69 - The near-death experience, long-term psychological outcomes and support of survivors

Summary

Since the 1950s and 1960s improvements in resuscitation techniques have led to improved survival for patients following cardiac arrest. Although many studies have focused on prevention and acute medical treatment of cardiac arrest, relatively few have studied cognitive functioning during and after this event. Nevertheless, this is one of the most intriguing aspects of cardiopulmonary resuscitation. Much of the work in this area has evolved from the finding that a proportion of cardiac arrest survivors report thought processes, reasoning, and memory formation that are consistent with previously described near-death experiences. These experiences are reported to have occurred at a time during cardiac arrest when consciousness appears to be absent. The first part of this chapter thus focuses on the history and phenomenology of near-death experiences, their relationship to cardiac arrest and current explanations for the experiences. We then review the longer-term psychological outcomes of surviving a cardiac arrest, as well as the impact of having a near-death experience on long-term quality of life. Finally we review the wider potential philosophical implications of research into near-death experiences during cardiac arrest.

History of near-death experiences

Although modern heart and lung resuscitation methods were established in the 1950s and 1960s, there is a long history, going back centuries, of attempts to resuscitate people after they had become ‘lifeless '. These involved using warm ash and hot water, whipping, blowing hot smoke in the mouth and rectum, as well as rolling people back and forth on a wine barrel or a horse to help the chest expand and take air in. The outcome of these methods was understandably poor.