The notion of near death experiences (NDE) have fascinated people for a long time. The notion is that some people report profound experiences after waking up from a cardiac arrest – their heart stopped, they received CPR, they were eventually recovered and lived to tell the tale. About 20% of people in this situation will report some unusual experience. Initial reporting on NDEs was done more from a journalistic methodology than scientific – collecting reports from people and weaving those into a narrative. Of course the NDE narrative took on a life of it’s own, but eventually researchers started at least collecting some empirical quantifiable data. The details of the reported NDEs are actually quite variable, and often culture-specific. There are some common elements, however, notably the sense of being out of one’s body or floating.

The most rigorous attempt so far to study NDEs was the AWARE study, which I reported on in 2014. Lead researcher Sam Parnia, wanted to be the first to document that NDEs are a real-world experience, and not some “trick of the brain.” He failed to do this, however. The study looked at people who had a cardiac arrest, underwent CPR, and survived long enough to be interviewed. The study also included a novel element – cards placed on top of shelves in ERs around the country. These can only been seen from the vantage point of someone floating near the ceiling, meant to document that during the CPR itself an NDE experiencer was actually there and could see the physical card in their environment. The study also tried to match the details of the remembered experience with actual events that took place in the ER during their CPR.

You can read my original report for details, but the study was basically a bust. There were some methodological problems with the study, which was not well-controlled. They had trouble getting data from locations that had the cards in place, and ultimately had not a single example of a subject who saw a card. And out of 140 cases they were only able to match reported details with events in the ER during CPR in one case. Especially given that the details were fairly non-specific, and they only had 1 case out of 140, this sounds like random noise in the data.

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There is no question that people occasionally have strange experiences, sometimes very strange. There is a tendency to interpret such experiences as external, reflecting something happening in the world, rather than internal, reflecting something happening in our brains.

Neuroscience, however, has provided us a powerful tool for understanding some of these experiences. They are a window into how our brains construct our experience of reality, and what we experience when that process breaks down or is altered by drugs, trauma, electrical stimulation, oxygen deprivation, or other stressors.

A recent study looking at the hallucinogen DMT (N,N-Dimethyltryptamine) adds an interesting insight into our collective knowledge of these altered states of consciousness. The researchers studied 13 healthy volunteers, who were given placebo, and then in a separate session a week later DMT, and extensively questioned about their experiences. The researchers specifically wanted to test the possibility that a DMT-induced hallucination would be similar to reported near-death experiences.

In short they found that the DMT experiences were extremely similar to near-death experiences (NDE), but let’s look at the details.

They gave the subjects an established NDE scale, which assesses for 16 features reported by those who experience an NDE. A score of 7 or higher is considered to be a genuine NDE. All 13 subjects scored 7 or higher on this scale when given DMT. Ten of the 16 features were statistically more likely during DMT than placebo. And the total scores were similar to a historical control group of reported NDEs. So again – DMT produced an experience that was very similar to reported NDEs.

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There has been a great deal of discussion about the planned study of near death experiences (NDEs) since I wrote about the study on Friday. I focused my attention primarily on the neurological and scientific issues, but other issues were raised with regard to this study.

GM Woerlee wrote an extensive piece on this topic focusing also on the medical aspects of what happens during cardiopulmonary resuscitation (CPR). His primary point is that CPR generates enough blood flow to the brain in order to explain the experiences that survivors report. He also emphasizes that this research into NDEs has been done enough to arrive at the reliable conclusion that it is the experience of an anoxic brain and tha this further research is unecessary.

This, of course, raises the question of the usefulness of this proposed study – to place signs near the ceilings in ERs and ICUs and then see if people with NDEs could read the signs, meaning they were actually outside their bodies and not just feeling as if they were. I agree with the argument that this is a questionable use of finite research funds. There are certainly more pressing medical questions with a greater probability of a practical outcome. Public interest and the ideology of individual researchers – not good medicine – is driving this research.

