Flashes of Clarity Before Death: The Controversy Stirring Neuroscience

“My mother had advanced Alzheimer’s. She no longer recognized us and seemed indifferent to those strangers who visited her once or twice a week. However, the day before her passing, everything changed. Not only did she recognize us, but she also wanted to know what had happened to each of us in the last year.” This testimony from a German woman, collected in 2019 by Alexander Batthyány, director of the Viktor Frankl Institute in Vienna, showcases a case of what has been dubbed terminal lucidity, a brief return of self in individuals who seemed to have vanished long ago due to brain injuries or Alzheimer’s.

In his book The Threshold (Errata Naturae), recently published in Spanish, Batthyány discusses his research on this little-studied phenomenon, recounting cases from family members and healthcare professionals who witness what appears to be a temporary resurrection of someone they had thought was lost. According to his estimates, up to 6% of those who seem to have permanently lost consciousness experience this. In an interview with Adolfo Kunjuk News, the psychologist advocates for the importance of studying these cases to understand their significance. To him, they challenge the current conception that the mind is merely an emergent property of the brain and that when the brain is damaged, consciousness disappears forever.

For Batthyány, terminal lucidity questions the “naive materialism” that associates capabilities such as memory or vision with specific areas of the brain and requires opening up to the possibility of a consciousness independent of the brain. “Under normal conditions, perhaps the best model is the materialist one, but as we approach the end, materialism no longer applies,” he asserts.

Terminal lucidity and near-death experiences would be an indication for people like Batthyány that, alongside the consciousness that arises from the brain and disappears when it deteriorates, there is another protected, ethereal consciousness, hidden during our earthly life by the former, that resurfaces in the twilight of life, finally liberated from the chains of matter. This would explain the final sparks of awareness or the accounts of people who revive after being clinically dead. That light at the end of the tunnel, the encounter with deceased loved ones, the sensation of ego dissolution and unity with the universe transmits an indescribable peace and causes many who experience it to lose their fear of death and even long for it.

For now, the evidence to support these ambitious hypotheses is scarce, and Batthyány acknowledges this. Most of his research, like that concerning near-death experiences, depends on the collection of retrospective cases, from witnesses recounting what happened—something that, in scientific terms, is low-quality evidence. In such extraordinary and unpredictable experiences, it is difficult to apply modern scientific criteria, such as being measurable, reproducible, and predictable.

Since the landmark study by Dutch cardiologist Pim van Lommel, published in the journal The Lancet in 2001, the field of research into these types of phenomena has been dominated by those advocating a dualistic interpretation, claiming that there is a consciousness separate from the brain. This occurs partly because the research into near-death experiences has seemed more like a task for collaborators of Cuarto Milenio than for serious scientists. Now, however, some conventional scientists are beginning to work in this field. This is the case with the Coma Science Group at the University of Liège, in Belgium. This year, a team from that group, led by Charlotte Martial, published an article in Nature Reviews Neurology, that presents a neuroscientific model of near-death experiences.

The NEPTUNE model (Neurophysiological and Evolutionary-Psychological Theory to Understand Near-Death Experiences) posits that these experiences are a cascade of neurophysiological and psychological processes initiated in critical situations. In those circumstances, deprivation of oxygen or changes in the brain induce increases in neurotransmitters like serotonin and dopamine and increase neuronal excitability in certain brain regions. This underlies the vivid sensations, calmness, or the feeling of leaving one’s body, characteristic of near-death experiences (NDEs). Moreover, they suggest framing this physiological response within evolutionary theory as a tool to confront threats. More than answers, this model proposes a framework for conducting rigorous experiments.

Martial believes that the dominance of the dualist view in the interpretation of NDEs is due, on one hand, to “the lack of a rigorous and convincing scientific framework to explain those rich and intense subjective experiences that occur at a moment we wouldn’t expect consciousness to be present.” Additionally, in recent decades, there have been no large-scale experiments to test a scientific model of NDEs.

