Apologies for the pun, but couldn’t help myself. As some of you may be aware one of the more valued members of this site, Tim, and I had a somewhat acrimonious discussion yesterday that became personal and resulted in Tim saying his goodbyes. Goodbyes, unlike death, can be reversible, so hopefully we will see him again and continue to learn from his outstanding knowledge of this subject.
So what was all the fuss about? For me it was a case of semantics – in this instance the meaning of the word death and its use in the term RED. The reason for us discussing what the word death means was due to this article:
First of all, the title is ludicrous and based on a huge assumption. The study of NDEs only requires neuroscientific expertise if NDEs are the result of neurological processes. I have spent the past 4 years of my life working in neuroscience, and I can assure you that there is nothing in human understanding of neuroscience that could explain a genuine OBE. That has and always will be the issue, therefore the study of NDEs does not need an expertise in neuroscience. It might benefit from it to interpret various neurological measurements that are acquired during a CA, but it is not necessary, especially when it comes to any experiments that attempt to validate OBEs. If you have a scientifically validated OBE, then that cannot be explained by science. Moreover, neurologists and neuroscientists were a part of developing the consensus statement.
Obviously starting off with the assumption that an NDE is a natural neurological phenomenon means that the rest of the article is constrained by this materialist assumption and therefore many other things that are said are just incorrect. However, there are a couple of points they make that are very pertinent and worth highlighting, and one in particular that caused the spat between Tim and me. It was my suggestion that I agreed in part with their statement about the use of term RED that set things off. This is what they said:
Second, contrary to what Parnia et al. write, people who recall NDEs are therefore inherently people who have not been dead and have not met brain death criteria. Since the introduction of brain death criteria in 50 the 1960s, not a single patient properly diagnosed as brain dead has come back to life….Because of these scientific inaccuracies, the proposed term “recalled experience of death” is wrong and we firmly reject it. The authors confuse “death” with the process of dying
My initial response of agreeing in part was more a gut reaction given that I was not aware of there being specific definitions for death and therefore given this state of affairs, and given the potentially reversible nature of the condition people are in when their hearts and brains have stopped functioning, stating these people had experienced death seemed a bit of an over reach. This gut reaction is reinforced by having watched all these TV shows in which the ER physician announces “time of death” when they give up CPR…i.e. the person is beyond medical help and the process of dying has become irreversible.
As the discussion continued I started looking into definitions of the word death. Dictionaries and on line resources tend to use the word irreversible, but what really nailed it for me was the UDDA definition which is used in the US:
The Commission ultimately recommended a Uniform Determination of Death Act (UDDA) which aimed to make the total brain standard into law in the states. This recommendation has been adopted by the American Bar Association and American Medical Association, and made into law in some form in all 50 states. The UDDA simply states: ’An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead. Sarbey B. Definitions of death: brain death and what matters in a person. J Law Biosci. 2016 Nov 20;3(3):743-752. doi: 10.1093/jlb/lsw054. PMID: 28852554; PMCID: PMC5570697
In Canada: Death occurs when there is permanent loss of capacity for consciousness and loss of all brainstem functions . This may result from permanent cessation of circulation and/or after catastrophic brain injury. In the context of death determination, permanent refers to loss of function that cannot resume spontaneously and will not be restored through intervention.
Now while this is adopted in the US and Canada, it is by no means globally adopted, and there is still uncertainty about the exact moment that the word death is appropriate, as evidenced in this NHS presentation on the subject: http://odt.nhs.uk/pdf/Diagnosis_of_death.pdf
For me the key quote in that discussion is the following:
Dying is a process; Death is a defined point in that process
This is the point that the article by Martial is making, and while it is a semantic point, it is central to the consensus paper and Martial is right to call them out for coming up with the term RED – recalled experiences of DEATH. Basically, using the dictionary, US legal, Canadian and wider medical community’s definition of death, someone who has achieved ROSC has not experienced death. Oops.
Now I understand why Parnia et al came up with the term, and I somewhat agreed with it in principal at the time, but my view has now changed, and I think theirs should too…although that is harder as they might need to retract their paper which is a pretty hideous thing to do from a researcher perspective. NDE is actually the most accurate term, and while it has been abused by people broadening its application from the one originally intended, it would be better to apply clarifications such as authentic, or classical, rather than completely discard it. In fact their recent attempt to completely change the meaning of the term NDE to not include REDs was something that I really objected to.
