A near-death experience (NDE) is a deep personal experience that happens when someone is close to death or facing death. Researchers say these experiences often share similar features. Most, but not all, NDEs are described as positive. People may feel separated from their bodies, float, feel calm and safe, experience warmth and happiness, feel as though they are disappearing, recall important events in their lives, see a bright light, or meet people who have died. While many NDEs have common parts, how people describe and understand these experiences often depends on their culture, beliefs, or religion.

NDEs usually happen during times when a person’s heartbeat or breathing stops but can be reversed. Scientists and religious groups offer different explanations for NDEs. Some scientific research suggests NDEs may result from how the body’s senses work together during dangerous situations. Some spiritual or religious beliefs about life after death include descriptions that are similar to NDEs.

Etymology

The French term "expérience de mort imminente," meaning "experience of imminent death," was suggested by Victor Egger, a French psychologist and scholar, after discussions in the 1890s among philosophers and psychologists about climbers' descriptions of a panoramic life review during falls. In 1892, Albert Heim reported a series of personal accounts from people who had faced life-threatening situations, such as workers falling from scaffolds, injured soldiers, and climbers who had fallen from high places. These accounts included experiences like near drownings and other accidents. This was the first time the phenomenon was described as a clinical syndrome.

In 1968, Celia Green published an analysis of 400 first-hand accounts of out-of-body experiences. This was the first effort to classify such experiences, which were viewed as unusual perceptual events or hallucinations. In 1969, Elisabeth Kübler-Ross, a Swiss-American psychiatrist and early researcher in near-death studies, published her well-known book On Death and Dying: What the Dying Have to Teach Doctors, Nurses, Clergy, and Their Own Families. The term "near-death experience" was first used by John C. Lilly in 1972. In 1975, psychiatrist Raymond Moody popularized the term, using it as a general term for experiences such as out-of-body experiences, the panoramic life review, seeing a light, passing through a tunnel, or reaching a border.

Characteristics

In 1975, psychiatrist Raymond Moody studied about 150 people who said they had near-death experiences (NDEs). He found that these experiences often included 15 common elements. Moody studied about 50 of these cases closely. A key similarity among all the people studied was that they had been very sick, faced life-threatening situations, or had died. Eleven of the 15 elements describe what people experienced during the NDE. These include:

• Finding it hard to describe the experience in their own words.
• Learning they were dead from doctors or others.
• Feeling pain replaced by peace or pleasant sensations.
• Hearing strange noises or peaceful, otherworldly music.
• Moving through a dark tunnel.
• Feeling separated from their body.
• Seeing other people.
• Meeting a bright being of light.
• Seeing a full review of their life.
• Reaching a point where they could not return.
• Returning to their body and life.

Moody also identified four elements related to what happened after the experience:
1. Sharing the experience with others.
2. Changes in how people lived their lives.
3. New views about death.
4. Evidence that the experience was real.

Moody explained that not everyone has all these elements, and each NDE can be different.

In 1980, Kenneth Ring simplified Moody’s findings into five stages:
1. Feeling peaceful.
2. Feeling separated from the body.
3. Entering darkness.
4. Seeing a bright light.
5. Entering another world through the light.

The final stage is returning to life after being resuscitated.

Over time, studies on NDEs have included people with different health conditions, making it harder to compare research. New guidelines now focus on clearly separating people who had real NDEs, as Moody originally described, from other experiences. These guidelines emphasize studying people who:
1. Experienced a connection with death.
2. Felt they left the physical world.
3. Found the experience hard to describe.
4. Had life changes linked to a deeper sense of purpose.

The guidelines also recommend studying people who:
– Lost consciousness due to serious illness.
– Did not show signs of typical coma symptoms, like dreams or confusion, even if they were in the hospital or elsewhere.

These steps help identify real NDEs and avoid confusing them with other experiences.

Because the term "near-death" is not clearly defined, some studies now include people who were not close to death, such as those under anesthesia. This has led to confusion. The 2022 guidelines say that real NDEs, which happen when people are near death, are different from other experiences like those caused by drugs (e.g., ketamine or DMT) or dreams. These other experiences often include strange body feelings, self-centered thoughts, or visions of aliens or bright lights, which are not common in real NDEs.

