Coma and the Near-Death Experience

This is a ground-breaking work that should be read by everyone involved in the field of death and dying, subtitled ‘the beautiful, disturbing, and dangerous world of the unconscious.’ Its message has assumed new urgency in the wake of Covid where, as Dr Wesley Ely MD puts it in his foreword, ‘in an effort to reduce suffering, a culture of deep sedation and medically induced coma crept into intensive care units (ICUs) and was rationalised as a more humane approach to clinical care.’ (p. xi) A 2021 study covering 69 hospitals found that 80% of Covid patients were placed into comas, and half of these contracted delirium. (p. 203) Clinical research shows that many survivors develop long-term, debilitating side effects – extensively documented here – that are collectively termed post-intensive care syndrome (PICS). The default assumption behind this approach is that the brain generates consciousness, so that when patients are unconscious, they are experiencing nothing. Jeff Kripal points out, however, that what is actually happening is that the brain is being shut down as a filter for time, and that many horrendous but also blissful experiences happen in the interim.

Given this wide view of the brain and consciousness, such induced coma treatments are risky and even irresponsible, at the very least producing nerve damage and muscle wastage; to make things worse, patients are treated as psychotic, and here there is an obvious contradiction between the experience of patients and the understanding of doctors. These experiences are lived as real, and need to be taken seriously, all the more so as they can be understood within a much wider spectrum of experiences. Moreover, there are further issues related to sleep deprivation giving rise to what is called ICU delirium. There are many harrowing accounts to illustrate the overall argument of the consequences of medicalisation, highlighting serious shortcomings in the scientific understanding of consciousness.

The rest of the book explores other avenues of research on death and dying, along with psychedelics, demonstrating a parallel pattern that this sedation allows the mind to break free from the body and experience a greater expansion of consciousness. The overall point is that the scientific (and military) world needs to expand its understanding of consciousness rather than dismiss first-hand accounts of mystics, philosophers, psychedelic explorers, near death experiencers, and coma survivors (p. 185). The book concludes with a passionate call to arms emphasising the absolute need for clinicians to be re-educated and take seriously the experiences of the patients and their implications for critical care.