But it is all just semantics. Fundamentally, while the term RED is technically wrong, we know exactly what condition they are describing: it is a condition in which the body is completely incapable of consciousness and in which the brain is incapable of producing or storing conscious recollections, and yet people report experiences occurring and have been able to “prove” these through human verification. This is why I say I partly agree with Martial et al say, because otherwise much of way they say is complete hogwash. For instance:
“There is hence no “recalled experience of death”; if anything, it should be ‘recalled experience of what might have been the start of the dying process just before consciousness was lost’.
Technically they might right in saying that it could be the start of the dying process, but by adding “just before consciousness was lost” they are betraying their materialist bias. That is an assumption, and the whole point of doing these studies. While they have a point in saying that studies have failed to empirically prove [beyond any doubt] that “people are able to report actual (real-life) events and details happening during e.g., cardiopulmonary resuscitation” neither do these studies, or any others disprove it. Moreover studies such as AWARE I and others, while not providing slam dunk proof, provide very strong evidence supporting the thousands of reports by very credible people, including Health Care Professionals, outside of the context of a clinical study.
Their third point is another tricky one and I find myself agreeing with a part of it:
“Third, the authors write that NDEs in post-cardiac arrest patients fundamentally differ from NDEs made in other life-threatening or non-life-threatening situations, and that the latter experiences are “mislabeled”. Again, the reasoning is flawed. There are no empirical data so far to indicate that the phenomenology of NDE differs in situations that are (a) associated with a threat to life and impaired brain physiology such as a cardiac arrest, (b) associated with a threat to life but unimpaired brain physiology such as a near-miss traffic accident, and (c) associated with non-life-threatening situations such as drug consumption or meditation. To the contrary, the data that do exist indicate that all these experiences are phenomenologically similar (e.g.,12-16). In other words, from the phenomenology of the experience one cannot tell if what happened was a cardiac arrest or e.g., use of a psychedelic drug. Contrary to what the authors state, this similarity suggests that the brain mechanisms behind these experiences are probably also similar, if not identical.”
I agree somewhat with their stating that some aspects of NDEs overlap with other experiences reported in different states. However, there are two ways of looking at this. The first, and one they cite, is that these experiences are the result of similar neurological processes, and the second that these experiences are possible in a variety of states and speak to the ability of the human consciousness to momentarily detach from the physical body. Both, in the absence of scientific, or empirical evidence, are possible explanations, but Martial et al only countenance one, and this is neither objective nor scientific. Moreover, the different conditions they cite are unlikely to produce similar neurological states and therefore it is unlikely they would produce similar psychological outcomes or recollections.
They make a few other statements based on their assumption that NDEs are the result of physiological process, which must be viewed in the light of this unscientific bias. However there is one statement they make that I absolutely 100% agree with, and which has troubled me enormously, and which I have commented on myself previously in this blog.
“Although Parnia et al. question the existence of distressing NDEs which they consider “related to [intensive care unit] delirium, delusions, and dreams in response to toxic metabolic states and withdrawal states (e.g., alcohol withdrawal)” (p. 17 of 127 File S2 from1), the latter claim is not empirically supported.”
The paper that Parnia cites to make this assertion actually suggests the complete opposite. I think this comes from a fundamental flaw in Parnia’s character…he is too nice! He doesn’t even want to consider the idea that people suffer after they die. I get that, but I do not believe that his position is the right one, and explain why in my book.
As for the conclusion of the article:
“Although (near-)death research certainly merits a framework directive, the paper by Parnia et al. is subject to a surprising lack of neuroscientific understanding. It reflects the fact that the field of NDE research (at least in parts) is biased by a widely held belief that there is something fundamentally special, if not supernatural, about NDEs, such as the notion that humans can have conscious experiences in the absence of a functioning brain.”
Yep, that’s the whole point isn’t it, and in the absence of scientific proof that consciousness in the absence of a functioning brain is not present, it should not be discounted as a possibility, and to do so is unscientific. The above statement displays a whopping lack of self-awareness when it comes to understanding their own lack of objectivity.
In summary, I think Parnia et al may need to rethink the use of the term RED. They also need to be aware of their own potential bias, such as on the subject of negative NDEs, and be open to outcomes that might be unappealing, but are nonetheless possible.