Ive been following the questions youve asked so far and found the
scope and range fascinating. Im glad I finally got a chance to answer
one of them.
I found that in exploring the issue of confronting death and having
spiritual experiences I had to deal with two different types of
situations and questions: 1) terminally ill people preparing for death
and 2) people who had a near death experience who are relieved they
dont have to face death just yet. I reframed your question to see how
spirituality comes into play in both of these classes of
My research showed that there is a large body of literature addressing
the topic of terminal illness and how people prepare for imminent
death. This literature has some information about the spiritual
aspects of illness and how religious faith may impact coping with
suffering and death, but its not the focal point of most of the
resources and articles. Instead, the main issue of the materials
dealing with the experiences of the terminally ill, their loved ones,
physicians and caregivers has to do with helping the patient have a
good death. There are some studies to evaluate how patients are
experiencing the dying process. The most striking finding has been
that patients are in pain to a greater extent than their doctors
thought. There are new movements in medicine to give better palliative
There is also a large body of literature on how to prepare the
terminal patient for death and especially on the role of hospice
services. Much of this literature treats the patient as the subject of
others care and concern and addresses the needs of the caregivers.
Some of the literature counteracts this by discussing how the patient
can take control of how they want to die. The role of religion and
spirituality in discussions of terminal illness speaks more to the
growth or evolution of existing beliefs rather than coming to a
There is also a large body of literature and resources for near death
experiences (NDE) and the experience of cheating death. This
literature is much more involved with spirituality and the claim that
the near death experience leads life transformation. There is much
anecdotal evidence and there are many web sites that collect personal
stories where people share their experience and what it meant to them.
Much of this personal literature claims mystical and life affirming
transformation for the subjects.
The description of near death experiences is fairly consistent (see
below) but there isnt scientific consensus on what causes the
reported experiences. The most interesting report I found on this
subject is the prospective study of cardiac patients that was
published in The Lancet in 2001. This study found that 18% of the
patients reported NDE experiences and that the experience had a
transformative experience. There are some other studies that seem to
confirm that patients are having an experience that changes how they
live their lives. It must be noted that not all NDE are positive and
that for some people the experience is very stressful and a few have
been diagnosed with post-traumatic stress type of symptoms.
The spiritual enlightenment aspect of the NDE experience does not seem
to have been studied rigorously. Most of the literature seems to be
anecdotal. Some patients see their experience through the lens of
their religious beliefs while others have a more generic spiritual
I think the resources Ive listed below will give you a deeper
understanding of the overview of this issue. Please ask for
clarification for any of this.
I look forward to your future questions.
TERMINAL ILLNESS -- DESCRIPTION AND ASSISTANCE
Symptoms in Terminal Illness: A Research Workshop
Patients at the end of life experience many of the same symptoms and
syndromes, regardless of their underlying medical condition. Pain is
the most obvious example, but others are difficult breathing
(dyspnea), transient episodes of confusion and loss of concentration
(cognitive disturbances and delirium), loss of appetite and muscle
wasting (cachexia), as well as nausea, fatigue, and depression.
Life-threatening illness - its psychological dimensions
The following are adapted extracts from a talk given by Josefine
Speyer to hospital and hospice nurses at the Centre for Cancer and
Palliative Care Studies at the Royal Marsden Hospital in London SW3.
It is aimed, however, at a wider group: the patient; the carer, family
and friends; nurses and others in the medical team and the volunteer
Accepting death and emerging spiritually
What I was interested in understanding was how facing death might
define how we lived; how the way we lived might define how we died. In
short, I wanted to know whether it was possible to live well while
preparing for death, and then to die well when it was time to die.
Beware the 5 Stages of "Grief"
Few concepts have insinuated themselves into the popular culture as
thoroughly as the so called "5 Stages of Grief": Denial, Anger,
Bargaining, Depression, Acceptance. We've heard it from professionals
in all areas of the healthcare system (who should know better) as well
as from lay persons of all ages (who shouldn't). There is even a
lengthy comedy routine about it by Dustin Hoffman playing Lenny Bruce
in the movie Lenny. The time has now come to ditch it as the concept
has done more harm than good.
