Near-Death Experiences

Dr. Raymond Moody popularized the term “near-death experience” (NDE) when he wrote his best-selling book, Life After Life, in 1973.¹ Since that time, hundreds, perhaps thousands, of papers and books have addressed NDEs.

Although definitions of NDEs vary, most refer to a constellation of experiences reported by people who have either come close to death or clinically died and were resuscitated. The experiences associated with near-death encounters include but are not limited to:

• Out-of-body sensations, including perceptions of events that could not have been perceived

• A bright light or being of light

• A sense of ineffable transcendence

• Passing through a dark tunnel

• Meeting dead people known to the experiencers

• Meeting other beings, such as angels

• A panoramic life review

• Feelings of peace

• A decision to come back into the body

• After the experience, loss of the fear of death, enhanced spirituality, and sense of purpose in life

NDEs are relevant to religion because so many NDErs claim that their experience demonstrates the reality of life after death.² A detailed review of 54 studies found that

Individuals reported heightened senses, in 39 studies and out-of-body experiences, in 35 studies. In 28 studies, the patients reported positive experiences including love, the feeling of peace, and tranquility, and in 6 studies, they reported negative experiences, mostly torture and hellish experiences. Most of the experiences presented by the NDEr's were supernatural and metaphysical experiences.³

Many NDE researchers either believe that the mind can exist apart from the body or are open or sympathetic to the notion that the materialist view of the mind doesn’t hold water.⁴ Other researchers maintain that NDEs can be explained biologically and do not have objective referents, that is, they are illusions generated in the brain. This paper will briefly examine the “sympathetic” and “skeptical” perspectives and then comment briefly on the religious significance of this research.

Sympathetic Perspectives

Compelling personal reports underpin the sympathetic perspective. Early in his book, Moody provides a composite case, excerpts from which I quote:

A man is dying and, as he reaches the point of greatest physical distress, he hears himself pronounced dead by his doctor. . . feels himself moving very rapidly through a long dark tunnel. After this, he suddenly finds himself outside of his own physical body. . . he sees his own body from a distance, as though he is a spectator. He watches the resuscitation attempt. . . He glimpses the spirits of relatives and friends who have already died, and a loving, warm spirit of a kind he has never encountered before – a being of light – appears before him. This being . . . helps him along by showing him a panoramic, instantaneous playback of the major events of his life. At some point he finds himself approaching some sort of barrier between earthly life and the next life. Yet, he finds that he must go back to the earth, that the time for his death has not yet come. . . He is overwhelmed by intense feelings of joy, love and peace. . . he somehow reunites with his physical body and lives.⁵

Moody makes clear that the elements of the near-death experience, most of which are listed in the bullets above, rarely all occur together, and different NDErs will report different sets of items.

Ring studied 102 persons who had come close to death. “Of these, 52 nearly died as a result of a serious illness; 26 from a serious accident; and 24 as a result of a suicide attempt.”⁶ Among his subjects, “27 persons (26%) were deep experiencers, 22 (22%) were moderate experiencers, while the remainder, 53 (52%) were nonexperiencers.”⁷

Ring proposes five stages of the near-death experience. They are, with the percentage of respondents reporting the experience in parentheses: peace (60%), body separation (37%), entering the darkness (23%), seeing the light (16%), entering the light (10%).

Here is a report of peacefulness:

. . . the thing I could never – absolutely never forget is that absolute feeling of [pause] peace [pause[ joy, or something . . . I remember the feeling. I just remember this absolute beautiful feeling. Of peace . . . and happy! Oh! So happy!⁸

The following is from an interview of a person reporting an out-of-body experience:

I had what I term a weird experience. It’s where my husband was in the [hospital] room, it was very late at night and I remember looking at the clock – out of my body. It was 11:10 P.M. and it was where I was looking down at my body; I was actually out of it! (Did you have any difficulty recognizing yourself?) Nope. (How did you look?) Very pale. Just lying there, arms outstretched, the IV in. I can remember a nurse coming in and tucking in the blankets and everything and making sure I was all right and everything. And my hair was all over the pillow. (Where were “you” in relation to your physical body?) I was, like, over in the corner, and being able to watch people walk in the door and being able to see my husband sitting here [she later implies that she felt that she was “up” as well as to one side of her bed].⁹

Not all out-of-body experiences, however, involved seeing oneself:

Mostly it was like a real floating sensation. I don’t remember seeing anything. It’s real weird. It’s like I was detached from everything that was happening. . . But I didn’t see me.¹⁰

Ring uses the phrase “entering the darkness,” rather than Moody’s “tunnel” concept, because not all of his subjects said that they entered a tunnel.

Well, it was like night. It was dark. It was dark. But it was like, like [pause] like in the dark sky. Space. Dark. And it was – there weren’t any things around. No stars or objects around.¹¹

But 9 of 23 subjects who reached this phase did describe the tunnel phenomenon. For example:

I remember going through a tunnel, a very, very dark tunnel . . . (Did you feel the tunnel was vast?) Yes, very, very. It started at a narrow point and became wider and wider. But I remember it being very, very black. But even though it was black, I wasn’t afraid because I knew that there was something at the other end waiting for me that was good.¹²

Sixteen of Ring’s subjects reported seeing a brilliant, ineffable light that was comforting and beautiful, with religious individuals calling the light “God” or “Jesus.”

