Chapter 7

A Brief History of NDE Research

Moody, Sabom, Ring, Greyson, van Lommel, Parnia, Long — and how a fringe topic became a peer-reviewed field.

A. The Question That Would Not Go Away

In the autumn of 1965, a young philosophy graduate student at the University of Virginia sat down for an evening meeting of his honor society and listened to a guest speaker tell a story he could not stop thinking about for the rest of his life.¹

The speaker was Dr. George Ritchie, a Charlottesville psychiatrist. The story was Ritchie’s own. In December 1943, as a private at Camp Barkeley, Texas, Ritchie had collapsed during basic training with double lobar pneumonia. His temperature soared. His breathing failed. The attending army doctor pronounced him dead. A medic placed a sheet over his body and began the paperwork. Some minutes later — accounts vary between four and nine, depending on the source — the same doctor, prompted by a hunch from the orderly preparing the body, returned, administered a shot of adrenaline directly to the heart, and brought Ritchie back.²

What Ritchie said happened in those minutes was not what the philosophy student, named Raymond Moody, was expecting. Ritchie did not describe a blank. He described leaving his body. He described traveling — vividly, with intent — to a town he could later identify by a specific roadside diner with a particular neon sign. He described an encounter with a being of overwhelming light whom he understood to be Christ. He described being shown his life. He described being returned. And he described being, in every important sense, a different man afterward.

Moody was not yet a religious skeptic and not yet a believer. He was a philosophy student in his twenties, trained to listen for argument and watchful for self-deception. What he could not get out of his head was Ritchie’s ordinariness. Ritchie was not a mystic. He was a working psychiatrist. He had not gone looking for the experience. He told it the way you might tell a story about being in a car accident — with that flat, slightly puzzled voice people use when describing something they themselves cannot quite believe happened.³

Over the next decade, as Moody finished his philosophy doctorate, taught for a few years, and then enrolled at the Medical College of Georgia for medical school, he kept hearing variations of Ritchie’s story. A patient in the cardiac ward. A retired schoolteacher whose heart had stopped on the operating table. An elderly woman whose family had gathered around her bed expecting the worst. The accounts were different in detail. They were strikingly similar in shape. Moody wrote them down. By 1972 he had collected about fifty. By 1975, when he finally pulled them together into a small book published by an obscure press in Atlanta, he had about a hundred and fifty.⁴

The book was called Life After Life. The phrase he coined for what these patients had reported was near-death experience. Both the phrase and the field of study it named were about to become permanent additions to the English language and to clinical medicine.

That is where this chapter begins. But this chapter is not finally about Raymond Moody, or even about Life After Life, however significant that book was. It is about what happened in the fifty years that followed — when a topic that began with one philosophy student listening to one psychiatrist in 1965 became a literature spread across more than two thousand peer-reviewed articles, multiple international research centers, four major prospective hospital studies, and a body of evidence that the most rigorous critics in mainstream neuroscience can no longer simply ignore. To take the dualism-physicalism debate seriously, you have to take this literature seriously. And to take this literature seriously, you have to know how it grew.

B. Why the History Matters

I want to slow down for a moment and say plainly what is at stake in this chapter, because if you are like most readers, the phrase “history of NDE research” sounds like something you can skip. It is not.

The most common reason intelligent Christians dismiss the NDE literature is that they think of it as a popular phenomenon — a subset of the self-help shelf, full of paperback memoirs and television specials, occasionally crossing into the daytime talk-show circuit, never quite serious. That is roughly how the field looked in 1976. It does not look that way now. In the past fifty years, NDE research has gone through three broad phases, and the change between phase one and phase three is the change between an interesting anecdote and a peer-reviewed empirical literature with implications that mainstream neuroscience has had to begin engaging.⁵

The phases are these:

Phase one (1975–1985): the founding decade. Moody collects and types. Sabom designs the first controlled studies. Ring publishes the first quantitative academic monograph. Greyson develops the first standardized measurement scale. The International Association for Near-Death Studies (IANDS) is founded. The Journal of Near-Death Studies begins publication. The phenomenon is named, mapped, measured, and given an academic home.

Phase two (1985–2010): the prospective-study decade. Researchers stop relying on retrospective reports and begin enrolling cardiac arrest patients prospectively, before they die or nearly die, so that NDE prevalence and content can be measured under controlled conditions. Pim van Lommel publishes the first such study in The Lancet in 2001 — the first NDE paper in a top-tier general medical journal in history.⁶ Sam Parnia begins his AWARE I program in 2008.

Phase three (2010–present): the methodological-maturation decade. Multi-center studies. EEG correlation. The Borjigin animal-model debate. Parnia’s AWARE II results in Resuscitation. Greyson’s career-summary After from St. Martin’s Press. Major peer-reviewed papers on what Parnia now calls “recalled experiences of death” — a term carefully chosen to be neutral on the metaphysical question but to register that something is happening that needs to be explained.⁷ The serious skeptics — Christopher French, Jimo Borjigin, Olaf Blanke — engage at the level of physiology and methodology. They do not dismiss.

The shift across these phases matters because it changes what kind of conversation a Christian can responsibly have about NDEs. In 1980, a pastor could be excused for treating Moody’s book as religious folklore — interesting, perhaps, but not the kind of evidence one would weight against centuries of theological reflection. In 2025, a pastor cannot be excused for that posture. There is now a real research literature, with prospective studies, control groups, peer-reviewed publication, and careful engagement with the physicalist alternatives. Whether the literature ultimately supports substance dualism is a separate question — that is the burden of Chapter 23 and the case-file chapters before it. But the literature exists, and it is not what its mid-1970s reputation would have you think.

