Guidelines and standards for the study of death and recalled experiences of death––a multidisciplinary consensus statement and proposed future directions

Abstract

An inadvertent consequence of advances in stem cell research, neuroscience, and resuscitation science has been to enable scientific insights regarding what happens to the human brain in relation to death. The scientific exploration of death is in large part possible due to the recognition that brain cells are more resilient to the effects of anoxia than assumed. Hence, brain cells become irreversibly damaged and "die" over hours to days postmortem. Resuscitation science has enabled life to be restored to millions of people after their hearts had stopped. These survivors have described a unique set of recollections in relation to death that appear universal. We review the literature, with a focus on death, the recalled experiences in relation to cardiac arrest, post-intensive care syndrome, and related phenomena that provide insights into potential mechanisms, ethical implications, and methodologic considerations for systematic investigation. We also identify issues and controversies related to the study of consciousness and the recalled experience of cardiac arrest and death in subjects who have been in a coma, with a view to standardize and facilitate future research. Keywords: death; cardiac arrest; resuscitation; death by brain death criteria; near-death experiences (NDEs); out-ofbody experiences (OBEs); external visual awareness (EVA); recalled experience of death (RED) coma; cardiopulmonary resuscitation-induced consciousness (CPRIC); post-intensive care syndrome (PICS)

Sawing the branch of near‐death experience research: A critical analysis of Parnia et al.’s paper

“…This redesign of the definition goes hand in hand with the division of the field into two categories of experiences: authentic NDEs and NDE‐like or “mislabeled NDEs” 1 (p. 16). Parnia et al 1 .…”

“…This redesign of the definition goes hand in hand with the division of the field into two categories of experiences: authentic NDEs and NDE‐like or “mislabeled NDEs” 1 (p. 16). Parnia et al 1 . (p. 10) describe a very degraded vision of the latter, which they reduce to being nothing more than delusions (p. 15).…”

“…An integration of these two hypotheses could be achieved by considering that the NDE is a heterogeneous experience of consciousness precipitated by the disjunction of processes usually combined in normal mental activity 11 . Thus, conditioning NDEs on a prerequisite period of loss‐of‐consciousness 1 (p. 4) is already a faulty claim: it rejects models that make NDE an altered state of consciousness via possible amplifications of consciousness (hyperalertness) combined with forms of dissociation.…”

“…This allows the authors to schematize their conception 1 (p. 8): an RED needs first an objective life‐threatening situation or a critical illness, then a loss of consciousness, followed by transcendental features in its narrative arc. But there are no empirical studies that support this phenomenological pattern.…”

“…Parnia and colleagues 1 recently proposed a new label for the near‐death experience (NDE): recalled experience of death (RED). However, we do not share several of the opinions shared by these authors and the “consensus” they proposed is far from general.…”