Not Near-Death NDEs
Incidence of near-death experiences in patients surviving a prolonged critical illness and their long-term impact: a prospective observational study
This study was recently published in the journal called critical care. Here is a summary of the key methodological details and findings:
- Prospective study designed to assess the incidence and patient characteristics of NDEs during stays in the ICU.
- Pts who had ICU stays >7 days were interviewed within 7 days, 1 month and 1 yr following discharge from the ICU.
- 126 patients were included with 19 (15%) reporting NDEs (score of ≥7 on the Greyson scale).
- Cognitive and spiritual factors outweighed medical parameters as predictors of the emergence of NDE.
My comments on this study:
What immediately makes it interesting is that these were patients who were in the ICU, NOT the ER. These patients were not in CA if they reported an NDE, hence the name of this post. Yet 15% of patients who stayed in the ICU had an NDE. These would not be classified as REDs using the criteria published last year, and yet if they are authentic NDEs, which the Greyson scoring suggest they were, then they occurred in a situation where the patients may have died without the intense medical interventions that were being applied in the ICU. This raises questions about the mechanisms of triggering an NDE, as well as the authenticity of them…the latter is perhaps what the authors are hinting at. This is what the authors say about NDE induction:
“Patients in ICU may face potentially physical stressors, such as inflammation, high catecholamine levels, independently of the primary organ failure triggering ICU admission . These are all potential inducers of NDE . Next to these (neuro)physiological factors, some cognitive processes have also been proposed to trigger NDE, such as the tendency for dissociation.”
As for the key findings that the authors highlight, much of it comes from this finding:
“…DES [a questionnaire that assessed the presence of dissociative states] and the WHOQOLSRPB [a WHO questionnaire that assesses a propensity to religious or spiritual beliefs] as the strongest predictors for the emergence of NDE…”
In the discussion they flesh out their thinking on these findings:
“a higher frequency of dissociative symptoms and a greater spiritual and personal well-being were the strongest predictors for the recall of NDE using multivariate analysis (Fig. 1). It is then reasonable to hypothesize that a propensity to dissociative states and to spiritual beliefs and practices make people more likely to report NDEs when exposed to certain physiological conditions.”
My big issue with this conclusion is that all the data relating to dissociative states and religious propensity was gathered after the ICU stay, and therefore after any potential NDE. The question must therefore be asked as to whether or not this propensity to dissociative states and to spiritual beliefs and practices was pre-existing or heightened or even induced by the NDE. It is hard to see how the questionnaires would explicitly be able to identify these traits as underlying and pre-existing, so the hypothesis is based on somewhat shaky ground. Moreover, even if the hypothesis is correct, it says nothing about the validity of NDEs being a manifestation of the dualist relationship of human consciousness with the brain. I state in my book on NDEs that it is possible, even likely, that some people are more prone to being spiritual, and that there are genetic links to this. This could mean that some people are physiologically more prone to NDEs…their consciousness may be less “tightly tethered” to their brains, for want of a better expression.
I do give credit to the authors here for not drawing any conclusions that do not belong outside of the parameters of the area of study, and to the potential nature of NDEs, although they do give a nod to some of the previous attempts to explain NDEs through neurological processes. Despite the latter, I don’t really know where the authors stand on the issue, and that is a very good thing because it suggests that their bias didn’t influence their research.
Returning to their discussions, the problem associated with only having data post ICU stay also applies to one of the key overall conclusions of the study, specifically that NDEs do not alter quality of life. Due to the small sample size, and the fact that we do not have QOL data from before the ICU stay, it is not really possible to say with certainty that NDEs have any effect on QOL. Moreover, the type of questionnaire used focuses on physical outcomes, and since these people all suffered conditions that required intensive care, and NDEs are largely understood in a spiritual context, then it would be highly unlikely that there would be much difference in physical outcomes. In fact, I think I once heard that people who have had NDEs were more likely to die in subsequent years than those who hadn’t, but I can’t remember the source.
My biggest gripe with this publication is that details from the NDE interviews are not revealed. There were 19 in total, it is therefore highly likely if ICU NDEs followed similar patterns to CA-induced NDEs that there would 2-4 OBEs. This is not mentioned or discussed, nor are the breakdowns of the Greyson scores. Given that this is the first study to prospectively look at NDEs in an ICU, I feel this was a bad omission since they could have determined if there might have been differences between the NDEs from ICU and CA. Also, were they hiding something? Were they discouraged or prohibited from sharing “subjective” OBEs by the reviewers?
Other than this, the study was well conducted and the findings neutral. Most of all, for us they highlight the fact that NDEs occur in instances beyond just cardiac arrest, and that they may be much more common as a result. The downside of this is that in the absence of scientifically validated OBEs, these types of NDE are much more open to mundane physiological explanations touted by neurologists.