This chapter is therefore a kind of historical apprenticeship. By the end, you should be able to name the half-dozen researchers whose work matters most, place the major books and studies in chronological order, and understand the methodological turns that took the field from anecdote to evidence. You should also understand why the conditional-immortality scholar who breezily dismisses the NDE literature in a footnote of his book on Christian physicalism is, frankly, behind the times. There is a literature now. It has to be reckoned with.⁸

One more thing before we begin the substance. The history I am about to tell is not a hagiography. The figures I will introduce are human beings with mixed records. Moody’s later writings drifted into territory that strained his early credibility. Eben Alexander’s 2012 bestseller has been criticized by serious researchers for theological overreach and selective presentation. Some of Kenneth Ring’s late work moved in directions that not all of his colleagues followed. I will say so where it matters. The point of careful history is not to make heroes of one’s sources; it is to know which parts of the literature carry weight, which parts carry less, and why.

C. The Major Figures and Their Contributions

Raymond Moody and the Naming of the Field (1975)

Raymond Moody was born in 1944 in Porterdale, Georgia, the son of a country physician who, by Moody’s later account, did not have much patience for talk about the soul.⁹ Moody took his bachelor’s, master’s, and doctorate in philosophy at the University of Virginia, finishing his Ph.D. in 1969 with a dissertation in the philosophy of language. He taught philosophy briefly, became dissatisfied, and enrolled in 1972 at the Medical College of Georgia for an M.D. — partly out of restlessness, partly because the medical world was where the conversations he most wanted to have were actually taking place.

Throughout these years, the case files he was collecting kept growing. By 1972 he was teaching philosophy of medicine to medical students and asking them, almost casually, whether they had encountered patients with stories like Ritchie’s. They had. Many had. He began to notice a pattern. The accounts varied in detail but recurred in shape. There was a sense of detachment from the body. There was movement through some kind of darkness or transition. There was a being or presence of overwhelming light. There was, sometimes, a panoramic review of one’s life. There was, almost always, a sense of return — often unwilling.

Moody published Life After Life in 1975 with Mockingbird Books, a small Atlanta press he had to coax into the project. The first printing was modest. By 1977 it had sold over a million copies. By the time the book entered its mass-market paperback edition, it had sold over thirteen million.¹⁰ Few academic books — and Life After Life was, in form, a slim philosophical essay, not a Harlequin romance — have ever reached that audience.

What made the book important was not just its commercial reach but its method. Moody did three things that nobody had done before. First, he gave the phenomenon a name: near-death experience. Before 1975, accounts of this kind were scattered across medical journals, religious literature, and the records of psychic-research societies, often classified under labels (“deathbed visions,” “experiences of dying,” “peri-mortem hallucinations”) that obscured what they had in common. Second, he derived a typology. Moody identified what he called the fifteen recurring elements of NDE accounts: ineffability, hearing the news of one’s death, feelings of peace, a noise (humming, buzzing, music), the dark tunnel, out-of-body experience, meeting others, the being of light, the life review, the border or limit, coming back, telling others, effects on lives, new views of death, and corroboration.¹¹ Third, he gave the field a research program: collect more cases, look for the recurring elements, see whether the pattern holds.

What he did not do is also worth noting. Life After Life is not, in its first edition, an argument for life after death. Moody himself wrote, in his preface, that he was not making metaphysical claims and was not trying to prove anything; he was reporting what people had told him.¹² That restraint matters. It is one of the reasons the book was taken more seriously by physicians than it might otherwise have been. Moody’s later writings — Reflections on Life After Life in 1977, The Light Beyond in 1988, several books co-authored with Paul Perry, and a memoir, Paranormal, in 2012 — drifted, at times, into more speculative territory: psychomanteum experiments, mirror-gazing, past-life work. Some of his colleagues regard the later work as a distraction from the empirical core of his early contribution. I am inclined to agree. But the early contribution stands. He named the field, mapped its core phenomenology, and put it on the desk of every physician who would later study it seriously.

Michael Sabom and the Atlanta Studies (1976–1982)

If Moody was the philosopher who named the field, Michael Sabom was the cardiologist who designed its first controlled experiment.

Sabom, born in 1944 — by coincidence the same year as Moody — was an Air Force physician completing his cardiology fellowship at the University of Florida in the mid-1970s when a colleague, Sarah Kreutziger, asked him to read Life After Life.¹³ Sabom was, by his own later account, a hostile reader. He was a working cardiologist. He had resuscitated many patients. None of them, in his recollection, had ever told him stories like Moody’s. Sabom suspected the book’s patterns were artifacts of Moody’s collection method — that Moody had unconsciously elicited the responses he was looking for. He set out to disprove the book.

To disprove it, he needed two things. He needed a population of cardiac arrest survivors he had not pre-selected for interesting stories. And he needed a control group: people who had not had NDEs but were asked to imagine what they would have seen if they had — so that the content of real NDE reports could be compared with the content of imagined ones. He began the study in 1976 in Florida, continued it after relocating to Emory University Hospital and the Atlanta Veterans Administration Hospital, and published the results in Recollections of Death: A Medical Investigation in 1982.¹⁴

The findings were, to put it mildly, not what Sabom had expected. Of 116 cardiac arrest survivors interviewed, 43 percent reported some form of NDE. The phenomenology matched Moody’s typology in almost every detail. More striking still — and this is the finding that broke Sabom’s skepticism — when patients in the NDE group described the resuscitation procedures they claimed to have observed from outside their bodies, their descriptions were medically accurate. They described defibrillator paddles correctly. They described the order in which drugs had been administered. They described, in some cases, conversations between staff that the patient’s closed-eyed body could not have heard at the level of detail reported.

The control group — twenty-five cardiac patients who had not had NDEs but were asked to imagine in detail what a resuscitation would look like — produced descriptions full of characteristic medical errors. They described the wrong instruments. They described the wrong procedural sequence. They described what television and movies had shown them, which is not what real resuscitations look like.¹⁵

Sabom’s conclusion, written in the careful voice of a clinician who had set out to debunk and found himself debunked instead, was that the OBE component of NDEs included accurate observational content of a kind that conventional explanations (memory of overheard conversation, prior cultural exposure, expectation effects) could not adequately account for.¹⁶ The Atlanta studies are the first systematic medical research on NDE veridicality. They are still cited in every serious treatment of the question.

