Near-Death Experiences and the Afterlife

It is generally agreed that the term ‘Near-Death Experience’ (henceforth ‘NDE’) was coined by Raymond Moody in a study of unusual phenomena experienced at or near the point of death which he entitled Life after Life, and which was published in 1975. According to his own account, Moody began to hear reports of such episodes in 1969 whilst teaching philosophy at the University of Virginia and afterwards at the University of Virginia Medical Centre where he had taken up a residency in psychiatry in the early 1970s. Life After Life effectively launched what has come to be known as ‘Near-Death Studies’ and its most striking – and influential – feature is the ‘model’ or composite NDE that Moody presented in it and which was based on approximately 150 cases he collected whilst researching this ground-breaking book. At the outset of this chapter, it is worth reproducing it in full:

A man is dying and, as he reaches the point of greatest physical distress, he hears himself pronounced dead by his doctor. He begins to hear an uncomfortable noise, a loud ringing or buzzing, and at the same time feels himself moving very rapidly through a long, dark tunnel. After this, he suddenly finds himself outside of his own physical environment, but still in the immediate physical environment, and he sees his own body from a distance, as though he is a spectator. He watches the resuscitation attempt from this unusual vantage point and is in a state of emotional upheaval.

After a while he collects himself and becomes more accustomed to his odd condition. He notices that he still has a ‘body’, but one of a very different nature and with very different powers from the physical body he has left behind. Soon other things begin to happen. Others come to meet and to help him. 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 asks him to evaluate his life and 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 or border, apparently representing the limit 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. At this point he resists, for by now he is taken up with his experiences in the afterlife and does not want to return. He is overwhelmed by intense feelings of joy, love, and peace. Despite his attitude, though, he somehow reunites with his physical body and lives.

Later he tries to tell others, but he has trouble doing so. In the first place, he can find no human words adequate to describe these unearthly episodes. He also finds that others scoff, so he stops telling other people. Still, the experience affects his life profoundly, especially his views on death and its relationship to life (Moody 1975: 21-3).

Near-Death Studies

In the 40 years since the publication of Life after Life the ‘Moody model’ has become a kind of agreed ‘narrative template’ that has defined what an NDE, essentially, is. To be sure, there have been variations on it, and even Moody ‘streamlined’ it in subsequent books: omitting details such as the uncomfortable noise from future ‘models’. Researchers following Moody’s initial model streamlined it still further, either in search of confirmation of his earlier work or in attempts to take his research in other directions. A small but significant number of studies have drawn attention to the fact that not all Near-Death Experiences (NDEs) are pleasant, for example, and there have been a variety of separate research undertakings that have sought to explore such experiences in childhood and within a myriad other contexts (Morse and Perry 1991; Sutherland 1995; Bush 2012). All of this material, whilst interesting and important for any attempt to understand the history, nature, and current status of study into NDEs, stands well outside of the scope of this chapter, however, as does any attempt to locate the burgeoning interest in NDEs within a social and cultural context that might explain why Moody’s initial book sparked such interest and why NDEs continue to exert a broad, popular, fascination. In what follows and in keeping with the theme of this collection overall I will confine myself merely to addressing the issue of whether or not NDEs give any grounds for belief in life after physical death. It might be expected that such issues have been much discussed within academic circles, and particularly those to do with theology and religious studies; involved, as they are, with much material that pertains to this very subject. That this has not been the case might also be considered an area with rich possibilities for research and investigation. In what follows, I attempt to tackle some of the issues surrounding NDEs and the afterlife by considering (1) what evidence exists for supposing that Near-Death Experiences are revealing that physical death does not entail the cessation of awareness, (2) how convincing this evidence is, and (3) what problems such evidence might present for philosophy and any philosophically-informed theology. Whilst these are potentially very large areas which merit far more treatment and analysis than a single chapter can provide, I nonetheless intend to highlight some of the key areas of existing research which might allow them to be considered.

Out of the Body?

A glance at the Moody model, above, reveals that it seems to assume – or to present – a view of human beings as consisting of bodies and something apparently non-bodily: whether that is called a ‘soul’ or ‘spirit’ or something else. Moody seems to resist calling it anything, but his use of language within his model seems to imply some kind of distinction between the subject of the experience and his (or her) body. A glance at the testimonies that he presents in his book reveals some of the case material that appears to lead him to this. One respondent whose testimony Moody recounts describes his experience thus:

