In 1977 Karlis Osis and Erlendur Haraldsson published At The Hour Of Death, describing their investigations into what they termed deathbed visions. Deathbed visions are experiences reported by some patients very shortly before they die which involve such things as apparitions of deceased relatives and friends as well as religious and mythological figures who, they believe, have come to take them away. These visions typically result in feelings of serenity, peace, elation, religious emotions, and often the cessation of pain.
Osis in 1959 launched an investigation of these deathbed visions with the support of the Parapsychology Foundation where he was director of research. The goal was to carry out a mass survey, asking thousands of doctors and nurses about the deathbed visions of their dying patients. Osis viewed these professionals as more likely to be reliable witnesses rather than others who might have been present, such as clergy or friends and relatives.
A questionnaire was mailed to a stratified random sample of 5,000 physicians and 5,000 nurses practicing in the United States. A number of questions were asked: the extent of their experience with dying patients and how many they had seen die, their observations of patients’ hallucinatory behavior (such as seeing apparitions of relatives or of religious figures or visions of heavenly scenes), and the patients’ emotional states shortly before death, including any sudden rise in mood to exaltation. This survey resulted in 640 returned questionnaires based on the respondents’ observations of 35,000 dying patients. They reported 900 cases of visions, 1300 of apparitions, and about 700 cases of a rise in their patients’ moods before death. Questionnaires were followed up with detailed interviews of 190 respondents.
In 1962 Osis, now with American Society for Psychical Research (ASPR), designed a second more ambitious and scientifically rigorous survey of deathbed observations to confirm or deny the findings of the earlier study. He recognized that cultural factors might well play an important part, as Americans pretty much all have the same background of biblical religion. What was necessary was to conduct the same survey in another country with a different religious tradition. India was identified as the best bet. Unfortunately, carrying out such a study was too costly, and the project was shelved.
In 1964 something quite fortuitous happened to revive the project, which in itself makes an interesting addition to the history of psychical research, the case of James Kidd. Kidd was a miner in Phoenix, Arizona, who to his neighbors appeared to be very poor. In November 1949 he went prospecting and did not return. A few years later he was declared dead. Kidd had a safety deposit box in an Arizona bank which was opened because the rent hadn’t been paid. A large number of securities were found along with a will, scribbled in pencil on a piece of paper. It stated that he had no heirs and wanted his property, which was in stocks, to be sold and the money to go “in a research or some scientific proof of a soul of the human body which leaves at death.” It turned out that the money from the stock sale amounted to $270,000. Some 130 different parties contended for this legacy. After a long litigation, in 1971 the money was granted to the ASPR to test the hypothesis that some part of the human personality is capable of operating outside the living body on rare occasions, and that it may continue to exist “after the brain processes have ceased and the organism is decayed.”
With funds from Kidd the Indian study (and other important work) became possible. Erlendur Haraldsson joined the project to contribute expertise from his experience in the Orient. For both the second American survey and the Indian survey the same questionnaire was used, consisting of 207 questions relating to hallucinations of persons, hallucinations of surroundings, and mood elevation. Interview questions were nearly all the same except for small changes made in order to accommodate significant differences in India. In the American survey the questionnaire was sent to a stratified sample of 2,500 physicians and 2,500 nurses in five eastern states with a return of 1,004. In India, the survey was conducted in hospitals in northern India where typically the professors of medicine and surgery arranged meetings with staff, and questionnaires were completed. Most Indian medical personnel cooperated, yielding 704 completed questionnaires. Of the 1,708 usable questionnaires in the two countries 877 were followed up with detailed interviews.
The researchers were well-aware of the limitations of their methodology, particularly having to rely on the reports of doctors and nurses rather than being able to talk directly with their patients. Although medical personnel are trained to provide objective observations, given the subject of what they were called on to report, there was clearly a possibility of unconscious if not overt bias. To address this they built into their survey checks and balances on such possible sources of respondent biases as religious beliefs, attitudes toward hallucinations, length of contact with the patient, patient load, and relationship to the patient. After extensively analyzing their data the investigators were confident they had been able to rule out bias. However, they concluded that the data very likely showed a lesser proportion of afterlife-related experiences than there actually were.
The resulting investigation in the two countries produced a huge body of data, including 471 cases of patients who saw hallucinations of persons (216 in the United States and 255 in India), and 120 cases of patients very close to death who did not die, but who also described seeing hallucinations of persons (56 in the United States and 64 in India). Each of the 471 cases involved detailed interviews averaging some 16 pages of data. This data was combined with that from the 135 cases in the pilot study. The investigators were interested in two main questions, the characteristics of the patients at the time they had their visions and the nature of the apparition experience.