I had the sensation of a warm, a very warm sensation, of a very [pause] it was like a light. You know, I can’t explain it, what the light looks like, but it has a very – and I can see it, just like I’m going through it right now – like a very warm, comforting light that I had. And it wasn’t centered on anything; it was, like, all around me. . . And the colors, the colors were very vivid – very vivid colors. I had a feeling of total peace. A feeling of total, total peace.¹³

Ten of Ring’s respondents – about a fifth of his experiencer sample – “entered the light.” The transcripts that Ring quotes from are varied. He describes this stage as

a world of preternatural beauty. The colors are said to be unforgettable. The individual may find himself in a meadow or see unusual physical-like structures, which, however, do not seem to correspond exactly to anything in our world. This is the stage where respondents report being greeted by deceased relatives. Five people claimed to see beautiful flowers here and four were aware of lovely music.¹⁴

A few of the respondents were disappointed when they were resuscitated. An example:

I happened to go down this path and it was beautiful. Beautiful flowers and the birds were singing, and I was walking down . . . [After she was resuscitated] I did reprimand my surgeon and my cardiologist. I said, “Why, in heaven’s name, did you bring me back? It was so beautiful.¹⁵

The preceding excerpts from Ring’s interviews provide a taste of near-death experiences, but do not come close to capturing the great variety among the thousands of accounts that researchers have recorded. Indeed, Moody and other authors made so many people aware of NDEs that the published generalizations about the phenomenon may have influenced subsequent reports of NDEs. Furthermore, at least three organizations provide substantial education and support regarding NDEs, and sometimes use their websites to recruit subjects for research studies: The Division of Perceptual Studies at the University of Virginia School of Medicine, the Near-Death Experience Research Foundation, and the International Association for Near-Death Studies. Professionals associated with these organizations appear to be responsible and, for the most part, avoid sensationalist portrayals of the phenomenon. Not all openly advocate for post-death survival, but many are at least receptive to the possibility.

Statistics regarding NDEs are varied and sometimes not credible. Kondziella says that “NDE occur in around 9–13% of cardiac arrest survivors (67, 74), and the worldwide prevalence in the general public is around 8–10% (11, 12, 68–70).”¹⁶ In a German survey (not random), 4% of respondents said they had experienced an NDE.¹⁷ Sellers says, “According to Zingrone & Alvarado (2009)50, around 17% of people who reported being close to death experienced an NDE.”¹⁸ Another report states:

. . . studies show that the prevalence of this phenomenon in the patients who have gone into cardiac arrest varies between 3.6 and 23% (Parnia et al., 2001; Schwaninger et al., 2002; Klemenc-Ketis et al., 2010). Other retrospective studies have estimated that between 43 and 48% of adults, and 85% of children who have been affected by life-threatening illnesses may have experienced the NDE phenomenon (Ring, 1980; Sabom, 1982; Morse, 2013).¹⁹

According to Shavitz, Bruce Greyson’s research indicates “that between 10% and 20% of people who come close to death report such experiences. That’s about 5% of the population overall.”²⁰

If 5% of the population have had an NDE and only 20% (one-fifth) of people who come close to death have an NDE, then 25% (5 times 5%) of the population has come close to death. The estimate above of an 8 - 10% prevalence of NDEs in the general public is even more preposterous. (This figure may derive from unrepresentative samples, as in the German study cited above.) If these figures were true, we all should know many people who had an NDE! I know none. Moreover, “more than 5 million patients are admitted annually to U.S. ICUs for intensive or invasive monitoring; support of airway, breathing, or circulation; stabilization of acute or life-threatening medical problems; comprehensive management of injury and/or illness; and maximization of comfort for dying patients.”²¹ If every one of these patients had an NDE, they would represent only 1.5% of the U.S. population (5 million divided by the U.S. population of 330 million). Hence, statistics in this field should be taken with a grain of salt.

Let us look at some of the more rigorous research.

Van Lommel and colleagues²² conducted a prospective study of 344 persons who were resuscitated after cardiac arrest. They compared patients who reported NDEs with those who did not, and performed 2 and 8 year followups.

62 patients (18%) reported NDE, of whom 41 (12%) described a core experience. . . . Significantly more patients who had an NDE, especially a deep experience, died within 30 days of CPR (p<0·0001). The process of transformation after NDE took several years, and differed from those of patients who survived cardiac arrest without NDE.²³

The follow-up studies revealed that

people who had NDE had a significant increase in belief in an afterlife and decrease in fear of death compared with people who had not had this experience. Depth of NDE was linked to high scores in spiritual items such as interest in the meaning of one's own life, and social items such as showing love and accepting others. The 13 patients who had superficial NDE underwent the same specific transformational changes as those who had a core experience.²⁴

In a multicenter observational study, Parnia and colleagues²⁵ examined a range of mental experiences during resuscitation. Among 2060 cardiac arrest (CA) events, 101 patients completed two interviews, with 46% reporting memories and 2% saying they saw or heard events related to resuscitation.

To assess the validity of out-of-body perceptions, the investigators employed an innovative method for testing the accuracy of patients’ perceptions during an out-of-body experience. They installed images on the top and underside of shelves in the emergency rooms, images that could only be seen if a “spirit” was indeed hovering up high in the room. Unfortunately, the two patients who reported auditory/visual awareness were treated in non-acute rooms where shelves and images were not installed.

Tressoldi did a “systematic review of all veridical near-death perceptions, published in scientific journals up to August 2024.”²⁶ Tressoldi’s abstract states:

Eleven studies reporting 11 single cases of veridical near-death experiences during or concomitant with severe illnesses in a clinical condition of general anesthesia or cardiac arrest, were included in the review. Ten of the eleven cases reported visual perceptions. Four of these ten cases also reported auditory perceptions. Only one case reported exclusively auditory perception. Evidence that they may be obtained by bypassing their sensory organs is more plausible for visual experiences than for auditory experiences because all participants had their eyes closed during their general anesthesia or during their cardiac arrest.

