Near-death experiences

A near-death experience (NDE) is the perception reported by a person who nearly died or who was clinically dead and revived. They are somewhat common, especially since the development of cardiac resuscitation techniques.

The experience often includes an out-of-body experience.

A number of more contemporary sources report the incidence of near death experiences as:

  • 17% amongst critically ill patients, in nine prospective studies from four different countries.
  • 10–20% of people who have come close to death.

Estimates vary, with some suggesting that as many as 10 to 20 percent of people who have been declared dead have had a near-death experience. In one study of patients who had survived cardiac arrest, 9 percent of survivors who could be interviewed reported a NDE.

Their descriptions of this experience are an increasingly popular topic for talk shows, books, television news and magazines. It is becoming almost a fashion and many stars chose to have their own N.D.E instead of the real one.


These experiences follow the general same scenario:

  1. The patient lie on a bed usually in an hospital, he can hear someone referring to his death like the classic “We’re losing him”. He then feel he leaves his own body, and usually remembers the vision of his body somewhere below.
  2. He is then drawn into what is described as a tunnel, a passageway, a portal, and toward a mystical, powerful light at the end of a tunnel.
  3. When he comes out, there is a very brilliant, warm, loving and accepting light. People at this point describe just amazing feelings of peace and comfort. In this light they say that relatives or friends of theirs who have already died seem to be there to help them through this transition.
  4. Another thing they will often tell us is that at this point they are met by some religious figure. Christians say Christ, Jews say God or an angel. This being, in effect, asks them a question. Communication does not take place through words as you and I are now using, but rather in the form of an immediate awareness: “What have you done with your life? How have you learned to love?” .
  5. Patients can also experience vivid experiences of reviewing their lives, either as a series of episodes or in a flash. Their life is displayed around them in the form of a full-color, three-dimensional panorama, and it involves every detail of their life, they say, from the point of their birth right up to the point of this close call with death.
  6. At some point they reach a boundary and return to life, with or without a choice being offered. The return to the body is often recorded as a blank, though others record this part of the experience as painful.


People who have undergone near death experiences often report feeling literally revitalized by the event. They may approach life with a greater awareness of its value, or with a changed perspective about the importance of relationships as compared to mere material gain. No more fear of death, renewed commitment to loving others, living in the present and not worrying about the future and a great sense of contentment are the usual attitudes they adopt. And in some cases, the person may perceive that they have gained intuitive abilities, such as seeming to know what someone is thinking or feeling.

These experiences are about near-death - not actual death. People whose physical functions have stopped for a short time are not truly, irrevocably dead. Their experiences may well be biologically induced, the result of shock, trauma of oxygen deprivation to the brain and the accounts they give are bot checkable against hard evidence. Perhaps these are glimpses of an afterlife, or perhaps they are simply psychological phenomena. However, the people who experience them remain convinced of their reality.


Explanations for NDEs vary from scientific to religious. Neuroscience research hypothesizes that an NDE is a subjective phenomenon resulting from “disturbed bodily multisensory integration” that occurs during life-threatening events. Some transcendental and religious beliefs about an afterlife include descriptions similar to NDEs

One hypothesized explanation for near-death experiences is that the body releases the hallucination-inducing chemical such as dimethyltryptamine (DMT) when it is near death, but this has yet to be established. There are similarities between experiences caused by hallucinogens and near-death experiences; however, there is evidence that ketamine has effects that are more similar to NDEs than are the effects of DMT.

A recent study ‘Prevalence of near-death experiences in people with and without REM sleep intrusion’ found an association between NDEs and Rapid Eye Movement (REM) sleep intrusion into wakefulness. REM sleep is a phase of the sleep cycle where the eyes move rapidly, the brain is as active as when someone is awake, dreaming is more vivid, and most people experience a state of temporary paralysis, as the brain send a signal to the spinal cord to stop the arms and legs moving. When REM sleep intrudes into wakefulness, some people report visual and auditory hallucinations and other symptoms such as sleep paralysis, where they feel conscious but cannot move.