I became very weak, and I fell down. I began to feel a sort of drifting, a movement of my real being in and out of my body, and to hear beautiful music. I floated on down the hall and out the door onto the screened-in porch. There, it almost seemed that clouds, a pink mist really, began to gather around me, and then I floated right straight on through the screen, just as though it weren’t there, and up into this pure crystal clear light, an illuminating white light. It was so beautiful and so bright, so radiant, but it didn’t hurt my eyes. It’s not any kind of light you can describe on earth. I didn’t actually see a person in this light, and yet it has a special identity, it definitely does. It is a light of perfect understanding and perfect peace (Moody 1975: 62)

This seems to have been a constant throughout the 40 years of study of NDEs: the inclusion of an out-of-body episode within the definition of ‘Near-Death Experience’ overall. To be sure, not every NDE recorded in the studies that have appeared during that time has included such a ‘component’, but testimonies containing some sort of out-of-body ‘journey’ are found in a great many NDEs and this has continued up to the present day. In this regard, for example, consider the following brief extracts from two NDE testimonies that have appeared in two recent studies of NDEs. The first, recorded in a British study by researcher Penny Sartori, was sent to her by a 43-year-old female who described how:

I was in a very bad way, in the Accident and Emergency unit, it was summer 1987. I was slipping in and out of consciousness. Anyway, I remember the doctor’s voice, saying, ‘there’s nothing else we can do’ to someone, at the same moment I realized I had somehow floated upwards, out of my own body, and was floating upwards towards the ceiling of the hospital room. I could actually feel my back physically pressing against the ceiling of the hospital room. I was watching the doctor and two nurses moving around my own body, lying on the bed below. They were talking, I could clearly hear what they were saying…it wasn’t very positive! I felt that I was floating there, against the ceiling, for about a minute. I felt strangely calm, deeply calm and incredibly peaceful, just observing, quietly (Sartori 2014: 10-11).

This is a very odd account. The subject appears to be observing events apart from her own body and seems able to hear a conversation between doctors and nurses. Yet it is notable that she still seems to have some bodily sensations – ‘I could actually feel my back physically pressing against the ceiling of the hospital room’ – whilst at the same time being, apparently, able to observe her physical body ‘lying on the bed below.’ A second – equally odd – account, appears to include a detail in which the subject’s ability to view events while apparently out of her body extends to events not in the immediate proximity of the body at all. Reproduced in a prospective study of NDEs carried out in ten Dutch hospitals by researcher Pim van Lommel, it contains another striking description of an apparently out-of-body episode within a more detailed NDE:

All of a sudden I knew that I was dead. This realization struck me as odd. I hovered about twenty feet above my body, which was still on the operating table. I was surrounded by doctors who were talking to one another, but I didn’t hear their voices. I also saw my husband waiting on a bench in a darkish room somewhere in the hospital. He was nervous. He was rolling a cigarette. From one moment to the next I found myself flying through a tunnel. It was extremely long, and I flew through it head-first. The tunnel was virtually horizontal, but at a slight upward angle. It was about 10 feet in diameter. I heard a whizzing sound, like wind blowing past my ear, and in the distance I saw a bright light, which I was being sucked toward, but which still seemed a long way off. And all this time I felt scared, powerless, and lonely, because nobody knew that I was aware that I was dead. I wanted to either return or not be aware of my death. But clearly I had no choice in the matter…(Van Lommel 2010: 29).

It seems clear that if persons might be said to survive their deaths to the extent that they can continue into some sort of post-mortem existence then this would require some kind of non-bodily continuity of their existing sense of selfhood, with all its attendant thoughts, memories, feelings, personality dispositions and mental processes. Those who would wish to assert that mind is simply the same as brain would, of course, at once object to any such possibility. For them, any such ontological reduction of mind to brain would simply preclude such a possibility: for if mind and brain are one, then once the brain has ceased to function any kind of mental processes required to produce a sense of self would cease also. It seems clear, then, that for any kind of continued life after death to be possible the ‘I’ must be in some sense separate from – and be capable of functioning independently of – the body.

Near-Death Experiences

As will have become clear from a reading of the accounts reproduced above, such a possibility has been given some apparent support over the last 40 years both by the very large number of NDE testimonies that have emerged and by the large number of studies devoted to them. NDE research has consistently revealed that such experiences are widely reported within all cultures and seem to happen whether the experient has any kind of existing religious belief-system or not. Occurring during episodes of apparent clinical death when all vital signs indicative of life are apparently absent, NDEs appear to lend support to the view that persons are more than their bodies, and that aspects of personhood can survive bodily death and continue into some form of afterlife.