Sabom’s later book, Light and Death (Zondervan, 1998), is a different sort of work. By the late 1990s, Sabom had become an evangelical Christian, and Light and Death reads at points more like a pastoral reflection than a clinical monograph. It is also the source of the most influential treatment of the Pam Reynolds case — the 1991 hypothermic-arrest neurosurgery in Phoenix that we will return to in Chapter 12. Reynolds reported detailed accurate observations of her surgery during a period when, by every measurement available, her brain was not capable of producing experience. Sabom obtained the medical records, interviewed the surgical staff, and published the case in detail.¹⁷ The Reynolds case has since become the single most discussed individual NDE case in the literature. Whatever one finally makes of it, the documentation is real and the reporting is honest.

What Sabom contributed to the field, in short, was the methodological insight that NDE reports could be tested against external medical reality — and that when so tested, they often passed. After Sabom, “veridical NDE” was no longer a category one could responsibly dismiss without argument.

Kenneth Ring and the Founding of IANDS (1980–1981)

Kenneth Ring, born in 1935, was a professor of psychology at the University of Connecticut when Life After Life appeared.¹⁸ Like Sabom, he was initially skeptical — not because he disbelieved Moody’s patients, but because he doubted that the kind of pattern Moody described would survive a study with proper sampling and proper statistics. Moody had collected stories. Ring wanted to count them.

Ring’s 1980 book, Life at Death: A Scientific Investigation of the Near-Death Experience, is the first major academic study of NDE phenomenology with statistical methodology applied to a sizable sample. Ring interviewed 102 people who had come close to death — through cardiac arrest, accident, suicide attempt, or critical illness — and developed what he called the Weighted Core Experience Index (WCEI) to measure the depth of NDE phenomenology in each case.¹⁹ The WCEI was the first standardized measurement instrument in the field.

What Ring found was that approximately 48 percent of his sample reported some NDE content, and that the depth of experience correlated with proximity to actual death. Patients who had been clinically dead reported deeper, more detailed NDE phenomenology than patients who had merely been seriously ill. The phenomenology fell into a five-stage typology Ring proposed: peace, body separation, entering the darkness, seeing the light, and entering the light.²⁰ Each stage was reported by a smaller number of NDErs than the one before, suggesting either that the experiences differed in depth or that NDErs “returned” from different points along a single sequence.

Ring’s second contribution to the field was institutional rather than empirical. In 1981, with John Audette, Bruce Greyson, Michael Sabom, and others, he founded the International Association for Near-Death Studies (IANDS). IANDS provided what the field had not yet had: a professional organization, a journal, an annual conference, and a place where physicians, psychologists, philosophers, theologians, and NDErs themselves could meet and share research. The Journal of Near-Death Studies began publication that same year (originally as Anabiosis) and remains the field’s flagship peer-reviewed journal.²¹

Ring’s most evidentially significant later work was Mindsight (1999), co-authored with Sharon Cooper. Mindsight is the first book-length study of NDEs in blind individuals. Ring and Cooper interviewed thirty-one blind NDErs — fourteen of them blind from birth — and found that the majority reported visual perception during their NDEs.²² The blind NDE cases are, to my mind, the single most powerful piece of veridical evidence in the entire literature, and they are the burden of Chapter 11. I will say almost nothing about them here, except to note that they exist and that Ring is the researcher who first documented them at scholarly length.

Ring also wrote two more popular synthetic works, Heading Toward Omega (1984) and Lessons from the Light (1998), the latter of which moved further from his strict empirical training and into what some of his colleagues consider speculative territory.²³ The early work, including Mindsight, is the work that matters for our purposes.

Bruce Greyson and the Standardization of Measurement (1983)

If Ring built the institutional home of the field, Bruce Greyson built its measurement instrument. Greyson, born in 1946, is a psychiatrist who joined the University of Virginia Division of Perceptual Studies in the 1970s and remained there for most of his career. He was, until recently, the longest-serving editor of the Journal of Near-Death Studies. His career-summary popular book, After: A Doctor Explores What Near-Death Experiences Reveal About Life and Death (St. Martin’s Press, 2021), was reviewed in major outlets and remains the best general introduction to the field by a working academic researcher.²⁴

Greyson’s 1983 paper in the Journal of Nervous and Mental Disease, “The Near-Death Experience Scale: Construction, Reliability, and Validity,” introduced what is now called the Greyson NDE Scale.²⁵ The scale consists of sixteen items, each scored 0, 1, or 2, grouped into four components: cognitive (time distortion, accelerated thinking, life review, sudden understanding), affective (peace, joy, cosmic unity, encounter with light), paranormal (vivid sensory experience, extrasensory perception, precognitive vision, out-of-body experience), and transcendental (other realm, mystical being, encounter with deceased spirits, point of no return). A score of 7 or higher on the 32-point scale qualifies as an NDE for research purposes.

The Greyson NDE Scale matters for two reasons. First, it gave researchers a common quantitative measure. Before Greyson, every researcher used a different threshold and a different definition; after Greyson, the field could compare studies and replicate findings. Second, the scale’s design forced a degree of methodological discipline. To qualify as an NDE under the Greyson criteria, an experience had to score on at least four of the sixteen items at sufficient intensity. Random brain hallucinations, drug experiences, and ordinary altered states do not, in general, score in the NDE range. The Greyson Scale is the screening instrument by which the prospective hospital studies of the next decade were able to identify NDEs systematically.