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Near death experiences (NDEs) have been a favorite topic for the paranormal crowd for some time. If one could prove that consciousness survives the physical death of the body that would go a long way to opening the door to a wide range of paranormal claims. NDEs often occur in the medical setting, and this is partly why a team of doctors from the UK and USA are planning a rigorous study of NDEs.

That NDEs occur is not controversial – many people report remembering experiences around the time of cardiac arrest from which they were revived. Typical experiences include a sense of floating outside of one’s body, even looking down upon oneself and the events going on. Some people report a bright light, and others report “passing over” and being greeted by deceased loved-ones. The experience is often peaceful or euphoric, which contrasts to the way people feel when they eventually wake up. Surviving a cardiac arrest takes its toll and is not a pleasant experience.

The question is not whether or not people have such experiences – the question is how to interpret them. Just as even the most rigorous skeptic does not question that people see UFOs, but rather what the UFOs likely are.

The burden of proof for anyone claiming that NDEs are evidence for the survival of the self beyond the physical function of the brain is to rule out other more prosaic explanations. This burden has not been met.

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The New Yorker magazine’s latest issue features an article about the sad story of Jahi McMath. Jahi was a 13 year old girl who four years ago underwent a routine tonsillectomy to treat severe snoring and breathing problems. Unfortunately the surgery was complicated by severe bleeding post-op, leading eventually to a cardiac arrest. After a sustained effort at resuscitation the doctors did manage to get her heart working, but by that time her brain was severely damaged by lack of oxygen. She was declared clinically brain dead.

This is not where the story ends, however. Since then the family has refused to accept the diagnosis of brain death, prompting a prolonged conflict with the hospital. Eventually Jahi was removed by the family to an undisclosed hospital in New Jersey, and ultimately discharged to home care, where she remains.

I have had several questions about the story, and I will try to add some insight, with the caveat that I have no direct knowledge of the medical facts of the case beyond what is reported in the New Yorker article and elsewhere. I have not examined her, spoken directly to anyone involved in her care, or reviewed medical records. But there is a lot of information in the public domain and I can speak to that information, as far as it is accurate.

There are several layers to this story. There is a legal layer, as the family is suing the hospital for malpractice. I will not address that aspect of the case. There is the neurological layer – what is brain death and is this girl dead? There is also a personal and cultural layer here in terms of the family’s reaction. Let me start with some thoughts on this.

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Recent reports that Oscar the cat can predict the impending death of hospice patients have been spread by the media rather uncritically (although my fellow science bloggers have already filled the skeptical gap left by the mainstream media). I was not going to write about it myself, but then yesterday “Freddy the Pig” left a comment in response to my seizure discussion asking about the so-called “seizure dogs” who can allegedly predict when their master will have a seizure. So I thought I would kill two birds with one stone.

Both cases bring up a few principles I want to touch on. The first is that before we waste too much time trying to explain the nature of a phenomenon we should first confirm that the phenomenon exists. This is a chronic problem in the paranormal research community, who spend far too much time weaving explanations out of quantum mechanics for phenomena, like ESP, that probably don’t exist. Admittedly, these can be useful thought experiments to assess the plausibility of a claim, but we need to resist putting the cart before the horse.

In both of these cases – Oscar the death predicting cat and seizure predicting dogs, neither has been scientifically validated. Both are likely a result of confirmation bias – the tendency to make and remember observations that confirm a belief we already have. For example, given that Oscar probably likes to lay next to warm people on their comfy beds, and these particular people are all very near death, it is likely that on occasion Oscar till spend time with someone right before they die. This, however, might seem rather creepy to nursing home staff, and rumors of Oscar’s apparent morbid ability would spread quickly. Now, everyone would be on the lookout for correlations between Oscar’s visitations and later death – to confirm the story. No one will much notice, report, or remember the times Oscar visited a patient and they did not die soon after.
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There has been a lively exchange surrounding John Horgan’s article about skeptics, which I responded to previously. (See also Orac’s and Daniel Loxton’s responses.) At the core of Horgan’s piece is a logical fallacy so common, I feel it deserves special attention. In fact, PZ Myers wrote approvingly of Horgan’s fallacy, showing that it is still alive and well.