For if all mental processes are ultimately reducible to brain processes and the subjects whose testimonies are reproduced above were genuinely clinically dead then such experiences should not occur: for clinical death would include brain death and with this all mental processes would stop. Yet a second glance at the accounts that we have looked at shows that mental processes are very much in evidence: there is a realization that death has occurred, together with continuing perceptions and a variety of feelings ranging from those of calm and peace to those of fear, loneliness and powerlessness. Perhaps most oddly of all, however, there are specific observations being made by persons that include the location of their own bodies, events surrounding their bodies, and even observations taking place at a distance from their bodies: and all, apparently, viewed from a remote location somewhere ‘above’ the seemingly lifeless corpse. That the experiences have been remembered at all is also highly odd: for it is now generally accepted that memories are ‘laid down’ in the brain and this should not be possible in a brain that has ceased to function.

Philosophy and Substance Dualism

Perhaps, then, accounts such as these are revealing that mind and brain are not the same, and that at death the mind simply ‘escapes’ the body and continues to exist, allowing the continuation of a range of mental contents including thoughts, feelings, perceptions, and memories. As is well-known, such a position is widely supported by many of the world’s religions but what is perhaps less widely known is that it has a rich philosophical history also. Moody’s Life after Life and the studies that followed it represent a continuation of interest in and study of out-of-body phenomena extending backwards from the twentieth century  and including the late nineteenth century’s preoccupation with deathbed visions and spiritualistic phenomena, medieval vision literature, and beyond. As Moody himself knew, having taught philosophy before he took up his medical career, in Book Ten of The Republic Plato talks about a warrior, Er, who was thought to have been killed on the battlefield and was mistakenly thrown on a funeral pyre to be burned. Er was not dead, however, and upon regaining consciousness was able to describe in detail a ‘journey’ to another world in which he encountered other souls who were either dying or waiting to be reborn. Moody discusses this experience in Life after Life as a very early historical antecedent to the experiences he himself presents (Moody 1975).

Philosophy and Near-Death Experiences

Probably the most famous Western philosophical proponent of the view that minds and bodies are not the same was Rene Descartes, who lived between 1596 and 1650. Philosophically, his position is referred to as ‘Cartesian Dualism’ and it is a variant on the more general position known as ‘Substance Dualism’: the notion that minds and bodies are ontologically distinct and not the same thing at all. There is no evidence at all that Descartes was familiar with what we today call Near-Death Experiences and the position he took with regard to the distinction between body and soul needs to be viewed in its historical context, and yet the issues raised by his treatment of some of the issues involved reveal problems as regards taking NDE testimonies at face value that have not always been acknowledged, let alone resolved.

In his sixth Meditation, Descartes provides a series of ‘thought experiments’ designed to demonstrate purely via reason that the mind and the body (including the brain) are not the same. These are complex and have attracted detailed philosophical critique but in essence he invites the reader to reflect on properties and processes that minds have but which bodies do not and cannot have. In this way he seeks to show that they are not, therefore, the same.  For example: he argues that it is impossible to doubt that you are a thinking thing, for in the act of doubting this you are actually thinking and so affirming the very thing you are trying to doubt. By contrast, he asserts that you can very easily doubt that you have a body. In a similar way he argues that it is impossible to imagine away your essence as a being that thinks, but it very possible to imagine your body away. In these and other ways Descartes thinks he has discovered mental properties and operations that are not shared by the body, and therefore that minds and bodies cannot be said to be the same. Further, Descartes defines the body as possessing extension: that is, occupying space. By contrast, he asserts that minds lack extension: their essence is thought and whilst you can destroy anything that possesses extension you cannot destroy something that doesn’t. So in addition to proving that minds are distinct from bodies, Descartes also thinks that he has proved that whilst bodies are mortal and can be destroyed, minds are immortal and hence cannot be.

It is clear that, if accepted, these arguments would lend powerful support to the notion that whilst death may mark the end of the body, it cannot and does not signal the end of the mind. If this or any other form of Substance Dualism could be shown to be the case, then we are offered hope that death is merely an event in the ongoing life of the mind. It would also lend powerful support to the view that NDEs should be taken at face value as providing experiential confirmation of what can also be proved philosophically and, moreover, as providing evidence that life continues when the body ceases to function.

