Consciousness Beyond Life: The Science of the Near-Death Experience (48 page)

Would patients’ desire for euthanasia or assisted suicide change if they realized that consciousness survives death because it has no beginning and no end?

The public at large remains confused about the precise meaning of euthanasia. Political debates on the subject have certainly added to this confusion. Active euthanasia involves the administration of a lethal injection, usually in the final stages of a malignant disease or AIDS, precipitating an accelerated and unnatural death. In the Netherlands doctors are legally allowed to carry out euthanasia only if the patient’s suffering is unbearable, without any prospect of improvement, and when a second doctor has been consulted. Doctors who refuse to perform active euthanasia on principle are obliged to refer their patient to a doctor who is prepared to go ahead with the procedure. Assisted suicide usually involves the prescription of lethal drugs.

The term
euthanasia
does not cover the practice of withholding medication to prevent further suffering. For example, the decision to withhold antibiotics from a ninety-year-old demented patient will, in combination with the patient’s refusal to eat and drink, probably result in death due to an untreated infection. Some people call this passive euthanasia. But the deliberate decision not to treat a complication results in a natural death. Our current medical techniques are capable of keeping people alive until a very old age, sometimes with a very poor quality of life, and often expressly against the wishes of patients (“I’m tired of life”) and families. How useful and desirable is it to keep treating malignant diseases at an old age, with disfiguring operations and intensive radiation treatment? To what extent are all these interventions informed by fear of death?

A request for euthanasia is often a request for support and assistance during the final stages of an intractable illness. If the doctor provides proper care and attention, as well as adequate medication for pain, shortness of breath, and fear, patients will often withdraw their request for euthanasia. As the work of Elisabeth Kübler-Ross in the United States and Marie de Hennezel in France demonstrates, this can be achieved through good twenty-four-hour home care or by placing terminal patients in a palliative care institution (a hospice).
¹²

The strict national guidelines for active euthanasia appear to be closely observed in the Netherlands. Euthanasia is a difficult and emotional intervention for patient, family, and practicing doctor alike; no doctor embarks on it lightly. In 2005 doctors in the Netherlands performed active euthanasia on 2,325 patients, which represented a 33 percent drop from 2001. About 96 percent of these patients who underwent active euthanasia were in the end stage of a malignant disease or HIV with a mean life expectancy of one to maximal two weeks and with untreatable pain or extreme shortness of breath. Euthanasia is not allowed in patients who are not able to express their wish for euthanasia, as in the end stage of dementia. Palliative sedation, the prescription of powerful medication for pain or shortness of breath, usually slightly reduces the terminal phase of dying patients. In 2005, 9,700 patients received palliative sedation in the Netherlands while 66,000 patients were denied life-prolonging treatment or given (in the case of mostly very old patients) intensive pain medication.
¹³

The Netherlands appears to be the only country in the world with so much openness about euthanasia and such careful monitoring of the various treatments available to terminal patients. There is certainly no sign of the downward spiral so feared abroad. In the many countries where abortion, assisted suicide, and euthanasia are officially banned, these procedures still take place but illegally and thus without proper medical guidelines, resulting in medical and psychological risks for patient, family, and doctor.

When asked about my own opinion on active euthanasia, my usual response is that I judge neither the patients or families who request euthanasia nor the performing doctor. Each case is unique. But one must not forget that families sometimes put pressure on doctors to perform euthanasia because the adult children “cannot bear it any longer” even though the elderly patient no longer exhibits any signs of conscious or visible suffering. Euthanasia also cuts short the time for patients and their families to settle matters or talk things through. Every procedure that curtails the natural life span reduces the available time for a peaceful, meaningful, and loving good-bye.

I have been told of people who used to be opposed to euthanasia on religious or political grounds and who changed their minds as soon as someone in their own family was affected by a terminal illness and suffered a great deal of pain, shortness of breath, anguish, and fear. I myself am not an advocate of active euthanasia, nor do I condemn it. My views on the issue have become more nuanced thanks to the research into the content and consequences of an NDE, in particular the stories about the continuity of consciousness and the loss of the fear of death. Familiarity with NDE research and the possibility of a personal afterlife can reduce fear of death and help inform people’s opinions and decisions on ethical and medical issues.

You’ll ne’er attain it, save you know the feeling.