Some of the cases that Tressoldi reviews are compelling on their face. Here are a few case excerpts from his “Procedures” section to give you a feel for the phenomenon:

At the beginning, I think, I heard the nurse say ‘dial 444 cardiac arrest’. I felt scared. I was on the ceiling looking down. I saw a nurse that I did not know beforehand who I saw after the event. I could see my body and saw everything at once. I saw my blood pressure being taken whilst the doctor was putting something down my throat. I saw a nurse pumping on my chest. . .I saw blood gases and blood sugar levels being taken.

I looked back and I could see my bed, my body in the bed. I could see everything that was happening on the floor. I saw doctors when I was up there . . . The blonde lady therapist boss, she was panicking; she looked nervous because she was the one who got me out in the chair. She hid behind the curtains, but kept poking her head around to check on me.

Dr. Higgins is down by my feet, which is odd because she controls my breathing. She should be up at the top, not down by the feet, but for whatever reason she’s down there.

Though at first one might be amazed by reports of patients who claim to have seen people working in the emergency room, Parnia et al., and other studies, demonstrated that anesthetized patients can be much more aware than was previously thought. Things patients may have heard, combined with the mind’s tendency to fill in gaps, might have caused them to construct organized visual memories from perceptual fragments.²⁷

Perhaps responding to sensationalist accounts and skeptical analyses of NDEs, Parnia, with 17 other authors, published “Guidelines and standards for the study of death and recalled experiences of death––a multidisciplinary consensus statement and proposed future directions.”²⁸ They conclude that

• People who have survived close encounters with death describe similar subjective experiences.

• Accounts of these experiences are consistent with what has been called the core NDE, and these experiences are not merely hallucinations, drug-induced, or illusions.

• These experiences are associated with long-term psychological and spiritual benefits.

• Studies of electrical activity in the brain suggest that cells take longer to die than was once believed and support claims of heightened consciousness among some who have come close to death.

What I have learned suggests that these assertions are not unreasonable. The consensus statement does not claim that research has proven that mind can exist apart from the body, although some of the statement’s signers may believe that proposition. The statement essentially asserts that NDEs are intriguing and that we do not understand them as well as some people believe.

Skeptical Perspectives

Skeptics suggest that NDEs are not as coherent or unique a phenomenon as sympathizers suggest, and that they can best be explained as the products of brains that are dying or in severe distress.

The research on deathbed visions, and especially studies of terminal lucidity, are, at minimum, related to NDEs, and suggest that NDEs may not be as unique as some believe.

Kerr and colleagues conducted a longitudinal study of end-of-life dreams and visions (ELDV).²⁹

Fifty-nine participants comprised the final sample. Most participants reported experiencing at least one dream/vision. Almost half of the dreams/visions occurred while asleep, and nearly all patients indicated that they felt real. The most common dreams/visions included deceased friends/relatives and living friends/relatives. Dreams/visions featuring the deceased (friends, relatives, and animals/pets) were significantly more comforting than those of the living, living and deceased combined, and other people and experiences. As participants approached death, comforting dreams/visions of the deceased became more prevalent³⁰. . . .

Almost half of the dreams/visions (45.3%) occurred while asleep, 15.7% occurred while awake, and 39.1% occurred while both asleep and awake. Nearly all ELDV events (267/269, 99%) were reported by patients to seem or “feel real³¹.. . .

The mean comfort rating for all dreams and visions was 3.59 (SD=1.21, 95% confidence interval [CI]=3.44–3.73) with 60.3% rated as comforting or extremely comforting, 18.8% distressing or extremely distressing and 20.7% neither comforting nor distressing.³²

Kerr and his colleagues estimate that 50% to 60% of dying and conscious patients experience ELDVs. Unlike hallucinations, which tend to be distressing, ELDVs are marked by peacefulness. Commonalities with NDEs include seeing dead relatives, positive affect, and a feeling that the experience is real. Unlike many NDErs, who may have been declared clinically dead, ELDV patients tend to be aware of their surroundings.

Phoebe Zerwick did a profile for the New York Times on Christopher Kerr and his work.³³ Though ELDVers do not usually speak of ineffable, brilliant light, as do many NDErs, their reports often communicate the same sense of peace:

What’s striking about this footage, which dates back to Kerr’s early work in 2008, is not so much the content of the visions but rather the patients’ demeanor. “There’s an absence of fear,” Kerr says. A teenage girl’s face lights up as she describes a dream in which she and her deceased aunt were in a castle playing with Barbie dolls. A man dying of cancer talks about his wife, who died several years earlier and who comes to him in his dreams, always in blue. She waves. She smiles. That’s it. But in the moment, he seems to be transported to another time or place.³⁴

The author relates a moving meeting with the parents of a child who had died. The report echoes some NDEs:

That was the case with Connor O’Neil, who died at the age of 10 in 2022 and whose parents Kerr and I visited in their home. They told us that just two days before his death, their son called out the name of a family friend who, without the boy’s knowledge, had just died. “Do you know where you are?” Connor’s mother asked. “Heaven,” the boy replied. Connor had barely spoken in days or moved without help, but in that moment, he sat up under his own strength and threw his arms around her neck. “Mommy, I love you,” he said.³⁵

It is not surprising, then, that proponents of life after death point to ELDVs as well as NDEs as evidence supporting their position.³⁶

They also point to the fascinating phenomenon of terminal lucidity, about which the Cleveland Clinic says:

Terminal lucidity, or “the surge,” is an unexpected episode (occurrence) of clarity and energy before death. Neurodegenerative conditions that lead to dementia, like Alzheimer’s disease, cause irreversible mental decline that can be hard to watch in a loved one. But terminal lucidity is a surprising exception where a person rallies. They may seem more like themselves again — briefly — before declining again. As the name suggests, terminal lucidity is usually a sign that death is near.

