Our conference starts with the beginning of the universe, and ends with a very human question: what happens to us after we die? Do we simply cease to be? Or is there some kind of continuity of consciousness after death, despite the best evidence of materially-based science?
As a writer with a life-long interest in science and pushing back the boundaries of what we know, I was excited to attend the 11th annual International Bioethics Forum, held in Madison, Wisconsin from April 26th to 27th, 2012. This year’s theme, Final Passages: Research on Near-Death and the Experience of Dying, promised an in-depth examination of one of the most challenging and taboo topics in Western society — our own mortality. For decades the question of what happens after we die has been largely ignored, often vehemently, by mainstream science and medicine. It can be an especially uncomfortable topic for people whose professions put them in frequent contact with death, such as doctors, nurses, and trauma surgeons. The accepted materialist view of reality supposes that human consciousness is a complex epiphenomenon which arises from a combination of biological processes in the brain that can be explained by physics and chemistry (Robinson 1999). In this model the brain generates consciousness, and when it stops working — for example, in the case of coma or death — consciousness ends.
Many people in the Western world probably find the materialist model of consciousness compelling in its simplicity, if not exactly attractive. For years I was one of those people: I thought there was enough scientific evidence to explain near-death and out-of-body experiences reported by people who had briefly died or come close to physical death due to accident, injury, or severe illness. For those of our visitors who are unfamiliar with these phenomena, an out of body experience occurs when a person subjectively sees and experiences the world from a viewpoint outside his or her physical body; perhaps standing next to it or floating above it. Some people claim to be able to induce OBEs at will through mind-training and meditation practices, and OBEs may also occur spontaneously (Blackmore 1986). A near-death experience occurs when a person has a similar out of body experience at a time when his or her physical body is gravely injured, in coma, or has been pronounced clinically dead. Clinical death is defined as “the permanent cessation of vital bodily functions, as manifested in humans by the loss of heartbeat, the absence of spontaneous breathing, and brain death [loss of brain activity, including in the brain stem]” (American Heritage Medical Dictionary 2007).
People have reported having near-death experiences (NDEs) after suffering cardiac arrest or serious physical injury, and in the middle of deep comas. Some of the common features of near death experiences worldwide include a feeling of floating out of the body, seeing a tunnel or a bright light, and encountering deceased relatives and friends who often act as guides to usher the person into the next world (IANDS 1996). People have reported feeling a sense of peace, joy, and universal love during an NDE. While a few people have had frightening experiences, many of those who have had NDEs attest that it changed life for the better: it resulted in a broadening of beliefs, gaining an enhanced appreciation for life, and most intriguingly, losing the fear of death (van Lommel 2012).
While modern medicine has done some research into the possible causes of NDEs, many of their features remain unexplained by science. One Swiss study discovered it is possible to induce an out-of-body perspective in patients using electrode stimulation of the right angular gyrus of the brain, which seems to be involved in regulating our proprioception, or sense of body position (Blanke 2002). A Swiss study also fitted participants with video cameras that displayed a view of their own bodies sitting in a chair as though from about six feet away, and then tested the subjects’ reaction to various stimuli (Ehrsson 2007). However, these experiments do not answer the compelling question of how a patient who is clinically dead (i.e., devoid of brain and heart function), or in a deep coma with no cerebral activity could be in any way conscious.
The Final Passages Conference attempted not to generate a definitive answer but to get attendees thinking about this question and the possibilities it raises. The conference’s basic premise was this: if there is indeed consciousness after death, it may mean we need to radically restructure our model of reality. The possibility of continuity after death holds implications for how doctors, psychologists and individuals treat the issues of end of life care, life-saving medical interventions, organ donation, and a host of related subjects. This article is designed to give our readers a relatively brief overview of the conference’s topics of discussion and the questions raised. For those of you who want to know more, the Bioethics Conference has also posted full-length video of the lectures and panels from Days One and Two here.
Day One addressed the basics of what near-death experiences are, how (and if) they can be clinically verified, and what kinds of impact they have on people who experience them by undergoing clinical death or coma. Possibly the most surprising thing about the first day of presentations were the presenters themselves: the conference began with a presentation on NDEs in victims of cardiac arrest by Dutch cardiologist Pim van Lommel, M.D.; a 5-year prospective study of near-death experiences in a Welsh intensive care unit by nurse and medical researcher Penny Sartori, PhD; and an interview with neurosurgeon Eben Alexander, M.D., who related his own NDE and how it changed his beliefs about the origin of consciousness and its continuity after death.
For someone like me who knew very little previously about the clinical study and breadth of the near-death experience, I was struck by the professionalism and seriousness with which these presenters tackled the reality of the near-death experience and what it suggests about the continuity of human consciousness after death. Van Lommel and Sartori both presented their own clinical studies of NDEs and their results, which suggested first of all that NDEs are a much more common experience than most people imagine, affecting around 18% of cardiac arrest revivals in van Lommel’s study (van Lommel 2012). Secondly, Sartori’s study indicated that the types of NDEs people have had are much more complex and varied than the popular picture of these experiences suggests. While some of her patients did undergo the “classic” NDE of being escorted by deceased relatives down a tunnel or toward a light, others met guide entities unknown to them, or seemed to float out over an expanse of water or empty space. One man was able to accurately report the actions of the nurses trying to revive him after he collapsed from oxygen deprivation (Sartori 2012). Sartori also described cases in which patients saw improvements in congenital conditions such as cerebral palsy after undergoing a near-death experience.