Questions for Substance Dualism

But how strong are the arguments for Substance Dualism? Descartes’ own arguments attracted powerful criticism even during his own lifetime, and his position has few if any supporters within contemporary philosophy and the philosophy of religion. One main problem with his position – and that of Substance Dualism generally – is known as the ‘problem of interaction’, and this problem remains relevant and pressing within the contemporary context of the study of NDEs. Simply stated: if, as Substance Dualists assert, the body and mind/soul are completely different things, how do they interact? Surely, if they are as radically different as Descartes supposed, with one possessing extension and the other not, how might the soul ‘act on’ the body in such a way as to make the body do its bidding? And how might what the body perceives through the senses be ‘relayed’ to the mind if they are completely different things? These rather basic objections to Descartes’ assertions might usefully be directed at supporters of the position that claimed out-of-body experiences during NDEs prove that souls and bodies are distinct, for they raise questions concerning how, exactly, the soul and body were joined prior to the NDE, where they were joined, what ‘mechanism’ allows for the temporary separation during the out-of-body phase of the NDE, and how they become re-joined after the episode is over. Even if one were to refuse to accept Descartes’ other notions regarding extension and non-extension, it still appears to be the case that within Near-Death testimonies something non-physical is claimed to temporarily separate from something bodily, and hence physical. Descartes could never satisfactorily solve the problem of interaction, and offered more than one solution before effectively giving up. At first he proposed that mind and body interacted at the pineal gland in the brain, asserting that its particular ‘lightness’ and location made it an ideal meeting point of mind and body. When it was pointed out that, light as it as, the pineal gland was still extended and that his proposed ‘solution’ did not do justice to the sense that bodies do not just interact with minds at one single point but throughout he proposed a second position in which the mind and body were intermingled not at one point but throughout.  Finally – and apparently despairing at finding a solution to the problem of interaction – Descartes declared that it was a mystery known only to God. Whilst this may be true, it hardly qualifies as a solution to the problem. It may very well be the case that Descartes failed to find an adequate solution because his whole division of mind and body was flawed. Interestingly, the question does not seem to have attracted much attention within the context of the study of NDEs, and yet it presents challenges to those prepared to take the out-of-body element of NDEs at face value.

Equally problematic for Substance Dualism is the empirical objection that might be raised against it. Simply stated: we do not reasonably doubt that we have bodies, but the same cannot be said of non-bodily minds. We can simply and easily detect our bodies via any of our senses. But we cannot do this with ‘disembodied minds’. Being effectively invisible – or undetectable via any of our other senses – we might reasonably doubt whether such things exist at all. Of course, it could be countered that even if minds are ‘nothing but’ brains their actual mental contents are equally invisible. However supporters of the view that minds and brains are in some sense one might point to the known correlations that exist between mental states and corresponding brain-based processes. To do full justice to these additional issues would take us beyond the boundaries of this chapter but a suspicion remains that the invisible, non-detectable mind or soul of substance dualists stands in need of some sort of empirical support and is based on weak philosophical foundations. And it certainly remains the case that whilst NDE literature is replete with descriptions of apparently disembodied souls making observations of events surrounding their apparently newly-vacated bodies, no observations of such disembodied observers have ever been made by those still occupying this physical realm.

Near Death Experiences and Substance Dualism

These problems and issues notwithstanding, supporters of the view that NDEs are enabling us to ‘prove’ the existence of the soul may well view their position as one which promises to breathe life into age-old philosophical and theological disputes. After all, there exists an exceptionally large – and growing – body of testimonies that has to be explained somehow. Perhaps – and especially with the advent of ever more sophisticated techniques and technologies for resuscitation – we are now being given glimpses beyond death’s door that earlier generations simply were not privileged enough to have: or at least not on anything like the same scale. Might, then, NDEs be giving some sort of empirical support – albeit anecdote-driven – for views which by the second half of the twentieth century had become deeply unfashionable but which are, themselves, now being revived? What might decide the issue one way or the other?

Unsurprisingly, given the volume and nature of both Near-Death Experiences themselves and the research they have provoked, the last 40 years have produced three main areas of research and enquiry that might help settle the issue once and for all. Firstly, there have been a number of celebrated cases where persons – sometimes named – have reported details of resuscitation procedures which (a) it is alleged that they could not possibly have seen unless they were temporarily apart from their bodies and which (b) subsequent checking has shown to be correct. Secondly, there have been a small but potentially earth-shattering number of cases where blind persons have temporarily regained – or in the case of congenitally-blind persons, temporarily gained – their sight during Near-Death Experiences. And thirdly, there have in recent years been a small number of experiments conducted in Intensive Care Units in which objects have been placed in locations which would, it is alleged, only be visible to persons outside of their bodies and looking down on them. Placed there as part of wider prospective studies into the incidence and detail of NDEs, these studies have appeared as part of the most recent ‘wave’ of research into the phenomenon and have provoked much discussion.

Taken together, these three areas of research contain direct and obvious relevance to the question of whether or not NDEs represent ‘proof’ that the cessation of the functioning of the physical body is not the end of awareness. Each, in their own way, may enable us to determine whether human beings are ‘more than’ their physical bodies, and hence may enable us to determine whether it is likely that any part of us might survive bodily death. We will therefore consider each area individually in what follows.