Terminal lucidity isn’t an official diagnosis. And not everyone who’s nearing death experiences it. Most healthcare providers who work with people who are dying only witness a few dozen incidents over their careers. But when these episodes do happen, they’re memorable for all who witness them.³⁷

Other terms for terminal lucidity include “end-of-life rallying” or “pre-mortem surge,” evidence for which Wilson provided. He followed four comatose patients after life-support was withdrawn. For one person, a “spike in power occurred in the somatosensory cortex and the dorsolateral prefrontal cortex, areas that are associated with conscious experience. It seems that this patient, 5 minutes before death, was experiencing something.”³⁸ Might this person have experienced a form of private terminal lucidity, or perhaps an NDE? Or was s/he as comatose as before death but with a brain that was simply making a mindless last gasp? We will never know. However, evidence such as Wilson obtained strongly suggests that brain death is a complex phenomenon that experts do not understand fully. Why, for example, did this person experience a surge in brain activity but the other three patients did not?

A literature review of terminal lucidity says that the medical field has known about the phenomenon for over 250 years. The review includes

case reports of patients suffering from brain abscesses, tumors, strokes, meningitis, dementia or Alzheimer's disease, schizophrenia, and affective disorders. Several of these accounts suggest that during terminal lucidity, memory and cognitive abilities may function by neurologic processes different from those of the normal brain.³⁹

A Psychology Today article says that 43 percent of people who experience this brief lucidity die within a day, while 84 percent pass away within a week.⁴⁰ An example:

. . . the case of a 91-year-old woman who had suffered from Alzheimer's for 15 years. For the last five years, she had been unresponsive, showing no sign of recognizing anyone. But one evening, she became more alert and started talking normally to her daughter, discussing her fear of death and her relationships with other members of the family. A few hours later, she died.⁴¹

Neurologist Daniel Kondziella offers several neurological hypotheses to explain NDEs, some of which might also apply to terminal lucidity. One possible explanation is “electrical stimulation of and structural lesions at the temporoparietal junction.”⁴² Because this brain area influences the perception of personal space, disruptions may lead to out-of-body experiences.

REM sleep intrusion, according to Kondziella, is another possible explanation for NDE

because it is a natural phenomenon, occurs instantaneously, occurs several times each night in everyone, is associated with dissociative features including muscle atonia and hallucinations, and REM sleep intrusion into wakefulness is a feature of narcolepsy as well as of healthy people (78–80). So far, two studies have investigated the association of NDE with REM sleep (11, 77). In a case-control study, the prevalence of REM sleep intrusion was 23% in a sample of people with NDE and 0% in controls (77). This study was criticized because of its selection bias: Although the groups matched for age and gender, the NDE sample was drawn from people who had taken the initiative to self-register their experience online, whereas the control group consisted of medical staff who most likely was more aware of the implications of the questions related to REM sleep intrusion (81). A crowdsourcing study recruiting over 1,000 unprimed laypeople from 35 countries, however, confirmed an association: While age, gender, place of residence, employment status, and perceived threat did not seem to influence the prevalence of near-death experiences, people with REM intrusion were much more likely to exhibit NDE than those without (OR 2.85, p < 0.0001)⁴³

Another possible mechanism for NDE is migraine aura

because a short-lasting variant of SD [“spreading depolarizations,” which results from impairment of normal neurovascular processes] is considered the pathophysiological correlate of migraine aura, while terminal SD occurs in humans at the end of life as outlined earlier. Indeed, migraine aura was also a predictor of NDE in another crowdsourcing study of unprimed lay people adjusted for age and gender (OR 2.33, p < 0.001) (Figure 9B), but it has not been investigated in more traditional interview-based surveys yet.⁴⁴

Kondziella concludes, however, that REM sleep intrusion, migraine aura, and dysfunction of the temporoparietal cortex, though strongly associated with NDE, are not sufficient to explain the phenomenon.

Romand discusses the time lag between clinical death and brain death:

What does this distinction between clinical death and brain death mean for the causal understanding of NDEs? With normal body temperature and without medical intervention, brain death occurs 4 to six 6 min after clinical death (Lind et al., 1975). Normally within about 10 s after circulatory arrest unconsciousness starts (Rossen et al., 1943). After about 5 min, substantial injury of the brain cells may begin (Neumar et al., 2008). It has been shown that some neurons of the brain are more resistant to the effects of anoxic injury [lack of oxygen] than others (Vaagenes et al., 1996; Kirino, 2000; Taoufik and Probert, 2008). Among them are neurons of the hippocampus and amygdala (Kirino, 2000; Kawahara et al., 2004), key brain structures in cognitive and emotional processes (Janak and Tye, 2015). The underlying physiological differences between hypoxia-sensitive and less sensitive neurons are not yet clear. What is clear, however, is the fact that neurons of the brain do not become irreversibly damaged or dead immediately after assessment of clinical death. There is a time window of roughly 5 min of progression toward irreversible damage ending with brain death.⁴⁵

According to Romand, a loss of energy supply, e.g., because of cardiac arrest, might trigger a short-lived period of high brain activity that could account for the NDE reports of people brought back before the pre-death brain surge dissipated.