For the majority of patients actual death followed closely after they witnessed an apparition. In fact, 27 percent died within an hour, 20 percent died between one and six hours later, and 62 percent within a day. Three types of apparitions were reported, those of living persons, dead persons, and mythological or historical religious figures. Only the latter two were considered related to the issue of postmortem survival. In all three surveys there was an overwhelming majority of afterlife-related apparitions of these types, 77 percent in the pilot study, 83 percent in the U.S. survey, and 79 percent in the Indian survey. Osis and Haraldsson point out that data from other surveys indicate that people in normal health appear to hallucinate dead and religious figures in less than one-third of cases. Thus, terminal patients saw these types of apparitions three times as often as do individuals in good health.
hile the number of afterlife-related hallucinations were very similar among both American (78 percent) and Indian (77 percent) patients, the proportions of those portraying dead and religious figures were reversed in the two countries. Americans respondents reported five times more hallucinations of the dead among their patients than of religious figures (66 percent versus 12 percent), whereas Indian patients hallucinated religious figures more often than those of the dead (48 percent versus 28 percent). Among Indian patients a small percentage were Christian (10 percent), and these patients also experienced a much smaller proportion of hallucinations of the dead than of religious figures Among those people seen, 91 percent were relatives of the patient with mother, spouse, offspring, sibling, and father reported in that order of frequency. The identity of the person was unknown in one-fifth of the cases.
The following is typical of US cases. A 65- year-old male cancer patient who appeared to be clear and rational in his thinking was observed to look up at the wall. His eyes and face brightened up, and he spoke of light and brightness. He apparently saw people who seemed real to him and said such things as “hello,” and “there’s my mother,” and stretched out his hands. After the vision ended he closed his eyes and seemed very peaceful, whereas before it he had been nauseated and very ill.
Among types of apparitions seen, the second largest category involved religious figures. Christians for the most part tended to hallucinate angels, Jesus, or the Virgin Mary, whereas Hindus most commonly saw Yama, the god of death, one of his messengers, Krishna, or some other deity.
The purpose of the contact by the apparition was typically obvious if not actually told to the doctors and nurses. In the majority of cases in both the US and India this was to assist the patient in making the transition to the other world, to take him or her away. The general pattern involved a deceased close relative, although sometimes religious figure, appearing to the patient and informing him or her that he was taking the patient away to a heavenly world.
The researchers found that most of the patients wanted to go with the apparition. In fact, among US cases, only one did not wish to do so, whereas in India two out of three wished to go, and one third did not. Responses to apparitional visits varied greatly among dying patients. Often the otherworldly messenger was greeted with emotions of serenity, peace, religious feeling, or sudden elation replacing an atmosphere filled with apathy and gloom.
Sometimes, however, particularly in India, negative reactions were involved. An 80-year-old Indian woman dying from cancer of the throat saw people coming to take her away. She was alarmed and said she didn’t want to go. She asked her daughter-in-law to hold her hand tightly and not allow her to get up and leave.
One of the most important and basic questions explored in the study related to the origin of deathbed visions. Are they, the investigators wondered, merely the result of psychophysiological malfunctions and cultural influences whose origins could be traced, or do they reveal a relatively independent and universal human characteristic.
One obvious candidate for increasing the likelihood of hallucinatory behavior is drug intoxication or sedation. In this regard, the researchers discovered that of those 425 patients for whom they had information concerning medication 61 percent had received no sedation at all. Furthermore, 19 percent had received such small or weak doses or such weak drugs that the respondents did not consider them to have been psychologically affected. Thus, the investigators concluded that most of the patients’ visionary experiences were not caused by drug intoxication.
Another physiological factor the investigators recognized that might well induce hallucinations is high fever, since elevated temperatures are sometimes known to bring on a delirious state. Of the 471 patients involved, the investigators received information on the temperatures of 442. Fifty-eight percent had normal temperatures, and 34 percent had low-grade fevers of up to 103°. High temperatures – 103° or more – were present in only 8 percent of the patients. The possibility that the apparitions were caused by fever seems plausible only in a small minority of the cases.
An important factor regarding the experience of the visions relates to the quality of the patients’ consciousness at the time. Relevant information was available in 86 percent of the cases, indicating that about half were in a clear state of consciousness and fully aware of their surroundings. Most of the remainder, while mildly impaired, could still be communicated with. Less than one-fifth had such impaired consciousness that little or no communication was possible. Thus, according to the doctors and nurses interviewed, the majority of their patients having visionary experiences were in a normal, wakeful state of consciousness.
To examine the possibility that some kind of brain disease or other medical condition might have contributed to the visionary experiences, the investigators obtained not only the primary diagnoses of the patients, but also data on secondary illnesses and histories of previous illnesses. Analysis revealed that that deathbed visions were relatively unaffected by medical conditions.
Regarding the sex and age of the terminal patients, in the U.S. men and women experienced deathbed visions about equally. In India there were more than twice as many cases of male patients most likely due to the fact that more males than females there are admitted into the hospitals.
Experiences of apparitions occurred among all age groups, children as well as the middle-aged and elderly, although, of course, the latter comprise a lot more of terminal patients in general. As with sex, age appears to not play a determining role in deathbed visions.
The researchers recognized that one possible source of these visionary experiences might relate to superstition. If less educated people are more likely to be superstitious, then they might be more likely to have deathbed visions. However, the data indicated that 52 percent of reports involved high school graduates or those who had attended college, whereas only 21 percent were illiterate. Thirty percent of those seeing apparitions were professionals, managers, and clergymen.
