NEAR-DEATH EXPERIENCE REMAINS A MYSTERY 
(pp 2010, 2039)

Authors of a Dutch study in this week's issue of THE LANCET conclude that medical explanations cannot account for the phenomenon known as near-death experience (NDE). Only a relatively small proportion of patients who became clinically dead (resulting in oxygen deprivation to the brain) reported NDEs after successful cardiac resuscitation.

Some people report a near-death experience (NDE) after a life-threatening crisis. Most previous NDE research has been retrospective and is therefore of limited value. Pim van Lommel and colleagues from Hospital Rijnstate, Arnhem, The Netherlands, aimed to establish the cause of this experience and assess factors that affected its frequency, depth, and content.

344 cardiac patients who were successfully resuscitated after cardiac arrest in ten Dutch hospitals were prospectively studied. All patients had been clinically dead. NDE was defined as the reported memory of all impressions during a special state of consciousness, including specific elements such as out-of-body experience, pleasant feelings, and seeing a tunnel, a light, deceased relatives, or a life review. The investigators compared demographic, medical, pharmacological, and psychological data between patients who reported NDE and patients who did not (controls) after resuscitation. In a longitudinal study of life changes after NDE, the investigators compared the groups 2 and 8 years later.

62 patients (18%) reported NDE, of whom 41 (12%) described a core (deep) experience. Occurrence of the experience was not associated with duration of cardiac arrest or unconsciousness, medication, or fear of death before cardiac arrest. NDEs were more common among people younger than 60 years; deeper NDE experiences were more common among women. Substantially more patients who had an NDE-especially a deep experience-died during or shortly after NDE-related hospital stays. At two-year follow-up, people who had NDE had a significant increase in belief in an afterlife and decrease in fear of death compared with people who had not had NDE. At eight-year follow-up, people who had reported NDE generally did not show any fear of death and strongly believed in an afterlife, in contrast to people who had not reported NDE.

In an accompanying Commentary (p 2010), Christopher French from Goldsmiths College, University of London, UK, cautions that problems with NDE definition and reliance on patients' memory about NDE makes clear interpretation of the study difficult. He concludes: 'Perhaps the switching of classification of patients represents nothing more than changes in definition of NDE at different stages of the study. This possibility may receive some support from the fact that, at the 2-year follow-up, over a third of the 17 patients who had originally reported superficial NDEs were then deemed to not have had NDEs at all. Another possibility is ordinary forgetting. Such problems must be rectified in future studies because their overall effect would be to blur the distinction between NDE and non-NDE-patients. This overlap would make it much more difficult to identify possible physiological and psychological differences between the groups.'

Contact: Dr Pim van Lommel, c/o Publicity and Press Department, Hospital Rijnstate, PO Box 9555, 6800 TA Arnhem, Netherlands; T) +31 26 378 6433; F) +31 26 378 6079; E) pimvanlommel@wanadoo.nl +<mailto:pimvanlommel@wanadoo.nl>

Dr Christopher C French, Anomalistic Psychology Research Unit, Goldsmiths College, University of London, London SE14 6NW, UK; T) (mobile) +44 (0) 7946 638587; E) c.french@gold.ac.uk