Keith Augustine has written many articles and co-authored (with Michael Martin) The Myth of an Afterlife: The Case Against Life After Death. He published a detailed, 50,000-word critique⁴⁶ of sympathizers’ research and theories, which I will refer to as “Augustine.”

Augustine critiques NDE claims in 8 general areas: (1) Out-of-body discrepancies, (2) bodily sensations, (3) living persons, (4) cultural differences, (5) random memories, (6) threshold crossings, (7) hallucinatory imagery, and (8) unfulfilled predictions. Since this essay is already long, I will only address what to me are the most compelling critiques in this list.

Augustine discusses methodological problems with NDE research that apply to all eight of his categories. Years often pass before NDE reports are shared with researchers. Interviews often include leading, and sometimes directed questions, e.g., “[W]ere you ever aware of seeing your physical body?” The public’s widespread belief in an afterlife could prime people for hallucinatory experiences that support that belief, especially in life-threatening situations. There may be substantial selection biases in the recruitment of subjects, e.g., some subjects come from NDE support groups. People naturally tend to construct organized memories from fragmented recollections; van Lommel’s 2- and 8-year followups demonstrated that NDErs continued to contemplate their experience, and presumably sharpen and elaborate upon their recollections of it. Thus, what is important is not only “what is happening to the brain during the NDE, but in how NDE reports are reshaped afterward.”⁴⁷

Reshaping is perhaps most likely to occur in reports of OBEs. In Ring’s study described above only 37% reported a “body separation,” which is a broader term than OBE. However, OBEs have also been reported by people who are not near death. In a study of sleep paralysis, for example, Buzzi and Cirignotta “found that about 11% of their subjects (28 people) ‘viewed themselves lying on the bed, generally from a location above the bed’ (Buzzi 2116). . . [and] these out-of-body experiences often included false perceptions of the physical environment.”⁴⁸ Augustine provides other examples of NDEs that include false or dubious perceptions, e.g., an NDEr holding hands with a living person floating together above the trees. Moreover, lack of oxygen can cause some people to have NDE-like experiences, e.g., dreamlets of beautiful places, euphoria, pleasurable memories.

Augustine goes into great detail in his reanalysis of some of the most compelling cases of NDEs that supposedly offered concrete evidence of out-of-body consciousness. In one case the NDE report included a description of a shoe on an outside ledge of the hospital room in a place that could not be seen from the room, thus lending credence to NDEr’s claim that she saw the shoe on the ledge when she was out of body. Further investigation, however, questioned this claim:

As part of our investigation, Ebbern and Mulligan visited Harborview Medical Center to determine for themselves just how difficult it would be to see, from outside the hospital, a shoe on one of its third-floor window ledges. They placed a running shoe of their own at the place Clark described and then went outside to observe what was visible from ground level. They were astonished at the ease with which they could see and identify the shoe. . . . It is quite likely, then, “that anyone who might have noticed the shoe back in 1977 would have commented on it because of the novelty of its location” and Maria could have heard such a conversation and consciously forgotten about it, incorporating it into her out-of-body imagery.⁴⁹

Augustine also describes the astonishing case of a soldier who “dislodged the pin of a dummy grenade he thought to be a live one, producing a classic NDE.” Thinking he was about to be blown up, the soldier saw a tunnel, bright light, a figure in the light beckoning him to come, and his life passing quickly in review. Then he realized that the grenade had not exploded, and he immediately felt himself sucked back into his body.

Perhaps the methodologically most interesting studies are “target identification experiments.” I described one of these, Parnia et al., in the previous section. Augustine reviews that and four other studies in which visual items are strategically placed in rooms where only a hovering OBEr could see them. As with Parnia et al., three of these studies did not produce NDEs or NDEs with OBE. One 5-year study had 8 OBEs, but “this study also yielded negative results, as ‘not all of the patients rose high enough out of their bodies and some reported viewing the situation from a position opposite to where the symbols were situated’ (Sartori 38).”⁵⁰ Augustine recommends that additional target identification experiments should be carried out.

In his review of studies pertinent to psychophysiological correlates, Augustine concludes that

. . . the best predictors of OBEs are dissociation, hypnotic susceptibility, absorption, and fantasy proneness (Alvarado 193-194) [and] . . . Though medical factors affecting a person’s brain state would not be expected to influence the course of a ‘brain-free’ experience, we nevertheless find medical influences on the content of OBEs and NDEs.⁵¹

Some of the findings on cultural differences in NDEs are striking. In Western NDEs religious figures tend to be Christian, e.g., Jesus, but most encounters are with dead relatives and friends. Not surprisingly, in India and Thailand Hindu religious figures are encountered in NDEs. Unlike Western NDEs, however, religious figures are more prominent than friends and relatives. Interestingly, “NDErs from India report meeting clerks in an impersonal afterlife bureaucracy who process the dead and send them back because they have been sent the wrong person due to paperwork mistakes (Pasricha and Stevenson 168-169).”⁵² A study of Japanese NDEs found similarities with Western NDEs:

In a tabulated chart, 73 reports noted an affective component which was predominantly positive: 32 included being at peace and another 32 included feeling happy, while only 9 were fearful. Leaving the body was reported in 59 NDEs. Of forty-five experiences of light, 16 were preceded by travel through a tunnel. Altogether 30 tunnel experiences were reported.⁵³

But for Japanese people, the light is not personal, and there is not one report of a Japanese NDEr communicating with the light.