Living with Serious Illness
As we face the possibility that we are in the last chapter of our
lives, our priorities suddenly change. Lifes details may fade to the
background, and we may find ourselves looking at its deeper meanings.
Old conflicts pale in importance, and the desire to resolve
difficulties with family relationships often comes to the fore.
Serious illness presents an opportunity to evaluate ones life. People
often reflect upon their accomplishments and even humbly acknowledge
their regrets. When facing a serious illness, we commonly think about
what remains undone and focus on addressing those issues one day at a
Defining Wellness through the End of Life
Resources for people facing life-limiting illness, their families, and
their professional caregivers
Helping Yourself Live When You Are Dying
You have learned that you are dying. Terminal illness presents human
beings with an exceedingly difficult and contradictory challenge; you
are dying, you know you are dying, yet it is your nature to want to
live. The thoughts in this brochure are intended to help you deal with
this tension and to continue to live even though you are dying.
TERMINAL ILLNESS -- SURVEYS AND RESEARCH
END OF LIFE
A Changing Impulse: Will to Live Fluctuates in Terminally Ill Patients
The most recent study on death and dying in the terminally ill
indicates that people's reaction to impending death varies widely, and
that care for the dying should take into account patients' changing
moods and needs.
Researchers tested 168 patients at the Riverview Palliative Care
Center, in Winnipeg, Canada, on a wide scale of emotional and physical
responses to their end-of-life situation.
Religion, spirituality, and medicine
R P Sloan, E Bagiella, T Powell
Lancet 1999; 353: 66467
Even in the best studies, the evidence of an association between
religion, spirituality, and health is weak and inconsistent.
We believe therefore that it is premature to promote faith and
religion as adjunctive medical treatments. However, between the
extremes of rejecting the idea that religion and faith can bring
comfort to some people coping with illness and endorsing the view that
physicians should actively promote religious activity among patients
lies a vast uncharted territory in which guidelines for appropriate
behaviour are needed urgently.
The promise of a good death
Ezekiel J Emanuel, Linda L Emanuel
Lancet 1998; 351 (suppl II): 21-29
Nevertheless, these efforts have been separate from the central
concerns of medical care; clinicians have not been trained to explore
spiritual and existential issues and rarely inquire about, discuss, or
address them with patients. Consequently, despite the avowed
importance of spiritual and existential issues, there are few data on
them and their relation to a good death.42,43 We do not know: what
proportion of dying patients become more religious, or, conversely,
alienated from spirituality; or what proportion receive comfort from
their faith, whether this comfort is from formal interaction with a
religious mentor or a more informal spirituality. As a result, there
is little information on what interventions--such as training
clinicians in discussing spiritual issues or closer interaction with
clergy--might improve the spiritual condition of dying patients.
TERMINAL ILLNESS -- PORTALS, DIRECTORIES, LIBRARIES
DSM-IV Religious and Spiritual Problems
LESSON 2.5 Terminal and Life-Threatening Illness
Although listed here as a religious problem, both religious and
spiritual beliefs and practices can influence the ways patients react
to illness. This is particularly true in the case of terminal
illnesses that raise fears of physical pain, the unknown risks of
dying, the threat to integrity, and the uncertainty of life after
death. In addition, religious and spiritual changes often occur during
terminal illness related to feelings of loss, alienation, abandonment,
anger, suffering; and dependency.
Religious coping is one of the main strategies used to address these
fears, along with exercising self-control and talking to friends and
family about them.
Associated Clinical Problems
The nursing diagnostic nomenclature specifically notes that Spiritual
Distress can be related to the inability to practice religious
rituals, and the conflict between religious or spiritual beliefs and
prescribed health regimen (as illustrated in the case example
below). Religious beliefs, participation in religious rituals, and
affiliation with a religious community can all be affected by serious
illness. Loss or questioning of faith, anger at God, guilt over
"sins", and discontinuation of religious practices are frequent
sequelae of terminal and life-threatening illness.