Proponents of dualist theories of death suggest that what is seen during an NDE or in the final moments of lucidity serves as a window into another world where the rules of this one do not apply. Those who have these encounters with the beyond return reporting that they were filled with a sense of peace and harmony with the universe, that they saw themselves separating from their bodies, or that they found themselves surrounded by bright light. However, as Martial has noted, it is not necessary to be near death to experience such events. Stimulation of specific parts of the brain with intracranial electrodes can induce similar experiences, as can psychedelic substances. This also occurs with syncopes.

In a recently published article, she and her team studied 22 healthy volunteers who self-induced syncopes. During their brief fainting spells, 36% reported a subjective experience that met the criteria for an NDE according to the scale created by psychiatrist Bruce Greyson for evaluating them. 88% felt peace or pleasure, 50% felt joy, 100% felt as if they were separating from their bodies, and 50% believed they entered a more ethereal world. This experiment suggests, according to Martial, that hypoxia plays an important role in NDEs.

Martial is collaborating on an experiment to test dualism by hiding signals in the resuscitation room that are invisible from the bed to see if patients can perceive them. “So far, there are no conclusive results,” says the researcher, who acknowledges that with current technology, such as electroencephalograms or magnetic resonance imaging, it will not be possible to test the idea of whether there is a source of consciousness distinct from the brain.

In Barcelona, driven by the Incloby Foundation, the Light Project is underway, an eight-year study to investigate NDEs and their long-term effects. The main objective of this work is to document how the lives and values of people change after being resuscitated from cardiac arrest. This project is led by Luján Comas, a specialist in Anesthesiology and Resuscitation at the Vall d’Hebron Hospital in Barcelona for 32 years: “They experience peace and love, and they are able to see deceased individuals, many express that they felt they were going home and didn’t want to come back to life.” “They return changed, with different values, more spiritual, though not necessarily religious, recognizing what truly matters in life and focusing on love,” asserts Comas.

The specialist believes that “if people have these experiences when the brain is flat and has no electrical activity, the concept that consciousness is merely a product of the brain and ends when it ceases to function is incorrect.” But she acknowledges that, for now, this is only a hypothesis.

In this leap, seeking scientific support that harmonizes ancestral spiritual intuitions with reason, proponents of the dualist view often turn to quantum physics. Surgeon Manuel Sans Segarra, famous for claiming he has scientific proof of life after death, often appeals to quantum mechanics as the basis to assert that there exists an immortal superconsciousness of which we all are a part. However, quantum physics “cannot be used to explain these phenomena,” according to Alberto Casas, research professor at the CSIC at the Institute of Theoretical Physics in Madrid. “The brain is a macroscopic system where these quantum effects wash out,” he concludes.

Einstein spoke of spooky action at a distance, and Comas believes that the phenomenon tells us that “everything is interconnected” and that there exists a non-local consciousness not anchored to an individual brain. Casas explains that “the idea that one brain could be connected to another by a kind of telepathy due to entanglement is untenable.” “Moreover, even if they could be entangled, quantum physics itself implies that no significant information could be transmitted,” he adds emphatically.

Dualism supporters are eager to go further. Partly because the materialist explanation, even if true, would not provide solace in the face of the anxiety of death, while the spiritual explanation does, regardless of its real basis. For Comas, the accounts of these experiences “give hope that life goes on and reassure those who have lost a loved one […] that you will meet again.” “I believe that is already enough; if it helps someone recover, why should we destroy it?” she asks.

Although it remains another speculation that is impossible to validate, the claims of Batthyány and Comas align with the evolutionary explanation for why experiences such as NDEs or vivid encounters with the beyond are reported throughout history and across all human cultures. They help people live. Those advocating dualistic hypotheses suggest that this universality of accounts proves that the afterlife is not a hallucination caused by neural mechanisms. For now, the evidence only allows one conclusion: the human need for comfort is insatiable.