Some researchers say that even among different groups, certain elements are common, such as:
– 50% of people feeling they were dead.
– 56% feeling peaceful or happy.
– 24% having an out-of-body experience (seeing themselves from outside their body).
– 31% entering darkness or a tunnel.
– 32% seeing dead loved ones or religious figures.

People’s beliefs about culture, religion, or philosophy often influence how they describe their NDEs. For example, in the U.S., people might see light as angels or loved ones, while Hindus might see it as messengers from the god of death.

After Moody’s work, some studies began describing unpleasant NDEs, where people felt scared or tormented. These are called "negative" or "hellish" NDEs. Recent research shows these experiences are different from classic NDEs and are more likely to be mislabeled cases of confusion or hallucinations in hospitals.

People who survive suicide attempts may describe intense emotional pain they feel is self-created, like being in a personal hell.

To help study NDEs, Bruce Greyson created a questionnaire with 80 questions to understand common effects, feelings, and experiences of people who had NDEs.

Establishment of research framework

To create a thorough way to study experiences of facing death, the 2022 guidelines chose the more accurate term "recalled experience of death" (RED) instead of "near-death experience" (NDE). A RED is a real near-death experience (see Common Elements, 2022 Guidelines). This means a RED is a unique mental and emotional event that happens during a time when a person loses consciousness due to a life-threatening situation, such as cardiac arrest. Like real near-death experiences, REDs follow a pattern described by Moody’s original study of transcendent events:

• A connection with death.
• A feeling of moving beyond the physical or material world.
• A sense of being difficult to describe.
• Positive changes in life linked to a greater understanding of meaning and purpose.

REDs do not include typical signs of being in a coma, such as dreams, confusion, or false beliefs. The term RED removes the unclear meaning of "near-death" by including both serious, life-threatening situations that bring someone close to death (from a medical perspective) and states involving the actual physical processes of death, such as cardiac arrest or other forms of heart failure. The authors of the 2022 guidelines believe focusing on REDs will improve research by clearly separating these experiences from other similar events, such as hallucinations caused by drugs, dreams, or memories formed while waking up from a coma.

Historical reports

Near-death experiences (NDEs) have been recorded since ancient times. The oldest known medical report about NDEs was written by Pierre-Jean du Monchaux, an 18th-century French military doctor. He described one such case in his book Anecdotes de Médecine. Du Monchaux thought that an increase in blood flow to the brain might create strong feelings in a person, leading to a near-death experience. In the 19th century, some studies looked at NDEs beyond single cases. One was conducted by members of the Church of Jesus Christ of Latter-day Saints, and another took place in Switzerland. By 2005, 95% of cultures around the world had some mention of NDEs.

In the United States, about nine million people have reported having an NDE, according to a 2011 study in Annals of the New York Academy of Sciences. Most of these experiences happened after serious injuries that affected the body or brain. More recent reports show that:
• 17% of critically ill patients experienced NDEs in nine studies from four countries.
• 10–20% of people who came close to death had an NDE.

Near-death studies

Bruce Greyson, Kenneth Ring, and Michael Sabom helped start the study of near-death experiences and brought this topic into academic research. Between 1975 and 2005, about 2,500 people in the United States who reported near-death experiences were studied in look-back studies. An additional 600 people in the West outside the United States and 70 people in Asia were also studied. Prospective studies, which involve observing groups of people (like emergency room patients) to see who had a near-death experience during the study, identified 270 individuals. These studies are more expensive to conduct. In total, about 3,500 people were studied in one or more studies between 1975 and 2005. These studies were conducted by about 55 researchers or teams.

Melvin L. Morse, who leads the Institute for the Scientific Study of Consciousness, and his colleagues studied near-death experiences in children. Researchers at the University of Michigan, led by Jimo Borjigin, found that parts of the brain involved in visual experiences became more active during cardiac arrest. After a rapid increase in brain activity in specific areas, long-distance communication between brain regions also increased. This was shown by delayed activity in networks connected to the brain’s front areas when the heart rate dropped. Interestingly, the connection between these brain areas was stronger in people who crossed the midline of the brain. Studies suggest that brain connections between the two halves of the brain are important for memory and learning.