There is certainly no shortage of anecdotal data suggesting that persons make sometimes strikingly accurate observations of persons, events, and situations surrounding their deaths. The last 40 years of research into NDEs have revealed many thousands of such cases. Rather less numerous are cases where, it is alleged, such details have later been checked and found to be correct and in which the information gleaned could only have been acquired if the subject was, somehow, disembodied at the time it was acquired.

Early on, cardiologist Michael Sabom recognised the importance of attempting to check the details reported by NDErs during the out-of-body ‘phases’ of their Near-Death Experiences and he first presented his findings in his 1982 study Recollections of Death. Here, he described and analysed a small but potentially highly significant number of cases in which observations made by Near-Death Experiencers (NDErs) whilst apparently apart from their bodies were checked with actual recorded surgical procedures that were carried out upon them. He found impressive correlations, such as when one patient’s description of how ‘my head was covered and the rest of my body was draped with more than one sheet, separate sheets laid in layers’ was compared with the surgeon’s description that the body was ‘draped in the customary sterile fashion.’ Such correlations became even more impressive when he asked a control group of patients who had not had NDEs during their operations to imagine what their operations might have looked like. According to Sabom, these invariably contained mistakes such as the incorrect supposition that mouth-to-mouth resuscitation would be applied to patients to clear airways and incorrect estimates of how far their bodies ‘jumped’ from their beds during CPR. By contrast, claimed Sabom, NDErs’ descriptions of their procedures, allegedly garnered from out-of-body observations, contained no such errors (Sabom 1982: 34-5).

Several years later in a second major study of NDEs it was Sabom again who provided details of a case which continues to provoke much discussion and debate. The subject, a thirty-five year old musician named Pam Reynolds, was undergoing a then-new surgical technique nicknamed ‘standstill’ in which her body temperature was lowered to 60 degrees, her heartbeat and respiration deliberately stopped, and all blood drained from her head. Thus rendered apparently clinically dead, she was then to have a life-threatening basilar artery aneurism removed from her brain. Following the successful procedure, Reynolds claimed that during her operation, at a point subsequently confirmed to be when the surgeon was about to drill through her head with a Midas Rex bone saw, she suddenly heard a sound:

It was a natural D. As I listened to the sound, I felt it was pulling me out of the top of my head. The further out of my body I got, the more clear the tone became. I had the impression it was like a road, a frequency that you go on…I remember seeing several things in the operating room when I was looking down. It was the most aware that I think that I have ever been in my entire life…I was metaphorically sitting on [the lead surgeon’s] shoulder. It was not like normal vision. It was brighter and more focussed than normal vision…There was so much in the operating room that I didn’t recognize, and so many people (Sabom 1998: 41).

What was particularly striking about this case was the description of the actual saw that the surgeon used to cut into her skull, a device that Reynolds claimed to have had no knowledge of before she identified it during her Near-Death Experience:

The saw thing that I hated the sound of looked like an electric toothbrush and it had a dent in it, a groove at the top where the saw appeared to go into the handle, but it didn’t…And the saw had interchangeable blades, too, but these blades were in what looked like a socket wrench case…I heard the saw crank up. I didn’t see them use it on my head, but I think I heard it being used on something. It was humming at a relatively high pitch and then all of a sudden it went Brrrrrrr! like that (Sabom 1998: 41).

At first Sabom was baffled by this account and particularly by the description of the surgical implement described in such detail by Reynolds. By his own admission he had to send away for a picture of the saw that was used during the procedure to check if it matched the description given. To his surprise, it did. But how to account for the accuracy of the description provided by a person apparently clinically dead when she claimed to have made her observations? The debate surrounding this case rumbles on, but it is clear that it stands amongst the most remarkable pieces of evidence suggestive of post-mortem survival that the last 40 years have produced.


Even more remarkable was a book published by researchers Kenneth Ring and Sharon Cooper at around the same time as Michael Sabom was presenting details of the Pam Reynolds case. Called Mindsight, it contained the even more striking claims that during the out-of-body phase of their Near-Death Experiences blind and congenitally blind persons temporarily gained the ability to see, an ability which left them again when they ‘re-entered’ their bodies at the end of their NDEs (Ring and Cooper 1997).