Last Aid Manual -- Table of Contents
Every family should have a First Aid manual in case of emergencies
which may or may not occur. Likewise, every family should have a Last
Aid manual, for death is an emergency that will definitely occur,
confronting each and every member of the family, and it is as well to
The present volume is a joint project between the Befriending Network,
a charity which trains and supervises volunteer Befrienders who visit
the homes of those with a critical illness, and the Natural Death
Centre, a charity which gives advice on inexpensive,
environmentally-friendly or family-organised funerals. This booklet is
a digest of recent material covering everything from how best to be a
companion to those who are dying to how best to arrange burials so as
to return the body to nature.
***** This is an exceptional guide and resource for anyone preparing
Growth House, Inc., provides this award-winning portal as your
international gateway to resources for life-threatening illness and
end of life care. Our primary mission is to improve the quality of
compassionate care for people who are dying through public education
and global professional collaboration. Our search engine gives you
access to the Internet's most comprehensive collection of reviewed
resources for end-of-life care.
Books for assisting the terminally ill, their caregivers, and their
Spirituality and Alternative Healing: Death, Dying, and Terminal
General Information, Near Death & Afterlife Studies and Information,
***** This site provides a variety of resources for anyone interested
in end of life issues with special resources for caregivers.
Reflections..on Being Human -- Living Our Dying
***** This is a collection of short pieces from authors in various
Terminal Illness & Dying Process
***** This site reviews about a dozen books on dealing with terminal
The Dying Person
***** This is a comprehensive guide for nurses and covers the
following topics in a pared down, no nonsense style.
Attitudes About Death
The Stages Of Dying
Psychological, Social, and Spiritual Needs
The Resident's/Patient's Family
"Do Not Resuscitate" Orders
Signs Of Death
Care Of The Body After Death
(Procedure) Assisting With Postmortem Care
Resources for the Dying
For those who are dying, information about legalities, practical
issues, and inspiration for their journey.
NEAR DEATH EXPERIENCES
NDE -- DESCRIPTION AND ASSISTANCE
The Near Death Experience
Listed below are a number of the common elements that fit a general
profile for the near death experience. Some people have reported all
of them, while others, only a few.
1. A feeling of peace and quiet overcomes them, a cessation of pain
at this point, floating out of their body, seeing the room they are
2. Suddenly they are drawn through a dark tunnel accompanied by a
3. They see friends, family, other people, or angel types who
welcome them and help them along while comforting them.
4. At the end they reach the light and encounter a being of light
that makes them feel loved and unafraid.
5. At this point they have a life review, where every detail of their
life is recalled. There is no judgment, only understanding what and
6. They reach a boundary or border over which they cannot pass. They
learn many things and see and hear beautiful things, some of which are
forgotten when they return.
7. Some are given the option to return, while others are told they
must return because it is not their time. Those that refuse to return
are ejected and they return to their bodies reluctantly.
8. Disappointment upon return, pain, if present before, returns,
9. Transformation takes place in their lives, more spiritual, less
materialistic and religious. No longer afraid of death. Some talk
about it, while others keep it to themselves.
International Association for Near-Death Studies
Understanding and Coping with a Frightening Near Death Experience
***** This is an 8 page brochure that reviews theories about the
experience and list a variety of organizations who might help.
Near Death Experience & Its Luminous Serenity.
Near death experience, or NDE, is an outlet into a divine dimension of
human consciousness, that is latent in all of us. This is similar to
mystic experience described by philosopher William James. This is an
experience that is noetic. It is self-certifying because it is a form
of knowledge. It is profoundly life changing. It is pure and simple an
experience of Light.
Spiritual transformation changes their lives.
After their Near death experience NDE, the majority claims that their
lives changed dramatically. They say that their Near death experience
has made them become more spiritual rather than religious and more
inclined to seek out the spiritual rather than the material aspects of
NDEs in the Terminally Ill
NDEs during terminal illness differ in several ways from those that
occur in acute settings, such as heart attacks or car accidents.