American radiation oncologist Jeffrey Long created a large database of near-death experiences through the Near Death Experience Research Foundation (NDERF). Out of 1,122 people who had near-death experiences, 835 reported feeling more alert and conscious, even though studies found no electrical brain activity. Another piece of evidence shows that people who had near-death experiences could describe their resuscitation process with 97.6% accuracy. Long documented seven other pieces of evidence that support the realism of near-death experiences, though not all can be confirmed with current medical tools. Because 95.6% of 1,000 participants said their near-death experiences felt real, Long concluded that, although these experiences are not fully explained by medicine, they are likely real.

According to research, the study of near-death experiences involves discovery, challenges, and controversy. Cant and others noted that interest in near-death experiences has grown as medical technology and resuscitation methods have improved. This topic is widely discussed in search results, medical papers, and opinion articles. Kopel and Webb observed that there is now a large amount of writing about near-death experiences, including both scientific views and non-scientific ones. Many scientists and doctors have been skeptical of near-death studies and whether these experiences can be studied scientifically. In the past, many researchers were unsure about the validity of near-death experiences. While more scientists now accept near-death studies as a legitimate field, this change has been slow.

Research shows that psychiatrists have helped recognize near-death experiences and made the topic more widely known, leading to further studies. Kinsella noted that scholarly interest in near-death experiences has grown after public interest increased. While there is no agreement on the philosophical meaning of near-death studies, the question of what human consciousness truly is remains unanswered and debated. Most researchers agree that near-death studies are now a legitimate area of scientific research, and recent discoveries have raised hopes that understanding the dying process may soon improve.

Kovoor and others pointed out that some studies have methodological problems. They noted that long-term results might be influenced more by health conditions than by near-death experiences. Skeptics say it is hard to confirm many stories about near-death experiences. Some scientists in psychology and neuroscience have criticized near-death research. Even within the field, some researchers have questioned the influence of religious beliefs on near-death studies. Ring, in an open letter, said that religious and spiritual beliefs have shaped the near-death movement, which may affect the objectivity of research.

A 2021 study of 101 patients who had deep hypothermic circulatory arrest found that none of them experienced anything that could be called a near-death experience.

Clinical research in cardiac arrest patients

In 2001, Sam Parnia and his team published findings from a one-year study at Southampton General Hospital. The study included 63 people who survived cardiac arrest. These individuals had no heartbeat, breathing, or eye movement when they were clinically dead. Researchers placed images on high shelves facing the ceiling, where patients could not see them from the floor. Four participants reported near-death experiences (NDEs), but none saw the images. Psychologist Chris French noted that none of the participants in this study experienced an out-of-body experience.

In 2001, Pim van Lommel, a cardiologist in the Netherlands, and his team studied 344 cardiac arrest survivors in 10 Dutch hospitals. They compared groups of patients who had NDEs with those who did not, looking at factors like fear before the event, age, sex, medical history, and medications. They also studied these groups over two and eight years to see how their lives changed. One patient described an out-of-body experience, watching events during his cardiac arrest. Hospital staff confirmed his account, and his memories matched real events rather than imagined ones.

At the University of Southampton, Parnia led the AWARE Study, which began in 2008 and ended in 2012. This study involved 33 researchers across 15 medical centers in the UK, Austria, and the US. It tested whether patients had awareness, memories, or consciousness during cardiac arrest. Researchers used tests like placing shelves with images on the ceiling in rooms where cardiac arrests were likely to occur. The study results were published in 2014.

A review of the study found that out of 2,060 cardiac arrest events, 101 survivors completed questionnaires. Of these, 9% had NDEs. Two others (2%) described seeing or hearing real events during their cardiac arrest. One patient’s experience could not be tested because the event did not occur in a room with ceiling shelves. For the second patient, the experience was verified, showing awareness occurred minutes after the heart stopped, a time when brain activity typically stops. This experience was not explained by illusions or hallucinations, as it matched real events.