Research on near-death experiences

A significant amount of the research on near-death experiences is coordinated through the field of Near-Death Studies. Among the pioneers of Near-Death Studies we find Dr. Raymond Moody, who has chronicled and studied many of these experiences in several books (Moody, 1975;1977;1999), and Dr. Kenneth Ring, co-founder and past President of the International Association for Near-Death Studies (IANDS). Major contributions to the field include the construction of a Weighted Core Experience Index (Ring, 1980) in order to measure the depth of the Near-Death experience, and the construction of the Near-Death Experience Scale (Greyson, 1983) in order to differentiate between subjects that are more or less likely to have experienced a genuine NDE.

These approaches include criteria for deciding what is to be considered a classical or authentic NDE. Among the researchers associated with the field of Near-Death Studies we find such names as Bruce Greyson, Michael Sabom, Melvin Morse, PMH Atwater, Yvonne Kason and Peter Fenwick. Most of these researchers tend to emphasize the interpretative and phenomenological dimension of the experience.

Other contributors to the research on Near-death experiences come from the disciplines of medicine and psychology. Neuro-biological factors in the experience has been investigated by researchers within the field of medical science (Britton & Bootzin, 2004). Among the researchers and commentators who tend to emphasize a naturalistic and neurological base for the experience we find the British psychologist Susan Blackmore (1993), and founding publisher of Skeptic magazine, Michael Shermer (1998).

Among the scientific and academic journals that have published, or are regularly publishing new research on the subject of NDE’s we find: Journal of Near-Death Studies, Journal of Nervous and Mental Disease, British Journal of Psychology, American Journal of Disease of Children, Resuscitation, The Lancet, Death Studies and Journal of Advanced Nursing

According to Martens (1994), the only satisfying method to address the NDE-issue would be an international multicentric data collection within the framework for standardized reporting of cardiac arrest events. The use of cardiac arrest-criteria as a basis for NDE-research has been a common approach among the European branch of the research field (Parnia, Waller, Yeates & Fenwick, 2001; van Lommel, van Wees, Meyers & Elfferich, 2001).

While skepticism remains, scientists are coming to recognize that more research is necessary. In December 2001, a Dutch neurologist, Dr. Pim van Lommel of Hospital Rijnstate in Arnhem, Netherlands, led a team that published an article in The Lancet, the United Kingdom’s highly respected journal of medicine. The study showed that 18 percent of clinically dead patients, later resuscitated, recalled near-death experiences years after the event.

Another study, this one conducted in the United States by the father of near-death-experience studies, Kenneth Ring, used blind patients, resuscitated from cardiac arrest, who likewise described seeing their body while clinically dead, although slightly out of focus. The book Mindsight was inspired by this research.

Spiritual and psychological after-effects

NDE subjects often report long-term after-effects, and changes in worldview, such as an increased interest in spirituality, an increased interest in the meaning of life, increased empathic understanding and a decrease in fear of death (van Lommel, 2001). Some subjects also report internal feelings of bodily energy and/or altered states of consciousness similar to those associated with the yogic concept of kundalini (Greyson, 2000). 

Greyson (1983) developed The Near-Death Experience Scale in order to measure the after-effects of a near-death experience. Researchers have pointed out that the aftermath of the experience can be associated with both positive and healthy outcomes related to personality and appreciation for life, but also a spectrum of clinical problems in situations where the person has had difficulties with the experience (Orne, 1995). These difficulties are usually connected to the interpretation of the experience and the integration of it into everyday life. The near-death experience as a focus of clinical attention, and the inclusion of a new diagnostic category in the DSM-IV called “Religious or spiritual problem” (American Psychiatric Association, 1994 – Code V62.89), is discussed more closely by Greyson (1997) and Lukoff, Lu & Turner (1998). 

