End-of-life experiences and deathbed phenomena as reported by Brazilian healthcare professionals in different healthcare settings.

OBJECTIVE: The objectives of the present study were to describe and compare the characteristics and reports of end-of-life experiences (ELEs) by healthcare professionals at different institutions and to investigate the influence of religious beliefs on these reports. METHOD: A multicenter study was carried out in Brazil that included six nursing homes (NHs), a cancer hospital (ONC), and a palliative care (PC) unit. Sociodemographic data, ELE reports (Fenwick's questionnaire), religiosity (the Duke Religion Index), spirituality (the Spirituality Self-Rating Scale), and mental health (the DASS-21 questionnaire) were assessed. The analysis was performed using ANOVA and chi-square tests in order to compare ELE perceptions in these different settings. RESULTS: A total of 133 healthcare professionals (46 ONC, 36 PC, and 51 NH) were interviewed, 70% of whom recounted at least one ELE report in the previous five years. The most common ELEs were "visions of dead relatives collecting the dying person" (88.2%), "a desire to mend family rifts" (84.9%), and "visions of dead relatives near the bed providing emotional comfort" (80.6%). Most healthcare professionals (70-80%) believed that these experiences had a spiritual significance and were not due to biological effects. Comparison among settings revealed that those working in the PC unit had more reports, a greater openness about the issue, and more interest in training. Individual religious beliefs had no influence on perception of ELEs. SIGNIFICANCE OF RESULTS: Our study revealed that ELE reports are not uncommon in clinical practice and seem to be little influenced by religious or spiritual beliefs. Although strongly reported in all settings, palliative care professionals tend to be more open to this issue and have a stronger perception of ELEs.

As experiências de quase morte (EQM) podem contribuir para o debate sobre a consciência? / Can near death experiences (NDEs) contribute to the debate on consciousness?

A EQM é um estado alterado de consciência que no ocidente inclui uma experiência emocional e de conteúdo estereotipado. Algumas características da experiência são transculturais e sugerem ou um mecanismo cerebral similar ou acesso a uma realidade transcendente. Características individuais da experiência indicam mais persuasivamente para transcendência que para um simples mecanismo cerebral limitado. Além disso, não há, até agora, nenhuma explicação reducionista que possa dar conta satisfatoriamente de algumas dessas características: o encontro com parentes falecidos, a aparente capacidade visual em cegos durante a EQM, a aparente aquisição de dons psíquicos e espirituais após a EQM, relato de cura ocorrida durante uma EQM e experiências verídicas durante a ressuscitação pós-parada cardíaca. Embora uma mente não local pudesse explicar muita das características das EQM, a não localidade ainda não é aceita pela corrente predominante da neurociência. Somente aquelas teorias baseadas num entendimento mais amplo da mente poderiam explicar totalmente a experiência subjetiva dos que vivenciaram uma EQM.

The NDE is an altered state of consciousness which in the West has stereotyped content and emotional experience. Some features of the experience are trans-cultural and suggest either a similar brain mechanism or access to a transcendent reality. Individual features of the experience point more persuasively to transcendence than to simple limited brain mechanisms. Moreover there are, so far, no reductionist explanations which can account satisfactorily for some of its features; the meeting of dead relatives, the apparent "sightedness" in the blind during an NDE, the apparent acquisition after an NDE of psychic and spiritual gifts, accounts of healing occurring during an NDE, and of veridical experience during the resuscitation after a cardiac arrest. Although non-local mind would explain many of the NDE features, non locality is not yet accepted by mainstream neuroscience. Only those theories based on a wider understanding of mind could fully explain the subjective experience of the NDEr.