What Greyson’s career as a whole established was that NDE research could be done at a major academic medical center, peer-reviewed in mainstream psychiatric journals, and held to the standards of the rest of psychiatry. After — published when Greyson was seventy-five — is the summing up of fifty years of careful, restrained empirical work. It is the book I most often recommend to pastors who want a single accessible introduction by a credentialed researcher.²⁶

Pim van Lommel and The Lancet Study (2001)

The first phase of NDE research — from Moody in 1975 through Greyson’s scale in 1983 and into the late 1990s — was almost entirely retrospective. Researchers found NDErs after the fact, often years after the medical event, and asked them what they remembered. This method had a built-in problem. Critics could always argue that the reports were contaminated by the intervening years — by what the patient had read about NDEs, by what the patient’s family had told them, by the natural human tendency to shape memory in the direction of cultural expectation.

To answer that objection, the field needed prospective studies: studies in which cardiac arrest patients are enrolled before their arrest, or as soon afterward as possible, and the NDE content collected and recorded before contamination has time to occur. The first such study at scale was conducted by the Dutch cardiologist Pim van Lommel.

Van Lommel, born in 1943, was a working cardiologist at Rijnstate Hospital in Arnhem, the Netherlands. In 1986 he began enrolling cardiac arrest survivors in a prospective study that eventually included 344 patients across ten hospitals in the Netherlands.²⁷ The patients were interviewed within a few days of their arrest. Sixty-two of them — 18 percent — reported some form of NDE, and 41 of them met criteria for a “deep” NDE on the Greyson scale. Van Lommel followed the cohort for eight years, reinterviewing them at two and eight years to assess the stability and life-effects of the experience.

Van Lommel’s findings, published in The Lancet in December 2001, were the field’s most consequential publication to that date.²⁸ First, the prevalence figure (18 percent) confirmed earlier retrospective estimates and ruled out the worry that NDE reports were primarily a function of selection bias. Second, the demographic correlations were essentially flat. NDE reporting did not correlate with age, sex, religious belief, fear of death, prior NDE knowledge, drugs administered during resuscitation, or duration of cardiac arrest in any way that would have supported a simple physiological-cause hypothesis. Third, the eight-year follow-up data showed that the after-effects of NDE — reduced fear of death, increased compassion, transformed value structure — were stable, and stable in ways that distinguished NDErs from non-NDE cardiac arrest survivors of comparable age and severity.

What made the publication consequential was not just the findings but the venue. The Lancet is one of the two or three most influential general medical journals in the world. To publish there, a paper has to survive a peer-review process that is, by intention, ferocious. The fact that van Lommel’s paper survived — with the title “Near-death experience in survivors of cardiac arrest: a prospective study in the Netherlands” — signaled that NDE research had crossed a threshold. It was, after that point, a topic the medical mainstream could not pretend was beneath its notice.²⁹

I want to dwell on one specific finding from the van Lommel cohort because it cuts against a common physicalist objection. Some critics have argued that NDE reports are produced during the brief window of partial cerebral perfusion that occurs at the very beginning of cardiac arrest, before the brain truly shuts down, or during the recovery period after CPR has restored some blood flow. If that were true, the depth of NDE phenomenology should correlate inversely with the depth of unresponsiveness — deeper arrests should produce shallower NDEs, and shallower arrests deeper ones, since longer periods of unconsciousness would mean less cerebral activity available to produce reportable content. Van Lommel found the opposite. The depth of NDE content correlated with the duration and severity of the arrest, not inversely with it. Patients who had been clinically dead for the longest reported the deepest NDEs.⁵² That correlation is not what a brief-perfusion-window theory predicts.

Van Lommel’s synthetic monograph, Consciousness Beyond Life (HarperOne, 2010), is his fullest argument that the prospective data — combined with the broader NDE literature and the philosophy of mind — cannot be accommodated within a strictly physicalist account of consciousness. He argues for what he calls “non-local consciousness,” a view in some ways closer to the substance dualism this book defends than to most secular alternatives. His evidential case is treated extensively in Chapter 12.

Sam Parnia and the AWARE Studies (2008–2022)

The most ambitious NDE research program ever attempted is the multi-center prospective study program led by Sam Parnia.

Parnia, born in 1972, is a critical-care physician trained at Guy’s Hospital in London who now directs critical care and resuscitation research at NYU Langone Health in New York. In 2008 he launched what became known as the AWARE study (AWAreness during REsuscitation) at fifteen hospitals in the United States, the United Kingdom, and Austria. The published results — in Resuscitation in 2014 — reported on 2,060 cardiac arrests, of whom 330 patients survived to be interviewed.³⁰ Of these, 9 percent met Greyson criteria for an NDE, and 2 percent reported full out-of-body awareness with explicit veridical content.

One of those cases — a fifty-seven-year-old man whose cardiac arrest had occurred in a hospital room equipped with a digital clock — reported observing his resuscitation from a corner of the ceiling. He correctly described the placement of the defibrillator, the actions of two specific staff members, and three audible verbal exchanges between them. The events he described occurred during a period of three minutes during which his cardiac rhythm was confirmed asystolic and his clinical state confirmed unresponsive. His OBE perception, in other words, occurred during a period when there was no detectable cardiac output and no neurological reason to expect any conscious experience whatsoever.³¹

AWARE I had a built-in evidential test that, in the end, did not produce its hoped-for result. Parnia and his team had placed visual targets — pictures — on shelves high in resuscitation rooms across the participating hospitals. The targets were positioned so that they could be seen only from a vantage point near the ceiling, not from the bed. The hypothesis was that an OBE patient who actually saw the room from the ceiling would, sometimes, see the target image. As it turned out, none of the patients who had OBEs in the AWARE I cohort had had their cardiac arrest in a room where a target had been placed. The test was, in effect, statistically underpowered. The targets did not falsify dualism; they just failed to give it a clean win.