NDE -- SURVEYS AND RESEARCH
The Lancet 2001, Volume 358 Issue 9298 Page 2039-45
Near-death experience in survivors of cardiac arrest: a prospective
study in the Netherlands
Pim van Lommel, Ruud van Wees, Vincent Meyers, Ingrid Elfferich
Division of Cardiology, Hospital Rijnstate, Arnhem, Netherlands (P van
Lommel MD); Tilburg, Netherlands (R van Wees PhD); Nijmegen,
Netherlands (V Meyers PhD); and Capelle a/d Ijssel, Netherlands (I
Methods In a prospective study, we included 344 consecutive cardiac
patients who were successfully resuscitated after cardiac arrest in
ten Dutch hospitals. We compared demographic, medical,
pharmacological, and psychological data between patients who reported
NDE and patients who did not (controls) after resuscitation. In a
longitudinal study of life changes after NDE, we compared the groups 2
and 8 years later.
Significant differences in answers to 13 of the 34 items in the
life-change inventory between people with and without an NDE are shown
in table 4. For instance, people who had NDE had a significant
increase in belief in an afterlife and decrease in fear of death
compared with people who had not had this experience. Depth of NDE was
linked to high scores in spiritual items such as interest in the
meaning of one's own life, and social items such as showing love and
accepting others. The 13 patients who had superficial NDE underwent
the same specific transformational changes as those who had a core
Thus, social conditioning causes NDE to be traumatic, although in
itself it is not a psychotraumatic experience. As a result, the
effects of the experience can be delayed for years, and only gradually
and with difficulty is an NDE accepted and integrated. Furthermore,
the longlasting transformational effects of an experience that lasts
for only a few minutes of cardiac arrest is a surprising and
Life Review, Changed Beliefs, Universal Order and Purpose, and the
This study is a retrospective review of data received from an Internet
survey on the Near Death Experience Research Foundation (NDERF)
website www.nderf.org (Long, 2003).
The Division of Personality Studies (DOPS) is a unit of the Department
of Psychiatric Medicine at the University of Virginia. Utilizing
scientific methods, we investigate apparent paranormal phenomena,
Children Who Claim to Remember Previous Lives (reincarnation)
Out of Body Experiences
Apparitions and After-Death Communications
Near Death Experiences Change Lives
June 27, 2002, ST. LOUIS, MO -- Patients who have near death
experiences gain an increased understanding of life and some felt they
recovered more quickly from their illnesses according to research at
Barnes-Jewish Hospital and Washington University School of Medicine.
Near-Death Experience, Religion, and Spirituality
ABSTRACT: One of the last frontiers of study surrounds spirituality
and NDE. However, this is a highly sensitive issue due to the nature
of religion. What this study attempts to do is to objectively look at
the data submitted by NDErs to the website and to categorize the
answers. Questions that are analyzed include pre and post NDE
religious preference, and changed beliefs. There are some surprising
results that focus on universal purpose and order gained from NDE
16 February 2001, Research body will shed more light on near death
University of Southampton researchers have just published a paper
detailing their pioneering study into near death experiences (or NDEs)
that suggests consciousness and the mind may continue to exist after
the brain has ceased to function and the body is clinically dead.
Using Ketamine to Induce the Near-Death Experience: Mechanism of
Action and Therapeutic Potential
Jansen, K. L. R. (1996) Yearbook for Ethnomedicine and the Study of
Consciousness (Jahrbuch furr Ethnomedizin und Bewubtseinsforschung)
Issue 4, 1995 (Ed.s C. Ratsch; J. R. Baker); VWB, Berlin, pp55-81.
Near-death experiences (NDE's) can be induced using the dissociative
drug ketamine. Advances in neuroscience have recently provided us with
new insights as to the mechanisms involved at the mind -brain
interface. On the 'brain' side, it is now clear that these NDE's are
due to blockade of brain receptors (drug binding sites) for the
NDE PORTALS, DIRECTORIES, LIBRARIES
Internet Guided Learning courses provide training in Internet skills
to keep up with developments in the mental health field using online
clinical resources and research
DSM-IV Religious and Spiritual Problems
LESSON 3.4 Near-Death Experience
The near-death experience (NDE) is a subjective event experienced by
persons who come close to death, who are believed dead and
unexpectedly recover, or who confront a potentially fatal situation
and escape uninjured.
