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“My mother had advanced Alzheimer’s. She no longer recognized us and seemed indifferent to the strangers who visited her once or twice a week. The day before she died, however, everything changed. Not only did she recognize us, but she wanted to know what had happened to each of us in the past year.” The testimony of a German woman, collected in 2019 by Alexander Batthyány, director of the Viktor Frankl Institute in Vienna, highlights a case of what has been dubbed terminal lucidity, a brief return of the self in people who seemed to have faded long ago due to brain injuries or Alzheimer’s.
In his book Threshold, Batthyány recounts his research on this little-studied phenomenon, relating cases of family members and healthcare professionals who witness what appears to be a temporary return of lucidity in someone they thought was lost. According to his estimates, up to 6% of people who appear to have lost consciousness forever experience it. In an interview with EL PAÍS, the psychologist defends the importance of studying these cases to understand their significance. For him, they challenge the current notion that the mind is only an emergent property of the brain and that when the brain is damaged consciousness disappears forever.
For Batthyány, terminal lucidity challenges the “naive materialism” that links capacities such as memory or vision to specific areas of the brain. He believes this idea needs to open up to the possibility that there is 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 argues.
For people like people like Batthyány, terminal lucidity and near-death experiences is a sign that — alongside the consciousness that arises from the brain and disappears when the brain declines — there is another protected, ethereal consciousness hidden during our earthly life by the former, which resurfaces in the final moments of life, finally freed from the chains of matter.
This would explain the final flashes of consciousness or the accounts of people who come back to life after having been clinically dead. In other words, it would explain the light at the end of the tunnel, the encounters with deceased loved ones, the sensation of ego dissolution and unity with the universe, which conveys an indescribable peace and leads many who have the experience to lose their fear of death and even long for it.
For now, there is little evidence to support such ambitious hypotheses, and Batthyány himself acknowledges this. Most of his research, like that dealing with near-death experiences, relies 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 measurability, reproducibility, and predictability.
Since Dutch cardiologist Pim van Lommel’s landmark study, published in The Lancet in 2001, the field of research into these types of phenomena has been dominated by people who favor a dualist interpretation, which claims that consciousness exists separately from the brain. This is partly because the research on near-death experiences seemed more like a task for conspiracy theorists than for serious scientists. Now, there are also some conventional scientists who 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 presenting a neuroscientific model of near-death experiences.
The NEPTUNE model (an acronym for Neurophysiological and Evolutionary-Psychological Theory to Understand Near-Death Experiences) proposes that these experiences are a cascade of neurophysiological and psychological processes triggered in critical situations. Under such circumstances, oxygen deprivation or changes in the brain cause increases in neurotransmitters like serotonin and dopamine and enhance neuronal excitability in certain brain regions. This would explain the vivid sensations, calmness, or the feeling of leaving one’s own body — features characteristic of near-death experiences (NDEs). Additionally, they propose framing this physiological response within evolutionary theory, as a tool for coping with threats. Rather than specific responses, this model provides a framework for conducting rigorous experiments
Martial believes that the dominance of the dualist view in interpreting NDEs is partly due to “the lack of a rigorous and convincing scientific framework to explain those rich, intense subjective experiences that occur at a moment when we would not have expected consciousness.” Moreover, 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 is a window into another world where the rules of this one do not apply. Those who experience these brushes with the beyond often report being overwhelmed by a feeling of peace and harmony with the universe, seeing themselves separate from their body, or being surrounded by a bright light. However, as Martial has found, people do not need to be near death to have such experiences. Stimulation of specific parts of the brain with intracranial electrodes can induce similar experiences, as can psychedelic substances. The same also happens with syncope (fainting).
In a recently published article, she and her team studied 22 healthy volunteers who induced syncope on themselves. During their brief blackouts, 36% reported a subjective experience that met the criteria for an NDE according to the scale created by psychiatrist Bruce Greyson to evaluate them. Eighty-eight percent experienced feelings of peace or pleasure, 50% felt joy, 100% felt like 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, 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 electroencephalography and magnetic resonance imaging, it will not be possible to test the idea of whether there is a source of consciousness separate from the brain.
In Barcelona, Proyecto Luz (Project Light) — an initiative driven by the Incloby Foundation — is conducting an eight-year study on NDEs and their long-term effects. The main goal of the project is to document how people’s lives and values change after being resuscitated following cardiac arrest. The project is led by Luján Comas, who has worked as specialist in Anesthesiology and Resuscitation at Vall d’Hebron Hospital in Barcelona for 32 years: “They experience peace and love, and are able to see people who have died. Many express that they felt like they were coming home and didn’t want to come back to life.” She adds: “They come back changed, with different values, more spiritual, although not necessarily religious, they recognize what truly has meaning in life, focusing on love.
Comas believes that “if people have these experiences when the brain is flat and has no electrical activity, the concept that consciousness is only a product of the brain and ends when it stops functioning is incorrect.” But she acknowledges that, for now, it’s only a hypothesis.
In this leap — in search of scientific support that harmonizes ancestral spiritual intuitions with reason — proponents of the dualist view often turn to quantum physics. Surgeon Manuel Sans Segarra, known for claiming to have scientific proof of life after death, frequently cites quantum theory as the basis for affirming the existence of an immortal super-consciousness of which we are all a part. But quantum physics “cannot be used to explain these phenomena,” says Alberto Casas, a research professor at the Spanish National Research Council (CSIC) at the Institute for Theoretical Physics in Madrid. “The brain is a macroscopic system, where these quantum effects are diluted,” he concludes.
Einstein spoke of “spooky action at a distance,” and Comas believes this phenomenon shows that “everything is interconnected,” and that there is a non-local consciousness not tied to an individual brain. Casas explains that “the idea that one brain can be connected to another by a kind of telepathy due to entanglement doesn’t hold water.” “Furthermore, even if they could become entangled, quantum physics itself implies that no meaningful information could be transmitted,” he says.
Dualism supporters are eager to go further. In part, because the materialist explanation, even if true, offers no relief in the face of death’s anguish — while the spiritual one does, whether or not it has a factual basis. For Comas, these experiences “gives hope that life goes on and gives hope to people who have lost a loved one [...] that you will meet them again.” “I think that’s enough; if it helps a person recover, why should we destroy it?” he asks.
Even if it remains another unverifiable speculation, the claims of Batthyány and Comas align with the evolutionary explanation for the fact that NDEs or vivid accounts of contact with the afterlife appear across all times and cultures on Earth. They help us survive. Those who support the dualist hypothesis suggest that this universality proves the afterlife is not merely a hallucination triggered by brain mechanisms. For now, the evidence allows only one clear conclusion: the human need for comfort is insatiable.
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