Living with death and dying
Living with death and dying

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Living with death and dying

1.3.11 The significance of the near-death experience

The sociologist Allan Kellehear (1995) observes that most studies have had a medical focus, investigating whether near-death experiences could be the result of a lack of oxygen to the brain or another medical or psychological cause. Kellehear suggests that the search for psycho-medical explanations has focused on psycho-neurological and defensive mechanisms emphasising altered status of consciousness or physical functioning and not taken into account the meaning of these experiences. Kellehear identifies three social features of near-death experience:

  • sudden and unexpected separation

  • a transition period involving expectation of death

  • a sudden return to the original social group.

Kellehear suggests that these features imply a ‘status passage’ and resemble other kinds of experiences, for example those of people who have been shipwrecked. ‘Status passage’ was described by Glaser and Strauss (1967), who conducted extensive research of dying people and those caring for them. It involves a ‘changed identity or sense of self, as well as changed behaviour’ (p. 2, quoted in Kellehear, 1995). We experience many transitions: changing jobs, careers, partners and locations. As our position changes we continually have to readjust to a transitional position, separating from our former status and then integrating and recognising our new position. Using this analogy, near-death experiences resemble many features of modern dying – it is unscheduled, undesirable, involuntary and not always predicted.

For some people the impact of near-death experience is very profound. For example, for some the existence of the near-death experience acts as a proof or an assurance of life after death. A respondent in the Fenwicks’ study put it as follows:

I’ve always believed in life after death, though I no longer belong to any form of organised religion, preferring to find my own path, but if I needed anything to confirm my belief in another plane of existence, that experience certainly did. I feel so grateful to have had it.

(Fenwick and Fenwick, 1996, p. 150)

For others it is no more than a subjective account of what is experienced as the brain closes down due to a lack of oxygen. A typical expression of this second view is given by Leslie Ivan (a neuro-surgeon) and Maureen Melrose (a nurse) in their book The Way We Die (1986), in which they assert that ‘all the experiences that have been described can certainly originate in the brain, caused by the well-known chemical changes that occur in near-death emergencies’. They describe the steps in the dying process as follows (adapted from Ivan and Melrose, 1986, p. 87):

  1. The triggering mechanism is decreased blood oxygen availability. The feeling of peace and tranquillity is an early manifestation of decreased nerve activity (the way tranquillisers work).

  2. As the chemical changes increase in quantity there is an effect in the limbic system of the brain (the part activated during arousal and motivated behaviour) such that there is a sense of euphoria and body-separation.

  3. With the progressive changes, other elements of the brain become involved and when the visual cortex is affected ‘blacking out’ occurs (entering the darkness).

  4. Further changes cause hyperactivity of the same nerve cells and visual hallucinations become intensified (seeing the light).

  5. In the final stage, just before the part of the brain responsible for consciousness is abolished, a hallucination occurs (entering the light).

This type of explanation is based on a commitment to the view that the material world in general, and neuro-physiological changes in particular, form basic reality and that consciousness and imagery are simply an effect or expression of these material changes. By and large people trained in medicine will tend to favour such an explanation, though some find it inadequate, as did Michael Sabom, who identified a number of discrepancies between the near-death experience accounts he gathered and existing neuro-physiological explanations. So, for instance, he was struck by the fact that some people recall in precise and accurate detail events and objects that had been outside of their visual field at the time of the experience. He also found major differences between the feelings and ‘visions’ associated with near-death experiences and those experienced in the delusions, hallucinations, dreams and temporal lobe seizures in terms of which near-death experiences have commonly been explained. Acknowledging that there are, however, strong similarities between near-death experiences and states of consciousness associated with raised levels of carbon dioxide in the brain, Sabom ended by questioning the premise underlying the neuro-physiological explanation by asking whether the experiences were ‘caused by the high levels of carbon dioxide per se or were they due to some other mechanism associated with the patients’ carbon dioxide-induced near-death condition?’ (p. 178).

Activity 5

What possible kinds of answer might there be to Sabom’s question? If you can think of any alternatives to the medical explanation briefly jot them down before continuing. You are not being asked to find the right answer but just to guess what possible answers there might be.

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