AWARE II ran from 2014 to roughly 2022 and was published in Resuscitation in 2023.³² AWARE II added EEG monitoring during resuscitation — an extraordinary technical achievement, given that placing EEG leads on a patient mid-arrest, while CPR is in progress, is a non-trivial logistical problem. The headline finding was that approximately 40 percent of the cardiac arrest patients who survived and were interviewed reported some perceptual or memory content from the period of their arrest. Of these, a subset reported full NDE phenomenology meeting Greyson criteria. And in some patients, EEG activity returned during CPR — sometimes including gamma-band oscillations, which are associated in normal physiology with conscious awareness — even before return of spontaneous circulation.

Parnia’s synthesis of the AWARE program and his broader research is most accessibly stated in Lucid Dying: The New Science Revolutionizing How We Understand Life and Death (Harmony, 2024). Parnia is, methodologically, the most cautious of the major NDE researchers. He resists the metaphysical conclusions some of his colleagues draw. He prefers the term “recalled experiences of death” to “near-death experience” precisely because the former term carries less interpretive baggage. But the data he has gathered, even on a strictly minimalist reading, are not what physicalism predicts. We will return to AWARE in Chapter 12.³³

The framework Parnia has been developing in his recent work and in invited talks since 2022 is what he calls the “lucid dying” framework. The basic claim is that consciousness and conscious experience do not necessarily cease at the moment of clinical death — that there is a substantial period (Parnia is cautious about exact duration; the data point toward minutes, possibly longer) during which the person is, in some recognizable sense, still “there.” What Parnia presents as a methodological hypothesis to be tested with EEG and patient-report data, the historic Christian tradition has long affirmed as theological truth: that death is not a clean instant of cessation but a transition during which the person is conscious, present, and met. The convergence is not coincidence. It is what one would expect if the tradition has been roughly right all along.

Jeffrey Long and the NDERF Database

While the prospective hospital studies were progressing, a parallel project of equal scale but entirely different design was underway: the systematic web-based collection of self-reported NDE accounts.

Jeffrey Long, born in 1954, is a radiation oncologist who founded the Near Death Experience Research Foundation (NDERF) in 1998. The NDERF website, hosted at nderf.org, invites NDErs to submit detailed written accounts of their experiences, with structured questionnaires that elicit information across roughly 100 questions. By the time of the author’s dissertation analysis in 2025, the NDERF database contained roughly 5,000 case reports, making it the largest single collection of NDE accounts in the world.³⁴

Long’s 2010 book, Evidence of the Afterlife: The Science of Near-Death Experiences (HarperOne), reports the patterns he found across the first 1,300 NDERF submissions. His follow-up, God and the Afterlife (HarperOne, 2016), focuses specifically on God-encounter accounts within the database. The strengths of the NDERF dataset are obvious: it is enormous, it captures cross-cultural data the prospective hospital studies cannot reach, and it preserves first-person accounts in the experiencer’s own words. The weaknesses are also obvious: self-selection bias (people willing to write a 100-question account are not a random sample), inability to verify medical context (NDERF cannot retrieve hospital records), and varying levels of detail and corroboration across accounts.³⁵

The author’s own dissertation work used the NDERF database as one of two principal data sources, alongside cases from peer-reviewed scholarly publications. The dissertation analyzed 5,278 cases in total — 832 from peer-reviewed sources and 4,446 from NDERF and from the IANDS online archive — using a three-dimensional scoring system designed to weight cases by medical context, veridical quality, and corroboration. Of the 5,278 cases, 1,618 (30.7 percent) scored “Exceptional” or “Strong” on the combined scale, meaning that they combined a verifiable medical crisis, clear and detailed veridical content, and at least moderate independent corroboration. That subset of 1,618 cases is the principal evidential foundation of this book. Among them are 1,114 cases of accurate distant observation during clinical death, 33 cases of NDE in congenitally blind individuals, and a substantial cluster of cardiac-arrest cases meeting the most rigorous physiological criteria. We will say more about the scoring methodology in Chapter 8 and Appendix A.⁵³

Penny Sartori and the ICU Study (1997–2005)

One more figure deserves mention because of the methodological care of her work. Penny Sartori is a Welsh intensive-care nurse who completed a doctoral dissertation at the University of Wales, Lampeter, on a five-year prospective study of NDEs in the intensive care unit at Morriston Hospital in Swansea.³⁶ Sartori’s monograph, The Near-Death Experiences of Hospitalised Intensive Care Patients: A Five-Year Clinical Study (2008), is one of the most carefully documented prospective studies in the literature. Her later popular book, The Wisdom of Near-Death Experiences (2014), translates the findings for a wider audience.

What Sartori’s study added was an even higher level of clinical control than van Lommel’s. As an ICU nurse herself, she could collect NDE reports while the patient was still in the ICU, sometimes within hours of the event. She was able to verify medical detail in a way that retrospective interviewers cannot. And, in one widely cited case, she documented an NDEr’s accurate description of a procedural detail (the precise position of a particular piece of medical equipment) that would have been impossible to know without unimpeded visual perception of the resuscitation room. Sartori’s case files do not match Sabom’s for sheer volume, but they match or exceed Sabom’s for clinical-detail rigor.

Eben Alexander and the Caution Required

I have left Eben Alexander for last in this section because his case requires careful handling. Alexander, born in 1953, is a Harvard-trained neurosurgeon who developed a severe case of bacterial meningitis in November 2008. His clinical course included a week-long coma during which his cortical brain function was, by his account and by the account of the attending physicians, severely compromised. While in the coma, he reported a long, vivid NDE that he later described in his 2012 book Proof of Heaven (Simon & Schuster).³⁷

Proof of Heaven spent ninety-seven weeks on The New York Times bestseller list and was, for many readers in the 2010s, their first encounter with NDE research. The book’s impact has been enormous. The book’s reception within NDE research itself has been mixed. Some researchers, particularly within the Christian-evangelical reception of NDEs, have embraced the book as powerful evidence; others, including credentialed NDE researchers, have raised serious concerns about its presentation of the medical record. The investigative journalist Luke Dittrich published a long piece in Esquire in 2013 documenting departures between Alexander’s narrative and the available medical evidence.³⁸ The author’s dissertation engages the Alexander case in detail and concludes that, while the experience is most likely a genuine NDE, the evidential strength of the case is significantly weaker than its popular reputation suggests, and that careful Christian readers should not rest theological weight on its specific phenomenology.