Kenneth Ring had already drawn attention in his earlier research to the intriguing possibility that sensation was heightened during NDEs, but the collection of cases discussed in the MIndsight study took these assertions to fresh new levels, with its claims of blind persons seeing – some for the first time – during NDEs. And as with the Pam Reynolds case, the claims were at first sight impressive. Ring and Cooper collected thirty-one cases for their study, of which fourteen involved congenitally blind persons, eleven adventitiously blind persons(that is, they had lost their sight at the age of 5 years), with the remaining six cases involving persons with severe visual impairments which did not seem to affect them during their NDEs. Particularly striking was the case of Vicki Umipeg, a congenitally blind nightclub singer who had two NDEs at ages 20 and 22. During the second of these – occasioned by a car crash – she described how she suddenly saw herself in the hospital, lying on a metal table:

I knew it was me…I was pretty thin then. I was quite tall and thin at that point. And I recognized at first that it was a body, but I didn’t even know that it was mine initially. Then I perceived that I was up on the ceiling, and I thought, ‘Well, that’s kind of weird. What am I doing up here?’ I thought, ‘Well, this must be me. Am I dead?…’ I just briefly saw this body, and …I knew that it was mine because I wasn’t in mine. Then I was just away from it. It was that quick (Ring and Cooper 1997: 110).

Combining Umipeg’s testimony with interview material, Ring and Cooper considered a range of naturalistic explanations for her experiences, before concluding that her NDE conveyed upon her a set of temporary abilities to see in ways that bettered the visual abilities of normally-sighted persons. On the basis of this and other cases they investigated they concluded that ‘our scrutiny of these transcripts frequently revealed a multifaceted synesthetic aspect to the experiencer’s perception that seemed to transcend normal sight’ (Ring and Cooper 1997: 134).

As with the Pam Reynolds case, the cases of Umipeg and others as presented in Mindsight sparked debate which is still ongoing. Some critics drew attention, for example, to the problems involved in supposing that congenitally blind persons suddenly given sight could identify what they were seeing. Studies of persons given their sight through conventional operative means have revealed post-operative difficulties that persisted for several years, with subjects simply unable to process the newly-restored impressions that they were suddenly receiving via their eyes. For Ring and Cooper, ‘new theories and a new kind of science’ are needed to explain their findings as regards temporary restoration of sight to the blind, but not all critics have been so convinced (Fox 2003: 234).

In Search of Experimental Confirmation

What might convince critics of such claims? One possible avenue of research that has promised to counter the claims of critics of NDE research in the blind and sighted alike has recently taken place in various hospitals: an avenue that is ongoing. This has involved the locating of objects inside Intensive Care Units visible only from certain vantage points and especially if persons were apart from their bodies and looking down. Located as part of prospective studies – which means, in effect, that everyone admitted to the ICU is interviewed to ascertain if anything happened to them, and not simply those subsequently claiming NDEs – these research endeavours have attracted widespread attention in recent years, although comparable studies go back to the 1980s.

In essence, an experiment is performed. Permission is granted from a hospital, distinctive signs or symbols are prepared, rigorous steps are taken to ensure that only the experimenter knows what and where they are and they are then located in ICUs in places likely to be seen by anybody ‘hovering’ above their beds and bodies.  Everybody treated in the Unit is subsequently interviewed, where part of the questioning involves enquiries into what, if anything, was seen during an episode of apparent clinical death, should one have occurred. As a result of such studies, even if one respondent correctly identifies the sign or symbol, we are moved beyond reliance on mere anecdote and given, instead, firmer grounds upon which to draw the conclusion that at the point of death – or in a situation of life-threatening illness or trauma – something leaves the body with concomitant awareness and subsequent memory of the event.

Between 1998 and 2002 a large-scale prospective study of Near-Death Experiences was conducted at ten Dutch hospitals by a team of researchers led by cardiologist Pim van Lommel. At one hospital – in Arnhem – the top cover of the surgical lamp in the ICU was decorated with a hidden sign, invisible from ground level but clearly visible to anybody hovering near the ceiling. The sign – a cross, circle or square on a red, yellow, or blue background – was known by none of the attendant doctors or nurses. Despite the four year study producing some very startling Near-Death Experiences, including one that provided strong anecdotal evidence of a veridical observation on a par with that of Pam Reynolds discussed above, not one patient correctly identified a hidden symbol. Van Lommel was forced to admit:

Unfortunately, no patients who were resuscitated in this room ever reported an out-of-body experience with perception. Because people are resuscitated everywhere – on the street, in the ambulance, in a CCU room, on the ward – we had estimated the chances of a hit to be relatively low. Still, one verified out-of-body experience would have been sufficient (Van Lommel 2010: 139).