Simpson (2001) notes that the number of people that have experienced an NDE might be higher than the number of cases that are actually reported. It is not unusual for near-death experiencers to feel profound insecurity related to how they are going to explain something that the surrounding culture perceives as a strange, paranormal incident.

As an afterlife experience

Many commentators see near death experiences as an afterlife experience, and some accounts include elements that, according to some theorists, are most simply explained by an out-of-body consciousness. For example, in one account, a woman accurately described a surgical instrument she had not seen previously, as well as a conversation that occurred while she was understood to be clinically dead (Sabom, 1998). In another account, from a proactive Dutch NDE study, a nurse removed the dentures of an unconscious heart attack victim, and was asked by him after his recovery to return them (van Lommel, 2001). 

However, researchers have been unsuccessful in running proactive experiments to establish out-of-body consciousness. There have been numerous experiments in which a random message was placed in a hospital in a manner that it would be invisible to patients or staff yet visible to a floating being, but so far, according to Blackmore (1991), these experiments have only provided equivocal results and no clear signs of ESP. 

Regardless of the origin of the phenomenon, the subjective experience of NDEs is well-documented by the field of Near-Death Studies, and follows certain patterns: 

It is generally accepted that some people who reported NDEs were shown to have approached the clinical boundary between life and death. However, it is not shown that the experiences themselves took place in any time other than just before the clinical death, or in the process of being revived. In altered states of consciousness such as this and during dream states or under the influence of drugs, the subjective perception of time is often dilated.

Those who report NDEs typically respond by a major change of life perspective and direction, generally away from self-orientation toward outward orientation, or what they call “a more loving life”. Greyson (2003) notes that Near-death experiences are associated with enhanced purpose in life, appreciation of life and with reduced fear of death, but also with adverse effects, such as posttraumatic stress symptoms. Many former atheists have adopted a more spiritual view of life after NDEs, for example Howard Storm (Rodrigues, 2004) and George Rodonaia. Howard Storm’s NDE might be characterized as a distressing near-death experience. The distressing aspects of some NDE’s are discussed more closely by Greyson & Bush (1992).

Many people who experience an NDE tend to see it as a verification of the existence of an afterlife (Kelly, 2001). Core NDE experiencers, in particular, tend to be convinced of the reality of the experience as an intimation of the afterlife. This includes those with agnostic/atheist inclinations before the experience. Few experiencers tend to view the NDE as a brain hallucination. The tendency to explain the experience in terms of a materialistic model is usually offered by non-experiencers.

As a naturalistic experience

Other commentators see near death experiences as a purely naturalistic phenomenon. For example; a Swiss study (Blanke., 2002), published in Nature Magazine, found that electrical stimulation on the brain region known as the right angular gyrus repeatedly caused out-of-body experiences to the patient[5]. According to this perspective the cause of the NDE might be understood as a result of neurobiological mechanisms, related to such factors as epilepsy, brain stimulation or altered temporal lobe functioning (Britton and Bootzin, 2004). 

The similarities amongst the experiences of the many documented cases of NDE may be understood to signify that the pathology of the brain during the dying and reviving process is more or less the same in all humans, as suggested by Russian specialist Dr. Vladimir Negovsky in his book Clinical Death As Seen by Reanimator (Pravda, 2004). However, this model fails to explain NDEs that result from close brushes to death where the brain does not actually suffer trauma, such as a near-miss automobile accident. 

A well-known scientific hypothesis that attempts to explain NDEs was originally suggested by Dr. Karl Jansen (1995;1997) and deals with accounts of the side-effects of the drug Ketamine. Ketamine was used as an anesthetic on U.S. soldiers during the Vietnam War; but its use was abandoned and never spread to civilian use because the soldiers complained about sensations of floating above their body and seeing bright lights. Further experiments by numerous researchers verified that intravenous injections of ketamine could reproduce all of the commonly cited features of an NDE; including a sense that the experience is “real” and that one is actually dead, separation from the body, visions of loved ones, and transcendent mystical experiences. 

