THEY report that they become detached from their bodies, looking down from above to see themselves lying in a hospital bed. They describe walking down a long tunnel that leads to a brilliant white light. Sometimes they hear music and conversation, or see Jesus or Krishna, or meet dead loved ones. Sometimes they are aware of a feeling of peace; sometimes they are turned back at the brink, and told that their time has not yet come.

These are “near-death exper­iences” (NDE), reported by people who were clinically dead. They are not a new phenomenon. Cases occur in historical writings as far back as Plato and Bede, and in 19th-century medical literature. Theolo­gians, philosophers, and para­psycho­logists all have an interest, and the study of NDEs became academically respectable in 1975 with the publication of Dr Ray­mond Moody’s Life After Life, a book credited with starting a revo­lution in popular attitudes.

Scientists and physicians are try­ing to provide a scientific under­stand­ing of what happens when we die. The global AWARE (AWAreness during REsuscitation) study, part of the Human Consciousness Project, is involving 1500 patients in 25 hospitals to help to establish what happens to the human mind and consciousness during “clinical death”. This is not the popularly perceived single moment of death, but a process that begins when the heart stops beating, the lungs stop working, and the brain ceases to function.

For anything from a few seconds to an hour, or even longer, emerg­ency medical efforts may succeed in reversing the dying process. Recent scientific studies during this period have showed the brain in the “flatline” state beloved of TV hos-pi­tal dramas. Yet ten to 20 per cent of those resuscitated report lucid, well-structured thought-processes — including, in some cases, the ability to see and hear precise details relat­ing to events that occurred during clinical death.

“With ever more improving discoveries, we will be able to bring even more people back to life from clinical death,” says the project leader, Dr Sam Parnia, Honorary Senior Research Fellow in the University of Southampton School of Medicine.

Dr Parnia, an intensive-care doctor, suggests that science has not properly explored near-death experiences. “What people exper­i-ence during a period of cardiac arrest provides a unique window of understanding into what we are all likely to experience during the dying process,” he says.

“In order for the medical profes­sion to be able to treat its patients more appropriately, and to address many of the ethical dimensions that arise from medical and scientific progress, it is paramount for physi­cians to be able to provide a scient-i­fic understanding of what happens to the brain and body, and, more importantly, the human mind and consciousness, during death.”

Sceptics about NDEs have variously ascribed them to brain failure brought on by a lack of oxygen; sleep oddities, or part of the dream mechanism; a fight-or-flight re­sponse when confronted with danger; or the result of drugs ad­ministered during resuscitation.

The AWARE study is the first to use light waves on a large scale to measure the blood flow to the brain directly, to determine the relation­ship between the circulation of blood in the brain and conscious­ness during cardiac arrest and clinical death. Researchers believe the results of the study have the potential to improve resuscitation for patients who have undergone cardiac arrest and clinical death.

THE project is being watched with interest by theologians. The Churches’ Fellowship for Psychical and Spiritual Studies (CFPSS), founded in 1954, pro­motes the study and integration of psychical and spiritual experience within a Christian context, in a climate where the Church has often regarded psychic sensitivity with deep suspicion, and has been un­willing to talk beyond a certain level about life after death.

Canon Michael Perry, president emeritus of CFPSS, insists that proper theology should take into account all empirical evidence. He received a Lambeth doctorate in 2003 in recognition of his study of the ministry of deliverance and his leadership in CFPSS, and has pleaded for the critical and sympa­thetic treatment of psychical exper­i­ences of all kinds.

In his book Psychical and Spirit­ual: Parapsychology in Christian faith and life (2003), he expressed the view that “Scientists and reli­gious thinkers need to engage with each other, and to incorporate the depths of each other’s human ex­perience into their own thinking.” Evidence needs interpretation, and interpretation needs faith, he believes.

Pioneering work continues to be done by the Religious Experience Unit at the University of Wales, Lampeter. A book by Mark Fox, Religion, Spirituality and the Near-Death Experience, published in 2002, brought the disciplines to­gether and summarised all the debates since Moody. Dr Fox has warned against using NDEs as a proof of Christianity, and has sug­gested that Christians would “find it difficult to press the claims of NDEs into an apologetic tool” .

THERE is no one closer to the subject than Dr Penny Sartori, an intensive-care nurse for the past 16 years at the Morriston and Singleton hospitals in Southampton. After working closely with critically ill patients in the 1990s, she began to research information around the subject of death, and discovered that there were very little reference data available for nurses and other health-care workers.

The trigger for her research was caring for a man who had been in intensive care for some time, and knew he was dying. “We made this connection on a night shift. He looked into my eyes, and didn’t talk because he was connected to a ventilator, but mouthed the words, ‘Please just let me die in peace,’” she recalls. “That made me think: is death so bad that we’ve got to put our patients through this? I just felt we had no understanding.”