A few years after Van Lommel’s attempt, a British ICU nurse, Penny Sartori, received permission to undertake a five-year project to investigate the incidence and detail of NDEs in the unit where she worked. Like Van Lommel, Sartori wanted to determine if any component of any claimed NDE reported during the research was veridical, and she attempted to do this by mounting symbols onto Day-Glo paper which were then laminated and placed on top of the cardiac monitor at each patient’s bedside. As the monitors were approximately seven feet off the ground it would only be possible to identify the distinctive symbols from above, in an out-of-body state, and to ensure they were invisible from the ground Sartori constructed ‘ridges’ to be placed around each one.  Initially, she encountered unexpected difficulties with the research, with nursing colleagues climbing up to view the symbols out of curiosity. Having overcome these initial hurdles, Sartori was then faced with the additional problem of a lack of NDEs. After the first year of the study she had interviewed a total of 243 patients with only two reporting an NDE and two reporting an OBE. There was, however, a much higher incidence of NDEs in her much smaller sample of cardiac arrest survivors (39) and putting these together with claims of NDEs from persons with different medical conditions she ended up with 15 NDEs and eight OBEs after five years.

As with Van Lommel, however, no patient correctly identified a symbol. Attempting to account for this, Sartori remarked:

Some of the patients did not rise high enough out of their body, some moved to positions in the room opposite to where the symbols were situated and two of the patients were so concerned with what was going on around their body that they were not looking on top of cardiac monitors for hidden symbols! One patient was so convinced of his experience that he remarked that if he knew there was a hidden symbol he would have looked at it and told me what it was (Sartori 2014: 133).

The recent studies of Sartori and Van Lommel take their place alongside other, similar, studies, in which experimental attempts to derive veridical NDE observations have similarly failed to provide the evidence that would settle the matter of whether anything leaves the body during an NDE once and for all. These have failed either because nobody during the study was able to correctly identify the hidden symbols, or because nobody within the course of the study reported an NDE with the out-of-body component. As things currently stand, therefore, not a single correct observation of a hidden sign or symbol has been reported by anybody during an NDE within any experiment conducted as part of any prospective study. We are left, therefore, with the anecdotal evidence as provided by Sabom, Ring, and others as our best evidence for supposing that something really does leave the body during these experiences.

All in the Mind?

One remark made by Penny Sartori is of particular note at this point. Writing of her experiment to find veridical evidence of out-of-body perceptions during NDEs, she notes that one patient who reported an NDE in which she accurately described events that occurred in the operating theatre – but not any of the symbols – made incorrect observations also: specifically, of a piece of jewellery pinned to her hospital gown. This was simply incorrect, Sartori asserts, as no jewellery is allowed into any operating room and strict checks are undertaken to ensure that this instruction is complied with. She suggests that the drugs given to this patient might have led to this misperception, which might therefore have simply been hallucinated by the patient (Sartori 2014: 133-4). Readers generally unfamiliar with the literature on NDEs might be forgiven for not realising that this incorrect description of events given within Near-Death Experiencers’ testimonies is actually rather common. In focussing on what they get right, discussion often omits to include what they get wrong.

This mixture of ‘hits’ and ‘misses’ within NDE testimony is rather reminiscent of the curious mixture of ‘hits’ and ‘misses’ that is frequently reported in spiritualistic literature, where mediums often combine remarkably correct information in sittings with basic errors. Whilst sceptics simply explain this away in terms of ‘cold readings’ of individuals by the mediums it is hard to invoke this explanation in the case of NDEs. Indeed, perhaps the errors encountered here might lead us to suspect that the whole experience, far from being evidence of the possibility of something leaving the body during near-death episodes, is simply a complex – but explainable – hallucination.

As might be expected after 40 years, the literature concerned with putting forward purely brain-based ‘explanations’ of NDEs is massive and would take us well beyond the scope of this chapter. But even a cursory glance at the number of naturalistic interpretations of NDE testimonies reveals a very large list of factors – taken singly or combined – that might ‘explain’ the NDE without recourse to hypotheses involving disembodied observers and which includes the effect of anaesthetics (specifically ketamine) and other drugs, the release of beta-endorphins during life-threatening crises, dreams mistaken for ‘reality’, anoxia, hypoxia, hypercarbia, temporal lobe seizures, changes to the functioning of the visual cortex brought about by the onset of death, sensory deprivation, and many more[1]. Susan Blackmore has combined many of these factors into a single model, suggesting that a combination of events might be expected to occur within a dying brain and that the NDE should be seen as a composite of these events, rather than as one, single, experience (Blackmore 1993).