—G
OETHE,
Faust I

In conclusion, knowledge about near-death experience can be of great practical significance to health care practitioners and to dying patients and their families. NDEs are much more common than previously assumed, and the personal consequences of such an experience are much more profound than doctors, nurses, and relatives ever imagined. Openness, sympathy, and proper support help NDErs accept and integrate this experience.
¹⁴
Fear of death and of the process of dying often informs decisions on ethical and medical issues on the part of doctors, patients, and families. A new perspective on death, which conceives of a continuity of consciousness after physical death, will have consequences for the way in which health care providers deal with coma patients and resuscitated, seriously ill, or dying patients and with stories about contact with the consciousness of dead relatives. Continuing improvement of the quality of health care depends not just on technical and medical advances but also on compassion for individual patients and their families.

Introduction

1. G. G. Ritchie,
Return from Tomorrow
(Grand Rapids, MI: Zondervan, 1978.

2. G. G. Ritchie,
Return from Tomorrow
(Grand Rapids, MI: Zondervan, 1978); R. A. Moody Jr.,
Life After Life
(Covington, GA.: Mockingbird Books, 1975).

3. D. Kennedy and C. Norman, “What We Don’t Know,”
Science
309, no. 5731 (2005): 75.

4. A. M. Owen et al., “Detecting Awareness in the Vegetative State,”
Science
313 (2006): 1402.

5. A. Korthals Altes,
Uit coma
[Out of Coma] (The Hague, the Netherlands: Mirananda, 2002).

6. Kerkhoffs, J.
Droomvlucht in coma
[Dream Flight in Coma] (Melick, the Netherlands: Marga Genot Melick, 1994).

7. For the Dutch population, see J. Becker and J. de Hart,
Godsdienstige veranderingen in Nederland
[Religious Change in the Netherlands], Werkdocument 128, Sociaal Cultureel Planbureau (2006), and the Association of Religion Data Archives, http://www.thearda.com. For the American studies, see F. A. Curlin et al., “Religious Characteristics of U.S. Physicians,”
Journal of General Internal Medicine
20, no. 7 (2005): 629–34, and the Pew Forum on Religion and Public Life,
U.S. Religion Landscape Survey
(2007), http://www.religions.pewforum.org. For the United Kingdom, see L. Halman,
The European Values Study: A Third Wave. Sourcebook of the 1999–2000 European Values Study Surveys,
question 30-B (Tilburg: EVS, WORC, Tilburg University, 2001).

8. I. Maso, “Argumenten voor een inclusieve wetenschap” [Arguments in Favor of an Inclusive Science], paper presented at the conference Wetenschap, wereldbeeld en wij [Science, Worldview, and Us], Brussels, Belgium, June 2003.

9. A. H. Maslow,
The Psychology of Science
(New York: Harper & Row, 1966), chap. 8.

10. T. S. Kuhn,
The Structure of Scientific Revolutions
(Chicago: University of Chicago Press, 1962).

11. D. Dennett,
Consciousness Explained
(Boston and London: Little, Brown, 1991).

12. D. J. Chalmers, “Facing Up to the Problem of Consciousness,”
Journal of Consciousness Studies
3, no. 1 (1995): 200. Chalmers’s review essay is “Consciousness and Its Place in Nature,” in
Philosophy of Mind: Classical and Contemporary Readings,
ed. D. J. Chalmers (Oxford: Oxford University Press, 2002). Also at: http://consc.net/papers/nature.html.

13. W. Heisenberg, “The Representation of Nature in Contemporary Physics,”
Symbolism in Religion and Literature
(1960), 231, cited in R. D. Boisvert, “Heteronomous Freedom,” in
Philosophy and the Reconstruction of Culture,
ed. John. J. Stuhr (Albany: State University of New York Press, 1993), 139.

14. P. van Lommel et al., “Near-Death Experience in Survivors of Cardiac Arrest: A Prospective Study in the Netherlands,”
Lancet
358 (2001): 2039–45; B. Greyson, “Incidence and Correlates of Near-Death Experiences in a Cardiac Care Unit,”
General Hospital Psychiatry
25 (2003): 269–76; S. Parnia et al., (2001). “A Qualitative and Quantitative Study of the Incidence, Features, and Aetiology of Near Death Experiences in Cardiac Arrest Survivors,”
Resuscitation
48 (2003): 149–56; P. Sartori, P. Badham, and P. Fenwick, “A Prospectively Studied Near-Death Experience with Corroborated Out-of-Body Perception and Unexplained Healing,”
Journal of Near-Death Studies
25, no. 2 (2006): 69–84.