That fallacy can be called the fallacy of relative privation, which is a type of red herring or distraction from actual issues. The fallacy is essentially an argument that a problem is not important or does not deserve attention and resources because there are other more important problems. “Why are you wasting your time on X when there are children dying of cancer?”

In Horgan’s case, he would like us to end all war and bring about everlasting world peace before we tackle lesser problems like quackery, fraud, global warming, vaccine denial, the environment, and other such trivialities.

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Back in May I participated in a debate for Intelligence Squared regarding “Death is not Final.” At the time I was updating myself on the published literature regarding alleged near death experiences or NDEs, and noticed that the AWARE study (AWAreness during REsuscitation) had been completed but the data not yet published. I was disappointed that I would not have these results available to me during the debate.

I had read about the study several years earlier. This is a prospective study of cardiac arrest patients to not only describe their NDEs when they occur, but to conduct a large prospective test looking for objective evidence of conscious awareness during resuscitation. The lead researcher, Sam Parnia, is a believer in NDEs, but designed a study theoretically capable of finding objective evidence.

The multi-center study involved placing an image in a location that was hidden from normal view but could be viewed by a person floating above their body during an NDE. This could be a way to objectively differentiate between the two leading hypotheses. Parnia and others believe that reports of NDEs represent actual awareness during cardiac arrest when the brain is not functioning. This, of course, would be compelling evidence for cognition separate from brain function.

I and most scientist favor the more mundane and likely explanation that memories of NDEs are formed at other times, when the brain is functioning, for example during the long recovery process. At least the memories themselves do not differential between these two hypotheses, and this explanation does not require inventing entirely new non-materialist phenomena.

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My recent discussion of neurosurgeon, Eben Alexander’s near death experience sparked a discussion about whether such topics are fruitful targets of skeptical analysis. For example, commenter smillsishere wrote:

This blog post in itself (as with many analyses) raises questions about the extent to which skepticism can be of use in society. I completely understand the well constructed and logical opposition to the anti-vaccine movement. I understand in generic terms the critique and possible dismissal of poor research and unsubstantiated claims that can have a negative impact on our progression as a species (one topic comes to mind immediately, the use of ‘interpretors’ to help parents communicate with their autistic children, an abuse of common decency and trust). However, sometimes I wonder if skepticism often targets topics or elements of human culture that are neither harmful or unhealthy?

This criticism of scientific skepticism, that we spend too much time and effort on claims that don’t matter, or beliefs that are harmless, has been around as long as there has been skeptical activism. It is an almost ubiquitous question when being interviewed about skepticism by the media. Who cares if people believe in life after death, or if this neurosurgeon visited heaven while he was in a coma?

The major unstated premise of this criticism is that a claim or belief must have direct demonstrable harm in order to be harmful. A further unstated premise is that the belief itself is the only subject of concern.

In fact, for “harmless” beliefs I don’t care, necessarily, about the beliefs themselves. This is mostly why I do not find it fruitful to address matters of pure faith, and in a way I don’t care what people believe about unanswerable questions with no immediate consequences.

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In an article for Newsweek, neurosurgeon Eben Alexander recounts his near death experience during a coma from bacterial meningitis. This is sure to become a staple of the NDE/afterlife community, as Alexander recounts in articulate and breathless terms his profound experience. His book is called, Proof of Heaven – a bold claim for someone who insists he is and remains a scientist.

Alexander claims:

There is no scientific explanation for the fact that while my body lay in coma, my mind—my conscious, inner self—was alive and well. While the neurons of my cortex were stunned to complete inactivity by the bacteria that had attacked them, my brain-free consciousness journeyed to another, larger dimension of the universe: a dimension I’d never dreamed existed and which the old, pre-coma me would have been more than happy to explain was a simple impossibility.

While his experience is certainly interesting, his entire premise is flimsily based on a single word in the above paragraph – “while.” He assumes that the experiences he remembers after waking from the coma occurred while his cortex was completely inactive. He does not even seem aware of the fact that he is making that assumption or that it is the central premise of his claim, as he does not address it in his article.

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