Ketamine acts in part by blocking the NMDA receptor for the neurotransmitter glutamate. Glutamate is released in abundance when brain cells die, and if it weren’t blocked, the glutamate overload would cause other brain cells to die as well. In the presence of excess glutamate, the brain releases its own NMDA receptor blocker to defend itself; and it is these blockers Dr. Jansen (amongst others) hypothesize as the cause of many NDEs. Shawn Thomas, director of, has suggested that agmatine is the key substance involved in near-death experiences.

 Critics of Jansen’s hypothesis point out that although some aspects of the experience may be similar, not all NDEs exactly fit the ketamine experience; and that while it might be possible to chemically simulate the experience, this does not refute the possibility that spontaneous NDEs have a spiritual component. As Dr. Jansen himself notes: 

Claims that NDE’s must have a single explanation (e.g. Ring, 1980), or that a scientific theory must explain all of the experiences ever given the name of NDE (e.g. Gabbard and Twemlow, 1989) are difficult to justify (Jansen, 1995).

Indeed Dr. Jansen’s own shifting perspective on the conclusions to be drawn from the ketamine-NDE analogy has been notable. He started out as an unequivocal debunker of the notion that NDE’s are evidence of a spiritual (or at least transnormal) realm. But with time he has developed a more agnostic hypothesis: that ketamine may in fact be one particularly powerful trigger of authentic spiritual experiences – of which near-death may be another. In each case, according to Jansen’s more recent pronouncements, all we can say is that the subject gets catapulted out of ordinary ‘egoic’ consciousness into an altered state – we cannot comfortably rule out the possibility that the ‘worlds’ disclosed in these ‘trips’ have ontological status. Latterly, therefore, Jansens position appears closer to thinkers like Daniel Pinchbeck (2002), who has written a book on hallucinogenic shamanism, and other names like Carl Jung, Ken Wilber and Stanislav Grof, than to thinkers like Susan Blackmore or Nicholas Humphrey (two particularly high-profile materialist skeptics). 

Related to the findings of Jansen we find the work Strassman (2001) who induced near death experiences (in addition to some different naturally-occurring altered states of being) in a clinical setting by injecting subjects with DMT, a powerful psychedelic tryptamine. Because DMT is a chemical that is produced endogenously in the human pineal gland it migh be relevant to the study of NDE’s and other mystical, religious, and transpersonal experiences. 

Ultimately, the hallucination theory is one which is very convincing to materialists, and very unconvincing to the vast majority of NDE experiencers.


Current scientific research strongly suggests that near-death experiences occur at the time of dying and are not unconscious secondary falsifications after the fact. As health care professionals, it is not necessary to take sides in the debate concerning the objective reality of these spiritual experiences. Simply the knowledge that they are a normal and natural part of the dying process has profound implications for those who work with death and dying. The ability to feel at ease in discussing the paranormal is an essential element of the bedside manner of all those who work with critically ill patients. The following points are adapted from Morse (1991) and Morse & Perry (1992):

Current scientific research strongly suggests that near-death experiences occur at the time of dying and are not unconscious secondary falsifications after the fact. As health care professionals, it is not necessary to take sides in the debate concerning the objective reality of these spiritual experiences. Simply the knowledge that they are a normal and natural part of the dying process has profound implications for those who work with death and dying. The ability to feel at ease in discussing the paranormal is an essential element of the bedside manner of all those who work with critically ill patients. The following points are adapted from Morse (1991) and Morse & Perry (1992):

Implications for health professionals

Death-related visions can play a role for us in alleviating our own guilt, lack of control, and spiritual/social isolation when dealing with death and dying.