Chapter 2: What Is a Near-Death Experience?

1. C. Zaleski,
Otherworld Journeys: Accounts of Near-Death Experience in Medieval and Modern Times
(Oxford: Oxford University Press, 1987).

2. B. Greyson, “Near-Death Experiences,” in
Varieties of Anomalous Experiences: Examining the Scientific Evidence,
ed. E. Cardena, S. J. Lynn, S. Krippner (Washington, DC: American Psychological Association, 2000), 316.

3. IANDS USA, http://www.iands.org.

4. Zaleski,
Otherworld Journeys.

5. For the American figures, see G. Gallup and W. Proctor,
Adventures in Immortality: A Look Beyond the Threshold of Death
(New York: McGraw-Hill, 1982). For the German incidence, see I. Schmied, H. Knoblaub, and B. Schnettler, “Todesnäheerfahrungen in Ost- und Westdeutschland: Eine empirische Untersuchung” [Near-Death Experiences in East and West Germany: An Empirical Study], in
Todesnähe: Interdisziplinäre Zugänge zu einem außergewöhnlichen Phänomen
[Near-Death: Interdisciplinary Approaches to an Extraordinary Phenomenon], ed. H. Knoblaub and H. G. Soeffner, 65–99 (Konstanz, Germany: Universitätsverlag, 1999).

6. R. M. Hoffman, “Disclosure Needs and Motives After Near-Death Experiences: Influences, Obstacles, and Listener Selection,”
Journal of Near-Death Studies
14 (1995): 29–48.

7. R. A. Moody Jr.,
Life After Life
(Covington, GA: Mockingbird Books, 1977); G. K. Athappilly, B. Greyson, and I. Stevenson, “Do Prevailing Society Models Influence Reports of Near-Death Experiences: A Comparison of Accounts Reported Before and After 1975,”
Journal of Nervous and Mental Disease
194, no. 3 (2006): 218–33. For culture-specific differences, see Zaleski,
Otherworld Journeys.
For the results of studies with indigenous peoples, see A. Kellehear, “Culture, Biology, and the Near-Death Experience: A Reappraisal,”
Journal of Nervous and Mental Disease
181 (1993): 148–56.

8. K. Ring,
Life at Death: A Scientific Investigation of the Near-Death Experience
(New York: Coward, McCann & Geoghegan, 1980); M. B. Sabom,
Recollections of Death: A Medical Investigation
(New York: Harper & Row, 1982); B. Greyson, “The Near-Death Experience Scale: Construction, Reliability and Validity,”
Journal of Nervous and Mental Disease
171 (1983): 369–75.

9. Greyson, “Near-Death Experience Scale.” I think the terms
paranormal
and
transcendental
are confusing, and I choose not to use them myself; they are Greyson’s terms.

10. Ring,
Life at Death.

11. Greyson, “Near-Death Experience Scale.” Greyson also calculated that both scoring systems are accurate and highly correlated, with a correlation coefficient of 90.

12. J. M. Holden, “Veridical perception in near-death experiences.” In J. M. Holden, B. Greyson, and D. James, eds.,
The Handbook of Near-Death Experiences
(Santa Barbara, CA: Praeger/ABC-CLIO, 2009), pp. 185–211.

13. P. van Lommel et al., “Near-Death Experience in Survivors of Cardiac Arrest: A Prospective Study in the Netherlands,”
Lancet
358 (2001): 2039–45; R. Smit, “Corroboration of the Dentures Anecdote Involving Veridical Perception in a Near-Death Experience,”
Journal of Near-Death Studies
27, no. 1 (2008): 47–61; T. Rivas, “Een gesprek met TG over de man met het gebit” [A Conversation with T.G. About the Man with the Dentures],
Terugkeer
19, no. 3 (2008): 12–20.

14. C. G. Jung,
Memories, Dreams, Reflections,
ed. Aniela Jaffé, trans. R. and C. Winston (New York: Random House, 1961), 289–90.

15. British Broadcasting Company,
The Day I Died: The Mind, the Brain, and Near-Death Experiences
(2002); K. Ring and S. Cooper,
Mindsight: Near-Death and Out-of-Body Experiences in the Blind
(Palo Alto, CA: William James Center/Institute of Transpersonal Psychology, 1999).