NDE and Psychopathology
In the proposal to the Task Force on DSM-IV for the new diagnostic
category, Religious or Spiritual Problem, the NDE was used as an
example of a spiritual problem that warrants clinical attention, but
is not a mental disorder.
Associated Clinical Problems
Despite generally positive outcomes, significant intrapsychic and
interpersonal difficulties frequently arise in the wake of an NDE.
Spiritual experiences that occur during an NDE are often a prominent
issue in therapy. Yet prior religious beliefs do not affect either the
likelihood or the depth of the near-death experience. An atheist is
as likely to have a life-changing NDE as a devoutly religious person.
Links to most of the near-death experience (NDE) information on the
THE NEAR-DEATH EXPERIENCE (Part One): The New Age Connection
Christian Research Journal, Spring 1992
THE NEAR-DEATH EXPERIENCE (Part Two): Alternative Explanations
In this issue our discussion explores alternative explanations to
those of the New Age movement for NDEs. First, there are a number of
medical explanations. These range from legitimate possibilities, such
as the effects of endorphins and hypoxia, to more incredible
propositions, such as the "memories of birth" interpretation. Second,
some of the findings of both secular and Christian psychologists and
medical professionals who have researched NDEs are found to conflict
with New Age interpretations.
Home > United States > New > Library > Sciences > Alternative Science
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Near Death Experience > Preview Category
***** List of 60 articles on the subject
The International Association for Near-Death Studies
A near-death experience (NDE) is one of the most powerful emotional
and psychological events known. Many people who have had such an
experience feel that it was the single most profound event of their
Near Death Experiences
Society > Death > Near Death Experiences
NEAR DEATH EXPERIENCE RESEARCH FOUNDATION (NDERF)
DEATH PSYCHOLOGY, SOCIOLOGY, RELIGION, SPIRITUALITY
SOCIOLOGY OF DEATH AND DYING
It has been claimed that one can never look directly at the sun nor at
one's own death. And yet, throughout the history of mankind, both have
been the enduring themes of myth and religion, science and magic,
curiosity and fear.
***** This is a comprehensive list with many interesting links on the
history and sociology of death and dying.
Mental Health and Psychology Directory
***** This is an outstanding portal site. The search capability is
With no completely new DSM in the offering until 2006 or later, in
2000 the American Psychiatric Association revised the text of DSM-IV
to include new research information that had been developed since
first publication in 1994. This text revision (TR) included a very few
changes in the criteria, designed mainly to correct what were
perceived as errors in the original text.
Disorder Information Sheet
***** You can click on the list of disorders and get a description of
symptoms, treatment and related links.
The Osho Institute for Living and Dying is situated in Italy, Toscana,
The work of the Institute is called THE OCEAN OF REALITY.
It is concerned with the preparation for a conscious death , and the
opportunity for the awakening to the reality of our true self , in
life as in death. To awaken means to be capable to authentically live
in the "present moment", which is the only real space to live in. It
means to feel the unmanifest , "that which never dies" , to surrender
to life in all its expressions. Then we are open to an authentic
transformation , which will be the door for a conscious death in
gratitude. A conscious death can really be the peak of our life, a
re-entry into the dimension where we are no more separate from the
OCEAN OF REALITY.
Spirituality and Medicine
This topic page inquires into the possibility that within the
boundaries of medical ethics and empowered with sensitive listening
skills, the physician may find ways to engage the spiritual beliefs of
patients in the healing process, and come to a clearer understanding
of ways in which the physician's own belief system can be accounted
for in transactions with patients.
The Meaning of Death Forum provides bibliography, reflections and
articles related to the existential and spiritual issues of death and
ON OUR OWN TERMS: MOYERS ON DYING
The complete, four-part ON OUR OWN TERMS series can be obtained on
video tape from Films of the Humanities (1-800-257-5126).
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