Lommel, “Near-death experience in survivors of cardiac arrest,” 2041.
[15]AWARE—AWAreness during REsuscitation—A prospective study Parnia, Sam et al. Resuscitation, Volume 85, Issue 12, 1799 - 1805
[16] van Lommel, “Dutch Prospective Research on Near-Death Experiences,” 130.
EEG (electroencephalogram) is a measure of the electrical activity of the brain. One use of an EEG is to confirm brain death. A flat EEG indicates the brain has no mearusable electrical activity. https://www.mayoclinic.org/tests-procedures/eeg/about/pac 20393875#:~:text=An%20EEG%20records%20the%20electrical,the%20time%2C%20even%20during%20sleep. (accessed November 15, 2024).
[17] Greyson B. “Incidence and correlates of near-death experiences in a cardiac care unit,” Gen Hosp Psychiatry. 2003 Jul-Aug;25(4):269-76. doi: 10.1016/s0163-8343(03)00042-2. PMID: 12850659. 275.
[18] Greyson, “Getting comfortable with near death experiences,”. 481.
[19] van Lommel, “Dutch Prospective Research on Near-Death Experiences,” 129.
[20] Long, “Near-death experience. Evidence for their reality,” 375.
[21] Ring, K., Cooper, S. Near-Death and Out-of-Body Experiences in the Blind: A Study of Apparent Eyeless Vision. Journal of Near-Death Studies 16, 101–147 (1997). https://doi.org/10.1023/A:1025010015662
[22] Bruce Greyson, Kenneth Ring, (2004). The Life Changes Inventory—Revised. Journal of Near-Death Studies, 23(1), 41–54.
[23] Greyson B. “Persistence of Attitude Changes After Near-Death Experiences: Do They Fade Over Time?” J Nerv Ment Dis. 2022 Sep 1;210(9):692-696. doi: 10.1097/NMD.0000000000001521. Epub 2022 Mar 29. PMID: 35350036. 694.
[24] van Lommel, “Dutch Prospective Research on Near-Death Experiences During Cardiac Arrest,” 130-131.
[25] Kevin Williams. Near-Death Experiences in Thailand, August 31, 2024. https://near-death.com/near-death-experiences-in-thailand/ (accessed October 3, 2024). Kevin Williams. Near-Death Experiences and Hinduism. September 19, 2019. https://near-death.com/hinduism/ (accessed October 2, 2024). See also, Farnaz Masmumian, “World Religions and Near-Death Experiences.” In The Handbook of Near-Death Experiences, eds. Janice Miner Holden, Bruce Greyson, and Debbie James. (Santa Barbara, Praeger Publishers, 2009)
[26] Kevin Williams. What Near-Death Experiencers Say About Hell. July 5, 2024. https://near-death.com/what-near-death-experiencers-say-about-hell/ (accessed October 3, 2024)