16. Ring and Cooper,
Mindsight,
26.

17. BBC,
Day I Died.

18. N. Evans Bush, “Afterward: Making Meaning After a Frightening Near-Death Experience,”
Journal of Near-Death Studies
21, no. 2 (2002): 99–133.

19. G. G. Ritchie,
Return from Tomorrow
(Grand Rapids, MI: Zondervan, 1978), 63–66.

Chapter 3: Changed by a Near-Death Experience

1. G. Groth-Marnat and R. Summers, “Altered Beliefs, Attitudes and Behaviors Following Near-Death Experiences,”
Journal of Human Psychology
38 (1998): 110–25.

2. K. Ring,
Heading Toward Omega: In Search of the Meaning of the Near-Death Experience
(New York: Quill William Morrow, 1984); M. Grey,
Return from Death: An Exploration of the Near-Death Experience
(London: Arkana, 1985); P. M. H. Atwater,
Coming Back to Life: The Aftereffects of the Near-Death Experience,
rev. ed. (New York: Citadel, 2001); C. Sutherland,
Transformed by the Light: Life After Near-Death Experiences
(Sydney, Australia: Bantam Books, 1992); M. Morse,
Transformed by the Light
(New York: Villard Books, 1990); P. Fenwick and E. Fenwick,
The Truth in the Light: An Investigation of Over 300 Near-Death Experiences
(New York: Berkley Books, 1997); K. Ring and E. Elsaesser-Valarino,
Lessons from the Light: What We Can Learn from the Near-Death Experience
(New York and London: Insight Books/Plenum, 1998); A. Opdebeeck,
Bijna dood: Leven met bijna-doodervaringen
[Nearly Dead: Living with Near-Death Experiences] (Tielt, Belgium: Uitgeverij Terra-Lannoo, 2001).

3. Sutherland,
Transformed by the Light.

4. Sutherland,
Transformed by the Light;
Groth-Marnat and Summers, “Altered Beliefs” B. Greyson, “Near-Death Experiences and Personal Values,”
American Journal of Psychiatry
140 (1983): 618–20; B. Greyson, “Reduced Death Threat in Near-Death Experiences,”
Death Studies
16 (1992): 533–46; Ring,
Heading Toward Omega.

5. Atwater,
Coming Back to Life;
Sutherland,
Transformed by the Light;
Opdebeeck,
Bijna dood
[Nearly Dead]; Greyson, “Near-Death Experiences and Personal Values.”

6. Schmied, Knoblaub, and Schnettler, “Todesnäheerfahrungen” [Near-Death Experiences].

7. Opdebeeck,
Bijna dood
[Nearly Dead].

8. Opdebeeck,
Bijna dood
[Nearly Dead].

9. Sutherland (
Transformed by the Light
) describes the four phases of the integration trajectory as follows: blocked, arrested, steady, and accelerated integration. Regina Hoffman identifies five phases: shock or surprise at the content of the NDE, the need for affirmation (and the lack thereof), the impact on personal relationships, the active quest, and finally the process of integration; see R. M. Hoffman, “Disclosure Needs and Motives After Near-Death Experiences: Influences, Obstacles, and Listener Selection,”
Journal of Near-Death Studies
14 (1995): 29–48; Atwater, “Coming Back to Life” B. Greyson, “Posttraumatic Stress Symptoms Following Near-Death Experiences,”
American Journal of Orthopsychiatry
71 (2001): 358–73.

10. R. M. Hoffman, “Disclosure Habits After Near-Death Experience: Influences, Obstacles, and Listeners Selection,”
Journal of Near-Death Studies
14 (1995): 29–48; Greyson, “Posttraumatic Stress Symptoms” B. Greyson, “Biological Aspects of Near-Death Experiences,”
Perspective in Biology and Medicine
42, no. 1 (1998): 14–32; B. Greyson and B. Harris, “Clinical Approaches to the Near-Death Experiencer,”
Journal of Near-Death Studies
6 (1987): 41–52; I. Corbeau, “Psychische problematiek en hulpverlening na een BDE” [Psychological Problems and Support After an NDE],
Terugkeer
(
Tijdschrift rond bijna-dood ervaringen en zingeving)
[Return (Journal of Near-Death Experiences and Meaning)] 15, nos. 2–3 (2004): 16–22.

11. Sutherland,
Transformed by the Light.