In addition to these neurological possibilities we might also consider the ways in which NDE narratives themselves are formed. According to this scenario an original series of purely brain-based phenomena is given order and plot when being recalled by the NDEr when he or she is safely out of danger. The narrative becomes further shaped in the telling of the tale; perhaps initially to friends and family, then to nurses, then perhaps to doctors. Finally we have the NDE researchers themselves, who have often failed to grasp that all questions convey information and that the very questions they put to NDErs in teasing out their narratives might further shape them. Finally the testimony appears in a researcher’s book, although even here it is notable that many are not presented in their entirety but are ‘cut up’ and provided under a number of headings: ‘The Tunnel’, ‘The Light’, ‘The Barrier or Border’, and so on. In these and other ways, what might have been originally experienced as a confused chaos of jumbled images and impressions becomes gradually redacted into a final testimony. As a result of these processes underlying the composition of NDErs testimonies, we might expect that there was actually more diversity than commonality in what they actually experienced during their near-death crisis events, adding weight to the thesis that NDEs are all simply hallucinations. The fact that NDEs may turn out simply to be hallucinations might then explain why details are recalled often incorrectly, although this would still leave a curious residue of – entirely anecdotal – accounts which contain some spectacularly correct observations. Problematic also for the NDE-as-hallucination hypothesis is the fact that such experiences are remembered at all. For as leading British researcher Peter Fenwick has remarked, memory is fragile and memories are easily damaged or lost. The fact that NDErs recall their experiences so vividly – and sometimes, accurately – puzzles him, for this is not at all what we would expect to be occurring within a dying brain (Fenwick and Fenwick 1995). And looming over every attempt to explain NDEs reductively and in terms of ‘mere’ brain processes is the so-called ‘hard problem’ of consciousness: the current impossibility of explaining how chemical and electrical reactions in a brain – healthy or dying – can give rise to the rich and qualitatively different world of conscious experiencing with all of its qualia, intentionality and subjectivity. Seen in this context, perhaps the thesis that consciousness is not to be equated with brain function emerges as the most parsimonious one: a thesis that might lend encouragement to those who view minds and bodies as ontologically different – and perhaps, therefore, separable – things after all.


And this is where things currently stand as regards Near-Death Experiences and the afterlife, 40 years after the coining of the term ‘Near-Death Experience’ and the concomitant birth of near-death studies. We simply do not know whether they strengthen the case for an afterlife or whether they are best interpreted in more cautious, more reductive, ways. It is to be hoped that the next decades of research into NDEs might bring closure to some of the questions that currently remain open. William James once remarked in his search for a genuine medium that ‘If you wish to upset the law that all crows are black, you must not seek to show that no crows are; it is enough if you can prove one single crow to be white’ (Wilson 1987: 169). Whether or not James ever found the mediumistic equivalent of a white crow is a matter of some conjecture. It remains the case, however, 40 years after the term ‘Near-Death Experience’ was coined, that the quest to find the NDE equivalent of a white crow – a case that proves beyond doubt that at the point of death something leaves the body – has so far drawn a blank. Perhaps it is time for the adoption of a whole new way of thinking about these very curious cases, given that they clearly occur and remain needful of adequate explanation.


Blackmore, S. (1993) Dying to Live: Science and the Near-Death Experience, London: Grafton.

Bush, N. (2012) Dancing Past the Dark: Distressing Near-Death Experiences, Nancy Evans Bush.

Descartes, R. (1998) Meditations and Other Writings, London: Penguin.

Fox, M. (2003) Religion, Spirituality and the Near-Death Experience, London: Routledge.

Marsh, M. (2010) Out-of-Body and Near-Death Experiences: Brain-State Phenomena or Glimpses of Immortality? Oxford, OUP.

Moody, R. (1975) Life after Life, Atlanta: Mockingbird.

Morse, M. And Perry, P. (1991) Closer to the Light: Learning from the Near-Death Experiences of Children, London: Transworld.

Ring, K. And Cooper, S. (1999) Mindsight: Near-Death and Out-of-Body Experiences in the Blind, California: William James Center for Consciousness Studies.

Sabom, M. (1982) Recollections of Death: A Medical Investigation, London: Corgi.

Sabom, M. (1998) Light and Death: One Doctor’s Fascinating Account of Near-Death Experiences, Michigan: Zondervan.

Sartori, P. (2014) The Wisdom of Near-Death Experiences: How Understanding NDEs Can Help Us Live More Fully, London: Watkins.

Sutherland, C. (1995) Children of the Light: The Near-Death Experiences of Children, New South Wales, Transworld.

Van Lommel, P. (2010) Consciousness Beyond Life: The Science of the Near-Death Experience, New York, HarperCollins.

Wilson, I. (1987) The After Death Experience, London: Sidgwick and Jackson.

[1] For a recent and comprehensive overview of the latest neurophysiological interpretations of NDEs, see Michael Marsh: Out-of-Body and Near-Death Experiences: Brain-State Phenomena or Glimpses of Immortality? (Oxford, OUP, 2010)