Psychological factors relating to those experiencing visions were considered. One such candidate, the dominant view of thanatologists, is that peace and serenity come to patients because they have given up the struggle for life rather than because of an encounter with supernatural elements. However, the data strongly indicated that the patients’ emotional response was determined by the nature and purpose of the apparition.
A nurse reported the following case involving an intelligent 76-year-old woman who had suffered a heart attack. Her consciousness was very clear, and she had no sedation and no hallucinogenic history. She was confident that she would recover and return to her daughter who badly needed her at home. Suddenly she smiled and called to the reporting nurse, asking her if she couldn’t also see the deceased husband with outstretched arms waiting for her. The woman described a beautiful place with flowers and music. The nurse observed “a kind of religious peace and serenity came over her.” During this vision, the woman was well-oriented and carried on conversations with both the nurse and her family.
Another clearly plausible psychological explanation for a patient’s visions might involve his or her desires or expectations. The investigators questioned respondents as to whom the patients had desired to see the day before the visions occurred. Often this was a loved one, perhaps living far away. The data indicated that only an insignificant portion (3 percent) of the cases involved hallucinations of persons the dying patients desired to see and who had not visited them. The patients’ desires did not appear to create the vast majority of apparitions. Furthermore, the investigators found no indication that persons recently seen by patients also appeared frequently in their hallucinations.
The researchers speculated that the patients’ expectations of either dying or recovering from their illness might shape their visions. If they expected to die, they might indulge in otherworldly fantasies in order to assuage their fear of dying. If they expected to recover, seeing an apparition coming to take them away to the realm of the dead would be surprising and no doubt unsettling. The data, however, showed that these expectancies were not significantly related to the purpose of the apparition.
The apparitions clearly appear to show a purpose of their own, contradicting the intentions of the patients. This was particularly apparent in those cases, nearly all in India, in which apparitions called a patient for transition to the other world, and the patient, not willing to go, cried out for help or tried to hide.
Based on the data the authors concluded that the question as to whether deathbed visions are merely outward projections from the patient’s psyche seems clearly to be ‘no.’ Terminal patients did not see those persons in their visions that they had expressed a desire to see. Furthermore, their visions did not seem to be directly related to such things as their stress, moods, or worries. Deathbed visions occurred to those who did not expect to die. The intent of the apparitions in many cases appeared to be very different from that of the patients. All of these findings, the investigators concluded, support the hypothesis that at least “some apparitions may be independent entities and not merely outward projections from the patient’s psyche.” (p. 88)
Among the cases collected, 120 did not go on to die but came back from near death states and were able to inform the doctors and nurses that they also had seen apparitions. Half were so ill they had given up hope and expected to die. Some were resuscitated by drastic medical procedures. These patients, of course, were not representative of all the very ill patients the respondents cared for, the vast majority of whom offered no reports of apparitional experiences.
What the researchers discovered among these “come back” patients was that in many respects they reported the same phenomena as those patients who went on to die. (p.146) However, many differed from terminal cases in one important respect. Among the majority of the apparitions whose purpose initially seemed to be to take the patient away (78 percent), at least one-third, and probably more, actually sent the patient back to life.
One case of this sort involved an accountant in her fifties who had suffered a heart attack and was expected by her doctor to die very soon. She told the reporter that her deceased parents were coming to take her far away. However, as the three of them were going along a hill her parents suddenly told her to go back. She left them and turned back. The next morning, some six to eight hours after her experience, the woman’s condition improved.
A doctor reported the experience of an engineer in his fifties stricken by coronary thrombosis. The patient said he saw a bearded man standing at the opening to a long golden corridor. The man was shaking his head, motioning him to go back, and said: “Not now, later.” The patient was very happy, saying he wasn’t “wanted up there” and told the doctor he didn’t need medicine anymore. Immediately after this experience he started getting better.
A minority of all the deathbed vision cases investigated, but still a significant number (112), mentioned environments glimpsed rather than persons. Two-thirds appeared to picture another world or realm and one-third places and objects in this world. Among all of the other-worldly descriptions by the patients, the most commonly reported elements included extraordinary beauty, visions of extraordinary, intense light and color, and the feeling of peace. Only a few cases (17 percent) included conventional Christian, Hindu, or Muslim ideas of the other world
In all of their cases from both countries the researchers discovered only one case where a patient saw “hell,” an Italian-born housewife from Rhode Island undergoing a gallbladder operation. She said, upon regaining consciousness, that she thought she was in hell. The respondent reporting this incident stated that “her eyes were popping out of fear.” Upon being reassured, she discussed her experience in hell and her belief the devil would take her. She interspersed her account with descriptions of her sins and the opinions people had of her. She became increasingly fearful and agitated, “almost psychotic.” The respondent noted that the woman had long-standing guilt feelings about her life that involved an extramarital relationship resulting in illegitimate children. She was scared because her sister had died from the same illness and believed God was punishing her for her sins. The researchers observed that the worldly origins of her hell can be readily seen as the “conflict between the “ought” and the “is” of her love life.