I mention Alexander not to diminish his experience but to make a methodological point. The popular NDE literature includes books by people who are not NDE researchers and have not subjected their accounts to clinical scrutiny. Some of those books are honest and useful; some are not. The serious empirical case for substance dualism does not depend on Alexander’s book, John Burke’s Imagine Heaven, Don Piper’s 90 Minutes in Heaven, or any other popular treatment. It depends on the prospective hospital studies, the case files of accurate distant observation, and the blind NDE cases. That is where the evidential weight is. The popular books are testimonies; testimonies have their place; but they are not where the metaphysical argument is finally won.

The Journal of Near-Death Studies and the Peer-Review Apparatus

Behind the figures is the apparatus. The Journal of Near-Death Studies, founded in 1981 as Anabiosis and renamed in 1986, has been continuously peer-reviewed for forty-four years and now publishes four issues a year. Its editorial board has included Greyson, Ring, Sabom, van Lommel, Parnia, Long, Sartori, and most other significant figures in the field at one time or another. Beyond JNDS, NDE research has appeared in the past three decades in The Lancet, Resuscitation, Lancet Psychiatry, Frontiers in Psychology, The Journal of Nervous and Mental Disease, Critical Care, Annals of the New York Academy of Sciences, PNAS, and PLOS One, among others.³⁹

What this means in practice is straightforward. If a critic dismisses NDE research as “not peer-reviewed” or “parapsychology,” the critic is, in a literal bibliographic sense, wrong. The peer review is real. The journals are real. The methodological standards have been rising for fifty years.

D. The Christian-Evangelical Reception

I want to pause here and address something that may be on the mind of any evangelical reader who has gotten this far. The Christian church — particularly the conservative-evangelical wing of it — has had a complicated relationship with NDE research, and it is worth understanding why.

Through most of the period from 1975 to about 2010, the dominant evangelical response to NDE accounts ran in three streams. The first and largest was hostile dismissal: NDEs are demonic deception, hallucination, or both. This view was articulated forcefully in the 1970s and 1980s by writers like Maurice Rawlings, who in Beyond Death’s Door (1978) argued that the “positive” NDEs collected by Moody and Ring were a deceptive cover for the more negative experiences he claimed to have observed in his own cardiac practice.⁴⁰ Rawlings’s claim that the field had under-reported distressing NDEs has been examined and largely not supported by later prospective work, though distressing NDEs are real and do exist (we will take that question up in Chapter 28). The broader hostile-dismissal posture, however, became the default in conservative evangelical circles for roughly thirty-five years.

The second stream was cautious engagement, mostly through popular pastoral writing rather than serious empirical engagement. John Burke’s Imagine Heaven (Baker, 2015) brought a wide collection of NDE accounts to evangelical readers within a Christian frame, with appropriate but light theological discernment. Don Piper’s 90 Minutes in Heaven (2004) and Todd Burpo’s Heaven Is for Real (2010) belong to a different sub-genre — the personal Christian NDE memoir — and have had enormous popular reach without contributing much to the academic literature.⁴¹ Eben Alexander’s Proof of Heaven, while not authored by an evangelical, was widely embraced in evangelical reading culture; the methodological cautions I mentioned above did not blunt its popular reception.

The third and youngest stream is serious scholarly engagement. J. Steve Miller’s Near-Death Experiences as Evidence for the Existence of God and Heaven (Wisdom Creek, 2012) was an important early entry, written by a credentialed academic, that took the empirical literature seriously and argued for a careful Christian engagement with it.⁴² Habermas and Moreland’s earlier Beyond Death (Crossway, 1998; revised edition Wipf and Stock, 2004) had laid foundational philosophical work for taking NDE evidence seriously within a Christian framework, treating it as one of several lines of evidence for personal post-mortem survival. Habermas in particular had been working on the evidential value of NDE accounts since his early articles in the 1980s and 1990s, often in collaboration with the philosopher Stewart Goetz on the broader case for substance dualism. J. P. Moreland’s The Soul: How We Know It’s Real and Why It Matters (Moody, 2014) treats NDE evidence as one of several converging arguments for substance dualism, alongside arguments from intentionality, qualia, and the unity of consciousness. Within the past decade, an increasing number of evangelical philosophers and theologians have begun engaging the NDE literature at the level of careful argument — not uncritically, but seriously. The author’s own dissertation belongs to this stream and was written, in part, to provide a comprehensive empirical foundation that the broader Christian-scholarly engagement had previously lacked.

The shift matters because the case the rest of this book makes depends on the Christian reader being willing to engage NDE research as a body of empirical data, not as a category of religious folklore. A Christian who is committed to the historic faith does not need to treat NDE accounts as having the authority of Scripture. Scripture is the authority. NDE research is empirical evidence, like the cosmological constants or the fossil record, that bears on theological claims at the points where it is relevant. Where an NDE account contradicts Scripture (universalist confidence without atonement, reincarnation, denial of judgment), Scripture wins and the NDE account is wrong on those points. Where the NDE evidence converges with what Scripture has always said (consciousness survives the death of the body; the dying meet a personal, loving, knowing presence; the moral life of the experiencer matters at the threshold of death), it is appropriate, even faithful, to take the convergence seriously.⁴³

The further question of how Christians should discern good from problematic NDE content — including content that uses Christian language but departs from biblical theology in subtle ways — we save for Chapter 30. The point here is more modest. There is a Christian way to read this literature, and it is neither uncritical embrace nor reflexive dismissal.

