Not everyone who recovers from a near-death event reports a near-death experience. Nor does everyone who has a near-death experience report the whole, prototypical series of events. Some recall only a brief out-of-body experience with a view of their own physical body below, followed by a quick return. Others get only as far as the dark passageway, while others proceed all the way into the light. We do not know the reasons for all these variations. Notably, much of what 'common sense' suggests about near-death experiences turns out not to be true.
First, NDEs do not seem to be dreams. Dreams seem less real than ordinary waking reality; NDEs seem hyper-real i.e. "...more real than ordinary waking reality." Patients describe their NDE as almost the antithesis of dreams and deny dream-like qualities.
The occurrence of NDEs does not seem related to patients prior religious training or beliefs. Many people with no prior interest or background in religion report powerful NDEs after surviving grave medical crises. NDEs are not related to specific medical conditions. Patients with infections, trauma, cardiac arrest, complications of childbirth and many other diverse conditions have reported NDEs. There is wide variation in patient ages from the very young to the very old and every age between.
Attempts to explain NDEs in physical or neuro-psychological terms have postulated complex seizures or brain anoxia. One problem with these explanations is that typical NDE phenomena often occur among deathbed bystanders. This is called a "shared death experience (SDE)." The bystanders are neither ill nor injured. NDE and SDE are not caused by brain hypoxia or atypical seizures.
Bystanders or onlookers at the death of a patient may include physicians, nurses, other medical personnel, and relatives or friends of the dying. All of these types of bystanders report SDE that are often indistinguishable from near-death experiences. For example bystanders sometimes say they saw a transparent replica of the dying person leave that persons body at the point of death. Or they describe leaving their own bodies and rising up to accompany their dying loved one part way toward the light. Onlookers at someone else's death also sometimes report that a brilliant light filled the room, they heard indescribably beautiful music and/or they perceived apparitions of the dead person's deceased loved ones. Occasionally, onlookers empathically report that they co-lived the "life review" of the deceased person.
I first heard a shared death experience from one of my professors of medicine in December 1972. Since then, I have heard thousands of such accounts from physicians, nurses, kith and kin attendant at someone's death. I want to re-emphasize that all the same elements of near-death experiences reported by people who almost die are also reported by onlookers at the death of someone else. As incredible as this statement may seem, it is easily confirmable by any thorough investigator who will considerately and sympathetically inquire among people who were present at the death of others. I do not know exactly what the incidence or prevalence of shared death experiences might be but they are common and under-reported.
In the late 1970s, dissemination of knowledge about near-death experiences, both in mass media and in the medical literature, caused a worldwide sensation. Books about NDEs sparked theological debates and speculation about the prospect of life after death. Popular movies and television talk shows enthusiastically took up the banner of near-death experiences. Almost forty years later, near-death experiences are still vigorously debated in every corner of the earth.
Numerous physicians have investigated the phenomenon and have been deeply impressed with patients' accounts of their near-death experiences. The topic remains a staple of television documentaries and newspaper and magazine articles.
This continuing fascination with near-death experiences has profound implications for the sociology of medicine. Advances in resuscitation techniques return to life a large number of people experiencing profound states of visionary consciousness at the very edge of absolute death. This is a prime example of how the progress of medicine can affect society in far-reaching and unanticipated ways.
Inevitably near death experience reports have fueled debate on the possibility of life after death. There are no known rational or logical principles that allow reliable inferences about the prospect of an afterlife. Research into near-death experiences that is not rigorously rational may blur the line between medicine and religion. The best practice for physicians is to stick strictly to clinical and research concerns.
What should a physician do when a patient recovers from an almost fatal illness or injury and reports a near-death experience? From talking with thousands of such patients, I find most simply want someone to listen to them noncommittally. They want to talk about what happened to them and to ventilate the powerful emotions and memories associated with their near-death experience. After listening, it also helps to reassure the patient that he or she is not alone, that millions of other individuals have had such experiences. Listening and reassuring them helps set them on a lifelong course of integrating what for most is their most profound transcendent event.
Intervening with their families can often save such patients considerable unnecessary discomfort and interpersonal conflicts. The family should know that the patient is not mentally ill nor are NDEs rare. Patients with near-death experiences are generally convinced from the outset that the experience was real and that they are not 'crazy.' They often worry that other people will make fun of them or doubt their sanity.
Near-death experiences are an ancient and very common phenomenon that spans from ancient philosophy, religion and healing to the most modern clinical practice of medicine. Probably we are not much closer to an ultimate explanation of NDEs than were early thinkers like Plato and Democritus. Puzzling cases of near-death experiences continue to come to light and the ancient debate about what they mean continues unabated.
Raymond Moody, MD, PhD, is a world-renowned author, lecturer, and psychiatrist whose seminal book, Life After Life, completely changed the way death and dying are viewed. He is widely acknowledged as the world's leading expert in the field of near death experience. His books are perennial best sellers and over 20 million have been sold.