Beyond the remarkable material regarding NDEs themselves, these studies are important because they indicate an increasing acceptance of the reality of NDEs within the medical community: a recognition that these phenomena cannot be written off as the hallucinations of a dying brain. Perhaps no NDE account illustrated this better than the case of Eben Alexander, a respected neurosurgeon who in November 2008 was hospitalized with a severe case of bacterial meningitis. The infection effectively shut down his brain and plunged him into a deep coma. In his interview with Steve Paulson, host of the Madison radio program To the Best of Our Knowledge, Alexander recounted the in-depth NDE he experienced during coma. You can watch the video, “A Conversation with Eben Alexander III, M.D.- Near-Death Experiencer”, at the Bioethics Forum’s website.
If consciousness is, in fact, generated by the brain (Alexander asked), how could he possibly have experienced these things when his brain was in a non-functional state? This is the question at the heart of all clinical research on NDEs, and the presentations on Day One were nothing less than a challenge to our conceived notions of how reality is structured: does matter have primacy over consciousness, or vice versa? And if consciousness comes first, how might that paradigm shift change modern medicine, including how we handle birth, death and end-of-life care?
The second half of the Bioethics Conference examined these issues directly: presenters examined the ways other cultures have developed strategies to confront the question of death and the afterlife, and how Western medicine and psychology might similarly help patients cope with their own anxieties and uncertainties about the process of dying. The driving question of Day Two was: if death is a transition to another state – a position that is hard to argue with – what strategies have humans developed to help ease people through this transition, and what therapies should we work to develop now?
Marilyn Schlitz, president and CEO of the Institute of Noetic Sciences (IONS), examined the ways diverse cultures have traditionally confronted the reality of death. Nearly all known cultures have cosmologies and myths regarding what kind of existence there might be after death, including instructions on what human beings should do to prepare themselves for this ultimate transition. In Western society, we sometimes forget that death is actually one of several major life transitions, the others being birth, puberty, marriage, birth of a child, and (for women) menopause. As psychology professor Stanislav Grof highlighted in his presentation, many indigenous cultures have developed complex rituals designed to guide people through these major transitions. Many non-Western cultures have a more animistic cosmology that sees all parts of reality as conscious and aware, and in response have developed “technologies of the sacred” — such as breath work, fasting, chanting, and the use of entheogens — that allow practitioners to explore these different facets of reality (Grof 2012).
In contrast, Western psychology and medicine have been influenced by a philosophical materialism which treats only objective physical reality as truly real, and dismisses intelligence and consciousness as epiphenomena. As a result, little attention has traditionally been paid in Western psychology to the life-death transition. Terminal patients might undergo heroic medical interventions to keep them alive with little concern for preserving their mental well-being or preparing them for the experience of dying (Grof 2012).
Yet, slowly, there has been a resurgence of interest in psychotherapy which addresses the life-death transition. Several of the top names in psychedelic psychotherapy research were present at the conference, including William A. Richards and Roland Griffiths, who helmed the groundbreaking Johns Hopkins study in which they demonstrated that healthy volunteers given psilocybin were able to achieve verifiable mystical experiences. Day Two partly focused on the promise of psychedelic psychotherapy, a psychiatric practice in which patients are given compounds such as psilocybin in a controlled, therapeutic setting. The focus of the therapy is often on helping patients diagnosed with terminal cancer and other conditions cope with anxiety as they approach the end of life. In his presentation “Training to Become a Psychedelic Psychotherapist”, Jeffrey Guss, a clinical assistant professor of psychiatry at New York University School of Medicine, underscored the power of psychedelics to present even hardened skeptics with a totally different version of reality that is not contingent on individual beliefs or biases. Used in a controlled, therapeutic setting, he argued that entheogens like psilocybin and LSD have great potential to help people through the depression, anxiety and turbulent emotions associated with the transition from life to death, as well as find meaning in the life they have left (Guss 2012).
The upshot of this conference was that a paradigm shift seems to be occurring in how people view reality, including medical professionals and psychologists. New, expanded models of reality have followed in the wake of discoveries in quantum physics, genetics, and phenomenology that suggest the world may be quite different from how our senses perceive it (Richards 2012). As a human being embedded in a vividly real physical world, I found many of the ideas presented at this conference challenging, even preposterous at times… but by the second day of the conference, I’d realized something: that’s exactly the point. The presenters were trying to shake up the audience, to get us to rethink our comfortable — or at least well-worn — assumptions about reality and our place within it, to get us to reconsider the possibility that reality may be more than matter, and consciousness more than just the physical brain. And that’s an idea that could change everything.
American Heritage Medical Dictionary, 2004, 2007 by Houghton Miffline Company.
Blackmore, Susan J. “Spontaneous and deliberate OBEs: A questionnaire survey”, January 1986, Journal of the Society for Psychical Research 53 (802): 218-224.
Blanke O., S. Ortigue, T. Landis, M. Seeck. Stimulating own-body perceptions. Nature 419: 269-270. 2002.
“Bioethics Forum”, BioPharmaceutical Technology Center Institute, last modified 2012, accessed May 10th, 2012. http://www.btci.org/bioethics/default.html
“Characteristics of a Near-Death Experience”. International Association for Near-Death Studies (IANDS), last modified 1996, accessed May 10th, 2012. http://iands.org/about-ndes/characteristics.html
Ehrsson, H.H. 2007. “The experimental induction of out-of-body experiences”. Science 317: 1048.
Robinson, William. Epiphenomenalism- Stanford Encyclopedia of Philosophy, January 18th, 1999. Last modified January 27th, 2011. http://plato.stanford.edu/entries/epiphenomenalism/.