E. The Physicalist Response and the Maturation of the Skeptical Side

If the past fifteen years have been the period of the field’s prospective-study maturation, they have also been the period of the most serious skeptical engagement in the field’s history. We will treat the major skeptical positions in detail in Chapter 15 and Chapter 16 and the cumulative refutation in Chapter 17. Here I want only to set the historical scene and to note that the skeptical side, like the dualist side, has matured in real ways.

Susan Blackmore’s Dying to Live (1993) is the field’s most influential single skeptical monograph. Blackmore, a British psychologist who had earlier been involved in parapsychology research, argues that NDEs can be accounted for by a combination of brain physiology (anoxia, neurochemistry), psychology (expectation, dissociation), and the brain’s tendency to construct coherent narratives out of fragmentary inputs.⁴⁴ Blackmore’s book is a serious work; it is not strawman material. The case-file chapters of this book engage her arguments at length.

Olaf Blanke, a Swiss neurologist at the École Polytechnique Fédérale de Lausanne, published a series of widely cited papers in the 2000s in which he argued that out-of-body experiences could be induced by direct electrical stimulation of the right temporo-parietal junction.⁴⁵ Blanke’s work is genuine neurology and the findings are real. Whether his TPJ-stimulation OBEs are the same phenomenon as the OBE phase of NDEs — with the latter’s veridical content and contextual coherence — is a separate and more contested question. The case for thinking they are not the same is treated in Chapter 17.

Christopher French, a psychologist at Goldsmiths, University of London, has been the most consistent academic skeptical voice on NDE research over the past two decades. French and his colleagues at the Anomalistic Psychology Research Unit have published careful empirical work on memory, expectation, and reporting bias in NDE accounts.⁴⁶ French is a careful empiricist who does not dismiss NDE reports out of hand; he proposes specific testable hypotheses for how they might be produced by ordinary brain mechanisms. His work, like Blackmore’s and Blanke’s, deserves and receives serious response.

The most consequential skeptical research of the past fifteen years is the Borjigin lab’s work on dying-brain electrophysiology. Jimo Borjigin and her team at the University of Michigan have published a series of papers documenting bursts of high-frequency gamma-band electrical activity in the brains of rats and, more recently, in human patients during the period immediately following cardiac arrest.⁴⁷ The original 2013 PNAS paper showed that, in the thirty seconds following cardiac arrest in rats, gamma-band oscillations briefly surged above baseline waking levels. The 2023 follow-up paper in PNAS documented similar gamma surges in two of four dying human patients in whom EEG was being monitored at the time of death. The findings are real and are reproducible. The interpretive question is whether such gamma activity, occurring in a brain that is no longer receiving oxygen and is shutting down, is sufficient to produce the kind of clear, structured, often veridical experience reported by NDErs — or whether it is, more plausibly, a final electrochemical cascade that has no necessary relationship to organized conscious content. Notice in particular that gamma surges in the Borjigin data last on the order of seconds to a minute, while NDE reports often describe phenomenal time-experiences that the experiencer estimates at hours and that include long sequences of structured, narrative content. Whether a brief gamma burst can produce a structured narrative experience, or whether it is closer to electrical static accompanying a system shutdown, is a question Chapter 15 will return to in detail.

What I want the reader to notice is the maturity of the conversation. The skeptical side is not the side of dismissal. It is the side of specific physiological hypotheses, controlled studies, and serious engagement with the empirical findings. The dualist side, in turn, has been forced by the skeptical pressure to sharpen its case — to focus on veridical content rather than subjective phenomenology, to develop scoring systems and standardized measures, to engage with the gamma data and the TPJ data on their own terms. The conversation is better than it was twenty years ago because both sides are stronger.

F. Assessment: What Fifty Years Has and Has Not Established

If we step back now from the figures and the studies and ask what fifty years of NDE research has actually established, the honest summary runs as follows.

Five things are well-established. First, NDEs are widely reported. The prevalence figures from prospective hospital studies cluster around 10–20 percent of cardiac arrest survivors reporting some Greyson-criteria NDE phenomenology, with deeper experiences reported by a subset of those.⁴⁸ Reports cross every demographic line that has been measured: age, sex, religion, prior knowledge of NDE literature, drug regimen during resuscitation, duration of arrest, cultural background. The phenomenon is not a quirk of one population.

Second, the core phenomenology is consistent across cultures and decades. The same recurring elements — sense of separation from the body, transition through some kind of darkness, encounter with a being or presence of light, sometimes a panoramic life review, often a boundary, often a sense of return — appear in NDE reports from before 1975 (when the “NDE” concept did not yet exist in popular culture), in reports from non-Western cultures, and in reports from young children who could not have had prior cultural exposure.⁴⁹ The cultural-conditioning hypothesis — that NDEs are simply what culture tells brains to imagine when they are dying — runs hard into this consistency.

Third, veridical perceptions during clinical death are well-documented. The Atlanta studies, the AWARE cases, the dozens of accurate-distant-observation cases in the literature, the Sartori findings, the blind NDEs documented by Ring and Cooper — this body of evidence cannot be reduced to anecdote. There is too much of it, gathered too systematically, by too many different researchers using too many different methodologies, for a single explanatory principle of contamination to apply across the board. The most important fact about the veridical case literature is its diversity. The cases come from different countries, different decades, different hospitals, different cultural contexts, and different research methodologies. A single confounder — say, “the patient overheard the surgical staff while still under partial anesthesia” — might apply to one case. It cannot apply to a thousand. The cumulative weight of the literature is its strongest feature.