In a survey of NDEs in Melanesia, Dorothy Counts “found that the NDE world ‘is a land that is described as having factories and wage employment. It has an appearance that reminds me of the view approaching Los Angeles from the air’ (Counts 130).”⁵⁴

Augustine concludes: “In 11 studies of 7 non-Western cultures (with 3 studies in India, 2 in Japan, and 2 in central Africa), very few elements of the prototypical Western NDE are universally present. . . . [and of] the 8 prototypical Western NDE elements, only ‘meeting others’ is truly universal in non-Western cultures.”⁵⁵

Augustine notes that popular accounts of NDEs rarely mention obviously hallucinatory details of NDE accounts. Here are a few from the section, “Hallucinatory Imagery”:

The next thing I remember, there was a cloud and a male, related to Jesus, ’cause he looked like the pictures of Jesus. He was in this chariot type [thing]… the torso was a horse, everything above the torso was a man with wings; sort of like a Pegasus except instead of a horse’s head it was a man… and he was beckoning to me.

. . . a man who had a heart attack while in the hospital reported having an out-of-body experience where he was flying as a “junior member” in a formation of swans he’d seen earlier.

The NDEr also encountered “four unknown nurses” who interrogated him “about possible subversive activities.”

After moving through the ceiling, instead of seeing her Australian hospital from above, she reported finding herself on a Russian battlefield “piled with dead men,” Russian tanks, and machines.

First I went into the animal heaven. There were lots of flowers and there was a bee. The bee was talking to me and we were both smelling flowers.

. . . one woman reported worrying about the flowers she was stepping on in her NDE, when the flowers telepathically communicated to her that they were alright!

Some sympathizers concede that “the NDE research done so far on the question of survival is not compelling.”⁵⁶ They recognize that anecdotal reports “lack any evidence of a careful attempt to interview all the parties involved in a patient's resuscitation to check the accuracy of the NDEr's report.”⁵⁷ Nevertheless, sympathizers respond to the critiques of Augustine and others.

Frankly, I find these retorts unconvincing. Fenwick⁵⁸, for example, implicitly says that Augustine hasn’t proven that NDEs are artifacts of consciousness: “many of the putative mechanisms of NDEs have been suggested by authors who have no proper grasp of the width of the field or the phenomena of NDEs, or of the very wide range of mental and physiological states that underpin these experiences.”⁵⁹ This may be true. However, I do not believe it is the critic’s responsibility to disprove every case of an NDE that offers what Fenwick calls “the hypothesis of a ‘peek’ into the afterlife.” The afterlife proponent is obligated to provide sufficient evidence to make the hypothesis of a mind outside the body compelling. Collections of anecdotes are not persuasive without the support of systematic and rigorous empirical studies.

Holden⁶⁰ says much the same thing: “both the reductionist and survivalist hypotheses remain worthy of consideration, and the most we NDE scholars can do at this point is evaluate the weight of evidence for each.”⁶¹ Evaluation of the “weight” of evidence, however, may depend greatly upon one’s preconceptions and biases. For example, in response to Augustine’s pointing to OBEs claiming to float in the air with living persons, Holden says: “Yet another hypothesis rests, again, on the possibility that a living individual's consciousness may function in more than one ‘place’ at the same time and usually unbeknownst to that person.”⁶² This is a plausible explanation; but plausibility can be a very low bar, especially when it strains credulity, as does this hypothesis.

To her credit, Holden challenges Augustine’s claim that OBEs are full of inaccuracies. She reports on a review of 107 cases of “apparently nonphysical veridical perception.” She claims that only 8 percent of these involved inaccuracy and that independent observers judged 37 percent to be accurate. Without knowing the details of this review, one cannot determine how to “weigh” this evidence. If, for example, an OBEr said “I saw doctors and nurses surrounding my body on the operating table,” an “independent observer” might code that statement as “accurate.” But is deeming such an obviously true statement, and perhaps similar statements, enough to conclude that a person’s consciousness has actually left the body? I doubt it.

It seems to me that the most effective NDE evidence against the materialist view of consciousness would be target identification experiments in which OBErs identify objects that are not possible to see from the floor and, ideally, that no hospital personnel know about. As Augustine showed, however, five such studies have failed to produce evidence of an out-of-body consciousness. But that does not mean more such studies should not be attempted. Approximately 290,000 in-hospital attempts at cardiac arrest resuscitation occur each year, with a success rate of 15% to 25%.⁶³ If NDEs occurred in 10% of these cases, the potential population to interview would be at least 4,000 persons each year. Granted, conducting such studies is not easy. But scientific studies that might definitively determine whether consciousness can exist outside the body would be very valuable, especially if the investigative team included skeptics and sympathizers collaborating. Such studies surely would be worth funding. If they found no evidence of out-of-body consciousness, then future NDE research could give up the afterlife theme and focus on neurophysiological and psychological causes of an intriguing phenomenon. If the studies did find positive evidence of objectively real OBEs, then those with faith in philosophical materialism might experience the same cognitive vertigo that unnerved so many Western Christians when Enlightenment science, e.g., evolution, challenged the underpinnings of their faith as they understood it at the time.

Religious Implications of NDE Research

Most popular interest in NDEs derives from the wish that there is life after death. Some compelling NDE case reports appear to fulfill that wish – until a clever skeptic analyzes the case in detail and gathers additional information to debunk the narrative.