In 1998, she launched a five-year clinical study of near-death exper­i­ences reported by patients. She submitted this as a doctoral thesis at Lampeter, under the supervision of Pro­fessor Peter Fenwick, a con­sult­ant neuropsychiatrist, and the Revd Dr Paul Badham, Professor of Theology and Religious Studies. Last year, it was published under the title The Near-Death Experiences of Hospitalized Intensive Care Patients. It was the largest study of its kind in the UK.

Dr Sartori has already employed some of the techniques being used in the AWARE project, which include placing pictures on top of special shelving in resuscitation areas, visible only from the ceiling, to see whether cardiac-arrest sur­vivors can recall the images in the pictures. (The results were negative: no pictures were seen. But the sample was small, and there are plans for more tests.)

She does not attempt to proffer any metaphysical explanations for the NDE phenomenon, nor does she approach it from a faith per­spec­tive. Her motivation is to improve the care of patients and to promote an awareness of death that reduces its taboo factor.

Her reflections are on the subject of consciousness: is it a by-product of the brain (the reductionist scien­tific view), or something primary, for which the brain merely acts as an antenna or filter? The work being done on consciousness is consistent with some of the work in quantum physics, she suggests.

Some of her patients’ recorded experiences have been dramatic: in one case, a critically ill patient, who also had cerebral palsy, awoke from a near-death experience able to use his right arm normally, even though it had been bent and contracted since birth. It was something that should not have been possible with­out an operation to release the tendons.

In another case, a patient re­ported an encounter with a dead relative who gave a message to pass on to another member of the family, who was still alive. The information stunned the receiver, because it had been a secret, and it was impossible for the patient to have had prior knowledge of it.

MANY within the medical profession were intrigued when Dr Sartori began her research, and not a few were sceptical. But the publication of her book brought a new respect. “I’m lucky, because I work with really good consultants. They are quite open to it, and I think patient care has improved as a result, because they recognise these experiences.

“They may have their own personal opinions of what they are, but they recognise the phenomena. Now, where they used to say, ‘Oh, it’s just hallucination,’ they actually recognise it, and say, ‘This patient may have had some unusual exper­i­ences, perhaps we’d better tell Penny about them.’” People from the wards and from other hospitals also refer patients to her who have had an unusual experience and need to talk to someone.

But those who have had near-death experiences are often reluc­tant to talk about them, mainly because they think no one will believe them, or because they will be thought mad, she says.

“Sometimes, it’s because the ex­perience is so profoundly pers­onal. Sometimes, they just don’t under­stand what’s happening to them, and, sometimes, they don’t attach any significance to it and just put it to the back of their mind.” Her study also includes heightened negative experiences that embrace the same phenomena.

It still amazes Dr Sartori that someone can report something with such lucidity after a time when he or she should have been uncon­scious. “Usually, after an event like that, you would expect the patient to be very confused or deluded, but they’re not. They have precise clarity of thought, and it’s quite uncanny,” she reflects. A patient’s level of con­sciousness is measured on the Glas­gow Coma Scale. Those in her study have registered the minimum score (three), which means there is no re­sponse at all.

Dr Sartori lectures widely on the subject, and finds that people of faith have a genuine interest. She has spoken on two occasions to the Welsh Chaplains Association, and, last year gave a lecture in the Theo­logy Public Lecture series at the University of Swansea. Hun­dreds had to be turned away, even though the Anglican chaplain, the Revd Nigel John, had booked the univers­ity’s largest lecture theatre. It brought the campus to a standstill.

There is hostility, too. “An Amer­ican clergyman seemed to think they [NDEs] were the result of the work of the devil, and people who had them were being fooled by the devil. That doesn’t really work out with how people change as a result of the experiences; they can become more loving and more compassion­ate, more tolerant of others,” she ponders. “You wouldn’t expect that if it were the work of the devil.”

She has found her experience useful in caring for people who are terminally ill, and cites the case of a woman she was looking after who had developed an acute problem in addition to a terminal illness, and had been bluntly told that death was imminent.

“She was beside herself, as was her daughter. I didn’t know what to say to her, and didn’t want to put my opinions on her, but I said: ‘I’ve done a lot of research into people whose hearts have stopped, and they’ve had some really pleasant experiences. If you want to talk about them, let me know,’” she re­members. “Later on that afternoon, she asked me if I could explain what I’d researched, and she seemed to get a lot of comfort from that.”

THE longer Dr Sartori has worked in intensive care, the more she has come across people who are unable to cope after the death of a loved one, and who subsequently end up in intensive care themselves, often owing to neglect or to using alcohol as a coping mechanism.

“One of the things I’d like to change as a result of doing research is a far greater awareness of death among our society rather than its being a taboo subject,” she says. “It’s through learning about death that I’ve learned about life, more than anything else.”

When the study was launched a year ago, a Sunday Times feature declared: “Positive results from [Dr] Parnia’s survey might foreshadow the soul’s return. The effects would be seismic.” Concrete results are unlikely to start to emerge until the end of 2010, and the full report is expected in 2012 or 2013.