Fourth, the after-effects of NDEs are real and durable. People who have had NDEs are different afterward in measurable, replicable ways: reduced fear of death, increased compassion, transformed value structures, often professional and relational re-orientation toward service. Van Lommel’s eight-year follow-up data and Greyson’s longitudinal studies establish this clearly.⁵⁰

Fifth, the standard physicalist explanations — anoxia, dying-brain neurochemistry, REM intrusion, expectation effects, retrospective shaping — do not, individually or in combination, account for the verified veridical content. Chapter 17 develops this conclusion at length. It is the cumulative-case argument that will, by the end of this book, do most of the metaphysical work.

What has not been established is also worth saying clearly, because intellectual honesty matters more than rhetorical advantage.

NDE research has not established a definitive, agreed-upon causal-mechanistic account of how veridical perception occurs during clinical death. There are competing hypotheses — van Lommel’s “non-local consciousness,” the substance-dualist account this book defends, various weaker forms of property dualism, and others — and the field has not settled on one. The data underdetermine the metaphysics, even though they constrain it sharply.

NDE research has not established the theological reliability of every NDE account. The dissertation found that 87 percent of qualitative NDEs in the dataset showed high or moderate compatibility with biblical anthropology and eschatology, which is striking, but 13 percent did not.⁵¹ Some accounts include elements (reincarnation, syncretistic universal-light-without-Christ, denial of moral judgment) that a careful Christian reading cannot endorse. NDE accounts are not Scripture and are not to be treated as such.

NDE research has not, finally, settled the eschatological questions of conditional immortality, universal restoration, and eternal conscious torment. NDEs are evidence for what happens at the boundary of death — typically the first minutes of postmortem consciousness. They are not direct evidence of the long-term state of the dead, the final judgment, or the ultimate fate of the unsaved. The author’s broader work in Beyond the Grave and Death Is Not the Deadline takes up the eschatological questions in their own right. This book’s evidential argument operates whether the reader holds CI, UR, or even ECT. What the NDE evidence supports is substance dualism, the conscious intermediate state, and a Christ-centered moment-of-death encounter. Each of those is a major claim. None of them, by itself, settles the eschatological debate.

One further candor is owed before we close the assessment. The history of the field shows a curious pattern that careful readers should know about: the more methodologically rigorous the study design, the smaller the yield of fully verified target-hit cases, even though the prevalence and qualitative richness of NDE reports themselves remain stable. AWARE II, the most ambitious prospective hidden-target study ever attempted, did not produce a confirmed perceptual hit on any of its hidden visual or auditory targets across more than a decade of multi-site enrollment.⁵⁴ What it did produce was striking EEG data showing organized brain activity, including gamma-band signatures associated with conscious processing, emerging during cardiopulmonary resuscitation in patients who were clinically dead and pulseless — and a cluster of detailed experiential reports, some of them veridical relative to the resuscitation environment, from survivors. The dimmer signal on the prospective hidden-target paradigm and the brighter signal on EEG and on environmental veridicality, taken together, raise a question we will work through in Chapter 12: are hidden targets simply the wrong instrument? An NDEr in the corner of the ceiling reports being drawn toward what the experience itself presents as the most important feature of the room — the dying person on the table, the resuscitation team, the loved one weeping in the hallway — not toward a card placed on a shelf for the convenience of researchers. We need to be honest that the cleanest experimental paradigm has so far yielded the most ambiguous results. That honesty does not undo the cumulative case. It refines it.

The honest summary, then, is that the past fifty years has produced a substantial empirical literature establishing the reality and consistency of the NDE phenomenon and the veridicality of a significant subset of accounts — while leaving open both the fine-grained mechanistic questions and the broader theological questions that lie beyond what NDE evidence alone can settle. That is the situation this book inherits and works within.

G. Why This History Matters for the Dying and Those Who Walk With Them

I want to close this chapter on a note that is closer to the bedside than to the journal article, because in the end this book is a theology of dying, not a literature review.

If you are a pastor, you have probably stood at the bedside of a dying parishioner whose eyes were focused on something you could not see and who said, in the last clear moment before drifting away, something like “Daddy’s here” or “the light” or simply “oh.” You have probably wondered, afterward, what to make of it. Was the parishioner hallucinating? Was she meeting her Lord? Was it brain chemistry, or grace, or both?

The history I have just told does not answer that question fully. No history can. But it gives you something you did not have before: a framework for taking what you saw seriously without either rushing to spiritual triumphalism or retreating into clinical reduction. Fifty years of careful work by physicians and psychologists and nurses and philosophers has produced a body of evidence that what is happening at the bedside is real, that it has structure, that it crosses cultures and centuries, that it sometimes includes verifiable content the dying person could not have known by ordinary means. You are not crazy for having noticed. You are not gullible for taking it seriously. You are within a research literature that has earned the right to be taken seriously.

If you are a Christian facing your own approaching death, the history matters in a different way. You are not the first person to wonder what it will be like. You are not the first person to hope that what the saints described — the welcoming face, the love, the light — might be more than pious metaphor. You are part of a long line of dying Christians whose experiences, when carefully collected and studied, look strikingly like what the historic Christian tradition has always said the dying experience. The NDE literature is not a substitute for the gospel. The gospel does not need NDE literature in order to be true. But the convergence is real, and it is allowed to be a comfort.

If you are a Christian skeptic of NDE research — or a Christian physicalist who finds the entire conversation distasteful — the history matters as a request for fairness. The literature exists. The peer review is real. The researchers are credentialed. The objections to the field have been heard, taken seriously, and answered. To dismiss the literature in a footnote because it does not fit your prior anthropology is no longer an intellectually serious posture. The literature has earned a hearing. Whether, on hearing it, you remain a Christian physicalist is a separate question. But hearing it is the price of admission to the conversation.

The next chapter takes up a question this one has presupposed but not defined: what does it actually mean for an NDE to be “veridical”? The whole evidential argument of the book turns on the answer.