As of May 2016, plans for AWARE II were announced. This two-year study aimed to examine 900–1,500 cardiac arrest patients. Recruitment started in 2014, and the study was extended until 2020. In 2019, a summary of the study with 465 patients was shared. Only one patient remembered hearing sounds, while none remembered seeing images. In November 2022, the full study results were published.

Explanatory models

In a 2005 review, psychologist Chris French grouped models that explain near-death experiences (NDEs) into three categories: spiritual (or transcendental), psychological, and physiological. These groups overlap and are not completely separate.

French explained that the most common view is that NDEs are exactly as they seem to people who experience them. This view suggests that NDEs might show evidence of a soul or mind that exists outside the body and provides information about a world beyond death.

Greyson noted that some NDE events are hard to explain with current knowledge of the body and mind. For example, some patients who were unconscious could describe events from a perspective outside their bodies. In two studies of people who survived cardiac arrest, those who said they left their bodies could accurately describe what happened during their resuscitation, while others described incorrect details. Sam Parnia also studied patients who had cardiac arrest or were in deep hypothermic circulatory arrest. These patients reported seeing or hearing things even when their brains were not active, and their reports matched real events.

Five studies tested whether people who claimed to have out-of-body experiences could see hidden objects placed in hospital rooms. Twelve patients said they left their bodies, but none described the hidden objects. This small sample raises questions about the accuracy of some NDE stories.

Neuroscientist Charlotte Martial said there is not enough strong scientific evidence to support theories about non-local consciousness, which some people claim exists. Chris French said the idea that NDEs prove the soul survives death is not scientific because it does not create clear, testable ideas.

French summarized psychological models, including the depersonalization, expectancy, and dissociation models.

The depersonalization model, proposed in the 1970s by psychiatry professor Russell Noyes and psychologist Roy Kletti, suggests that NDEs are a type of mental detachment that happens during extreme stress, such as life-threatening danger. According to this model, people who face death may feel emotionally disconnected from their bodies and experience time differently. However, this model struggles to explain NDEs that do not involve feeling separated from the body. Unlike NDEs, these experiences are often described as unpleasant and include feelings of fear or emptiness. People who have NDEs usually remain clear about who they are, unlike those who experience depersonalization.

The expectancy model suggests that NDEs are not real events but are created in the mind in response to the stress of facing death. These experiences may reflect what people expect or want to happen, such as imagining a peaceful place to comfort themselves. However, some people’s NDEs differ from their cultural or religious beliefs about death, which challenges this idea. Also, children who report NDEs often describe similar experiences to adults, even though they are less influenced by cultural beliefs about death.

The dissociation model suggests that NDEs help people avoid emotional pain during stressful events. In extreme situations, some people may mentally separate themselves from painful feelings or their surroundings.

The birth model proposes that NDEs might resemble the experience of being born. Like a baby moving from darkness to light and feeling warmth, some believe the brain of a dying person may recreate this journey through a tunnel to light and comfort. However, newborns lack the ability to remember birth events because their brains are not fully developed.

Many physiological theories explain NDEs using brain-related factors, such as lack of oxygen, brain chemicals, or unusual activity in brain areas like the temporal lobes. Susan Blackmore, a British psychologist, proposed the "dying brain hypothesis," which suggests NDEs result from brain activity during near-death states.

Greyson said several brain regions have been linked to NDEs, including the limbic system, hippocampus, and parts of the temporal and frontal lobes. Researchers Olaf Blanke and Sebastian Dieguez from Switzerland suggested two types of NDEs based on brain damage:

• Type 1 NDEs occur when the right side of the brain, especially the temporal-parietal junction, is damaged. These experiences include feeling separated from the body, altered time perception, and sensations of flying or lightness.
• Type 2 NDEs occur when the left side of the brain, especially the left temporal-parietal junction, is damaged. These experiences include seeing glowing figures, hearing voices, or feeling the presence of spirits.

They suggested that damage to the occipital cortex might explain some NDE features.