As I indicated at the end of the previous section, the scientific evidence for out-of-body consciousness is at best equivocal. Skeptics have poked many holes in the arguments and evidence of sympathizers. That skeptics have not debunked all compelling anecdotes, however, is not evidence in favor of the survival hypothesis. We should not expect skeptics to prove a negative, i.e., to show that there are no instances of consciousness existing outside a body and to debunk each and every anecdotal claim of such. The burden of proof falls on those maintaining that at least some out-of-body experiences are objectively real.

Putting aside the methodological issues, Potts makes an important point that religious people may overlook: “some conscious experience and perception after death . . . does not necessarily refer to unending life after death.”⁶⁴ Nor would evidence of brief out-of-body consciousness argue for the correctness of any particular religious faith. At most, it would compel philosophical materialists to regroup and revise their theories of consciousness’s dependence upon matter and energy. Since it would be unwise to underestimate the intelligence and creativity of scientists with deep faith in materialism, NDEs, even with confirmation through target identification experiments, would not necessarily prove the existence of God, let alone the correctness of a particular religious faith. Tomorrow’s neo-materialists might theorize, for example, about a formerly unknown form of energy that gives rise to consciousness, within and outside of bodies. May the Force be with you!

If out-of-body consciousness were demonstrated to exist, all kinds of religions could celebrate – for a little while. Then they, and the neo-materialists who would surely arise, could return to debating whose view of reality is true.

In short, NDE research is fascinating. If future research findings point in one direction, it may strengthen the faiths of religious people. If it points in the other direction, it is unlikely to shake the faith of many people. Ultimately, whether NDE research proves or disproves out-of-body consciousness, that research is not likely to significantly impact the faiths of religious people or atheists.

1 Moody, R. A. (1973/1976). Life After Life. New York: Bantam Books. (Originally published by Mockingbird Books in 1973.)

2 See Greyson, B. (2006). Near-death experiences and spirituality. Zygon, 41(2). https://med.virginia.edu/perceptual-studies/wp-content/uploads/sites/360/2017/01/NDE46_spirituality-Zygon.pdf

3 Hashemi A, Oroojan AA, Rassouli M, Ashrafizadeh H. (2023, April 20). Explanation of near-death experiences: a systematic analysis of case reports and qualitative research. Frontiers in Psychology, 14:1048929. doi: 10.3389/fpsyg.2023.1048929. PMID: 37151318; PMCID: PMC10158795.https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1048929/full

4 See, for example: Greyson, B. (2010). Implications of near-death experiences for a postmaterialist psychology. Psychology of Religion and Spirituality, 2(1), 37-45.

5 Moody, pp. 21-22.

6 Ring, K. (1980). Life at death: A scientific investigation of the near-death experience. New York: Coward, McCann & Geoghegan, p. 29.

7 Ring, pp. 33-34.

8 Ring, p. 43.

9 Ring, p. 47.

10 Ring, p. 45.

11 Ring, p. 55.

12 Ring, p. 53.

13 Ring, p. 59.

14 Ring, p. 60.

15 Ring, p. 61.

16 Kondziella, D. (2020, July 20). The neurology of death and the dying brain: A pictorial essay. Frontiers in Neurology, 11. https://doi.org/10.3389/fneur.2020.00736 Section: Near-Death Experience—Phenomenology, Epidemiology, and Biological Mechanisms.

17 Knoblauch, H., Schmied, I., & Schnettler, B. (2001). Different kinds of near-death experience: A report on a survey of near-death experiences in Germany. Journal of Near-Death Studies, 20, 15-29. https://doi.org/10.1023/A:1011112727078

18 Sellers, J. (2021). Transformation or pathology: A brief review of studies of some anomalous human experiences. Journal of Consciousness Exploration & Research, 12(1), p. 67.

19 Hashemi A, Oroojan AA, Rassouli M, Ashrafizadeh H. (2023, Apr 20). Explanation of near-death experiences: a systematic analysis of case reports and qualitative research. Front Psychol. 14: 1048929. doi: 10.3389/fpsyg.2023.1048929. PMID: 37151318; PMCID: PMC10158795. https://www.frontiersin.org/journals/psychology/articles/10.3389/fpsyg.2023.1048929/full Section: Introduction.

20 Shavitz, J. (2025, July 16). Life after death: New research suggests human consciousness may survive death. Brightside News. https://www.thebrighterside.news/post/life-after-death-new-research-suggests-human-consciousness-may-survive-death/ Section: More Than Just a Flicker?

21 Society of Critical Care Medicine. (Updated May 15, 2024). https://sccm.org/communications/critical-care-statistics#:~:text=More%20than%205%20million%20patients,of%20comfort%20for%20dying%20patients. Section: Critical Care Patients.

22 van Lommel, P., van Wees, R., Meyers, V., & Elfferich, I. (2001). Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands. The Lancet, 358(9298), 2039-2045. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(01)07100-8/fulltext.

23 Van Lommel et al. Section: Summary/Findings.

24 Van Lommel et al. Section: Prospective Findings.

25 Parnia, S. et al. (2014). AWARE—AWAreness during REsuscitation—A prospective study. Resuscitation, 85(12). https://med.virginia.edu/perceptual-studies/wp-content/uploads/sites/360/2017/01/NDE74-AWARE-Resus-2.pdf.

26 Tressoldi, P. (2024). Veridical near-death perceptions: A systematic review. Pre-Print: https://osf.io/preprints/psyarxiv/jm2dk_v1.

27 See: Lee, T. (2025, May 8). False memories explained. UChicago Explainer Series. https://news.uchicago.edu/explainer/false-memories-explained#:~:text=falsely%20remembering%20something?-,What%20is%20a%20false%20memory?,in%20fact%20you%20had%20sushi.