  1. Death-related visions can relieve us of responsibility and the need to always be in control, always have the right answer, the right dose of medicine, etc. when confronted with the deaths of our patients.
  2. Ultimately, we may see a decreased need for irrational adherence to rules and policies that reflect our own need to impose control and order on the process of dying, instead of focusing on patient care needs.
  3. Death-related visions or the use of guided imagery with the dying can result in increased bedside related activities, conversations about death and dying, touching, holding, and simply sitting: all of which can reverse the social isolation of the dying.
  4. What to do and say?
    • Analyze your spiritual beliefs and feelings about death. Dismissing a patient’s vision of the afterlife as “hallucinations” can often reflect our own religious beliefs and values.
    • When in doubt, do and say nothing.
    • Recognize that most death-related events are not dramatic visions of an afterlife, but might be simple feelings and intuitions. Patients are often troubled if they don’t have a dramatic vision of another life.
    • Encourage discussion among family and friends. Often death-related visions and their significance only become evident when several family members report having the same experience at the same time. A professional being willing to validate the experience as normal and natural can often give the family permission to trust their instincts and beliefs.
    • Family members often perceive comatose patients as “stuck in the tunnel”. Others want to know why their child or spouse did not “choose” to return to them. These issues must be addressed in an individual manner.
    • Resist the urge to have all the answers or interpret the experiences. The whole point is to give up control to the dying and family.
  5. Recognize that near death experiences may make death more attractive to those considering suicide. Those who have attempted suicide and have had near death experiences return to life with the firm conviction that suicide is not a solution.

Implications for the dying patient

  1. The near death experience validates the patient’s own psychical experiences and can restore control and dignity to the process of dying.
  2. The knowledge that the process of dying is not painful or scary, but spiritual and wonderful, can be comforting.
  3. Comatose patients often are able to hear and see what is going on around them and can emotionally process conversations. Often they subjectively perceive themselves to be floating on the ceiling and perceive themselves to have a bird’s eye view of their own deathbed or resuscitation.
  4. If the dying patient has had spiritual visions, these can be used to interpret the process of dying for them. There is no need to dismiss such visions or intuitions as drug induced experiences or hallucinations. They often contain seeds of healing.
  5. For patients who have not had death-related visions, guided imagery or fantasy can often serve the same purpose.
  6. Knowledge of near-death experiences can reverse the isolation and neglect of the dying. People will want to visit to hear about pre-death visions or to work with guided imagery with the dying. The old-fashioned deathbed scene crowded with friends and relatives may be resurrected.

Implications for family and friends

  1. Research on near-death experiences validates a variety of death-related visions. The knowledge that NDEs are “real“ events can bring new meaning to a peaceful smile before death, a faraway look in the eyes, or simple and brief statements such as “the Light, the Light” that might otherwise be missed
  2. Frequently, friends and family members have post-death visions and intuitions that can be properly interpreted in light of this new scientific information. For example, Dr. Therese Rando states that 75% of grieving parents have post death visions of their deceased child. Simply restating that most parents will see their child again after death, without using a medical term such as “hallucinations,” can bring enormous comfort and can give parents “permission” to interpret the event in their own way.Death related visions can serve to restore a sense of control and order to the universe, which is particularly important in dealing with untimely deaths or the death of a child.
  3. Death related visions can promote healthy grieving and decrease the incidence of pathological grief, by decreasing guilt and a sense of personal responsibility that can interfere with normal grieving.
  4. Death related visions generate a sense of meaning for death, even if that meaning is elusive. For example, a pre-death vision of a child’s accidental death can allow parents to feel there is some meaning to the death. This can convert a senseless tragedy to a “senseful” one, which is helpful in preventing pathological grief.
  5. Family and friends can find comfort in knowledge that those last moments of life may be serene and peaceful.
  6. Knowledge that it is now scientifically possible to entertain the survival hypothesis can give hope for eventually being reunited with the dying. This can be extraordinarily comforting to many.
  7. Death-related visions can give faith and confidence to survivors to trust their own spiritual intuitions and reaffirm their religious faith.
  8. Near-death experiences are in no way something spiritual


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