28 Parnia, S. et al. (2022). Guidelines and standards for the study of death and recalled experiences of death––a multidisciplinary consensus statement and proposed future directions. Annals of the New York Academy of Sciences. https://doi.org/10.1111/nyas.14740.

29 Kerr, C. W., Donnelly, J. P., Wright, S. T., Kuszczak, S. M., Banas, A., Grant, P. C., & Luczkiewicz, D. L. (2014). End-of-life dreams and visions: A longitudinal study of hospice patients’ experiences. Journal of Palliative Medicine, 17(3). https://doi.org/10.1089/jpm.2013.0371. https://www.liebertpub.com/doi/full/10.1089/jpm.2013.0371.

30 Kerr et al. Section: Abstract/Results.

31 Kerr et al. Section: Frequency and prevalence of dreams.

32 Kerr et al. Section: Comfort and distress associated with dreams and visions.

33 Zerwick, P. (2024, March 12). What deathbed visions teach us about living. New York Times. https://www.hospicebuffalo.com/news/in-the-news/what-deathbed-visions-teach-us-about-living#:~:text=Most%20significant%2C%20as%20people%20near,with%20profound%20meaning%20and%20solace

34 Zerwick.

35 Zerwick.

36 Spitzer, R. (2023). Science at the doorstep to God. San Francisco: Ignatius Press.

37 Cleveland Clinic (no date). Terminal lucidity. https://my.clevelandclinic.org/health/symptoms/terminal-lucidity.

38 Wilson, F. P. (2023, May 3). Surprising brain activity moments before death. Neurology Reviews. https://www.mdedge.com/neurologyreviews/article/262735/mixed-topics/surprising-brain-activity-moments-death.

39 Nahm, M., Greyson, B., Williams Kelly, E., & Haraldsson, E. (2012). Terminal lucidity: a review and a case collection. Archives of Gerontology and Geriatrics, 55(1), 138-142. https://doi.org/10.1016/j.archger.2011.06.031.

40 Taylor, S. (2024, June 2). The enigma of terminal lucidity. Psychology Today. Section: Terminal Lucidity. https://www.psychologytoday.com/us/blog/out-of-the-darkness/202406/terminal-lucidity#:~:text=Although%20many%20people%20assume%20that,broken%20television%20producing%20clear%20images.

41 Taylor. Section: Terminal Lucidity.

42 Kondziella, D. (2020). The neurology of death and the dying brain: A pictorial essay. Frontiers of Neurology, 11. https://doi.org/10.3389/fneur.2020.00736. Near-Death Experience—Phenomenology, Epidemiology, and Biological Mechanisms.

43 Kondziella. Section: Near-Death Experience—Phenomenology, Epidemiology, and Biological Mechanisms.

44 Kondziella. Section: Near-Death Experience—Phenomenology, Epidemiology, and Biological Mechanisms.

45 Romand, R. (2023, January 17). Neuro-functional modeling of near-death experiences in contexts of altered states of consciousness. Frontiers in Psychology, 13. https://doi.org/10.3389/fpsyg.2022.846159 Section: Brain function in between clinical death and brain death.

46 Augustine, K. (2003/2008). Hallucinatory near-death experiences. Modern Library, Internet Infidels. https://infidels.org/library/modern/keith-augustine-hndes/

47 Augustine. Section: Veridical Paranormal Perception During OBEs?

48 Augustine. Section: Out-of-Body Discrepancies.

49 Augustine. Section: Maria’s Shoe.

50 Augustine. Section: NDE Target Identification Experiments.

51 Augustine. Section: Psychophysiological Correlates.

52 Augustine. Section: Cultural Differences.

53 Augustine. Section: Cultural Differences.

54 Augustine. Section: Cultural Differences.

55 Augustine. Section: Cultural Differences.

56 Greyson, B. (2007). Comments on "Does Paranormal Perception Occur in Near-Death Experiences?" Journal of Near-Death Studies, 25(4), 237-244.

57 Potts, M. (2002). The evidential value of near-death experiences for belief in life after death. Journal of Near-Death Studies, 20(4), 233-258. https://digital.library.unt.edu/ark:/67531/metadc799266/m2/1/high_res_d/vol20-no4-233.pdf. Section: The Case That NDEs Provide Strong Evidence of Survival.

58 Fenwick, P. (2007). Commentary on "Near-Death Experiences with Hallucinatory Features." Journal of Near-Death Studies, 26(1), 43-49. https://digital.library.unt.edu/ark:/67531/metadc798944/m2/1/high_res_d/vol26-no1-43.pdf.

59 Fenwick. Section: Summary.

60 Holden, J. (2007). More Things in Heaven and Earth: A Response to "Near-Death Experiences with Hallucinatory Features." Journal of Near-Death Studies, 26(1), 33-42. https://digital.library.unt.edu/ark:/67531/metadc799193/m2/1/high_res_d/vol26-no1-33.pdf.

61 Holden. Section: Introduction.

62 Holden. Section: Assumptions Regarding the Nature of Consciousness.

63 Ramenofsky, D. H., & Weissman, D. E. (2025, Feb. 2). CPR survival in the hospital setting. Palliative Care Network of Wisconsin. https://www.mypcnow.org/fast-fact/cpr-survival-in-the-hospital-setting/#:~:text=Background%20for%20Fast%20Fact%20%23179,arrests%20requiring%20an%20emergency%20response.

64 Potts. Section: Introduction.