About four years ago I wrote a post about the AWARE (AWAreness during REsuscitation) project being lead by Dr. Sam Parnia. The AWARE project is summarised on its official website as being about “using the latest technologies to study the brain and consciousness during cardiac arrest… [and] testing the validity of out of body experiences and claims of being able to see and hear during cardiac arrest through the use of randomly generated hidden images that are not visible unless viewed from specific vantage points above”. I previously expressed a number of concerns about the research, with the chief complaints being: 1) the methodology for placing ‘hidden’ images was poorly controlled (i.e. some images were visible to staff, giving patients a rather less esoteric means of learning about their content) and 2) the lead researcher, Dr. Parnia, was already promoting and offering dubious (quantum) interpretations about the meaning of the positive results, before the data was collected!

The study has finally been published, and despite breathless headlines such as the Telegraph’s “First hint of ‘life after death’ in biggest ever scientific study” or the Independent’s “Largest-ever study provides evidence that ‘out of body’ and ‘near-death’ experiences may actually be real”, the findings are actually remarkably unimpressive. For a start, the main finding, which is not mentioned in the abstract and quickly dismissed in one sentence in the discussion section, is that none of the 140 patients interviewed were able to identify a single hidden image. The paper tries to downplay this by pointing out that 78% of cardiac events occurred in areas without the special ‘shelves’ that held the images, this percentage however appears to be based on the full sample of 2,060 cardiac events rather than the 140 cases included in the study. It may be that the percentage is similar for these specific cases but the paper doesn’t tell us that and regardless, since the researchers seem to feel this makes the measure all but useless, you have to wonder why such a serious methodological issue was not identified as a problem in the piloting stage. Indeed, if we go back to this report from the BBC in 2009, we find a rather different take from Dr. Parnia on the importance of this null finding:

“If you can demonstrate that consciousness continues after the brain switches off, it allows for the possibility that the consciousness is a separate entity. It is unlikely that we will find many cases where this happens, but we have to be open-minded. And if no one sees the pictures, it shows these experiences are illusions or false memories.“

This seems to be a rather unavoidable case of ‘moving the goalposts’ but the next question this raises is where exactly the goal has been moved and the answer… well, it is kind of amusing but also depressingly predictable. The new ultimate ‘objective’ measure for whether a patient had a verifiable out of body experience was, “an interview… conducted by the study principal investigator (PI)”, aka Dr. Sam Parnia. So the final, most objective, measure to determine whether a patient’s account represented a true OBE, was an interview from a heavily invested researcher, who gives public talks and interviews (and published a number of books) arguing that OBEs are evidence that consciousness is separate from the brain and has spent half a decade running a study to prove that to be the case.

It is hardly surprising that Dr. Parnia would find such ‘objective’ evidence, but what was genuinely unexpected was that from the 140 cases included, he was only able to manage to ‘detect’ one suitable case (see the flow-chart breakdown above). That is, from the 55 patients who were designated as having “perceptions of awareness and/or memories” of their cardiac arrest experience, only two were selected for the ‘Stage 3 ‘objective’ interviews with Dr. Parnia and only one of those had “verified accuracy of recall”. At this stage you may wonder how accuracy was verified and you may presume 1) that the ‘objective’ Stage 3 interview, would be conducted shortly after the event, to avoid possible contaminating sources of information, and 2) that there would be some ‘objective’ scoring method provided to verify the accuracy of the account. In both cases you would be wrong, the paper doesn’t mention when this single patient was interviewed, likely a telling omission, but it does indicate that in many cases interviews were conducted “between 3 months and 1 year” and even for the in-hospital interviews, “these took place between 3 days and 4 weeks after cardiac arrest depending on the severity of the patients’ critical illness”. It’s possible that the patient in question was one of the cases interviewed in hospital, 3 days after the event, but it seems likely that the study would have mentioned this, if that was the case. The omission of the length of delay before the interview instead is rather likely due to there having been a significant delay, during which time the patient could have unconsciously learned, or reconstructed, many of the ‘verified’ details from more mundane sources. (UPDATE: It seems the interview in question was conducted over a year later, see the comments below for more details)

As for the precise ‘verified’ details of the account reported in the study, these are:

The use of an AED (a defibrillator). The medical team present during the cardiac arrest. The identification of a bald man in blue scrubs.

The study claims that it is able to ‘verify’ that these memories were created at the time of the cardiac arrest due to the mentioning of an AED, which is only used following cardiac arrest. The study neglects to mention that the use of a defibrillator is probably one of the most common motifs associated with cardiac arrest in popular culture and also unfortunately doesn’t tell us if the medical team present during the cardiac arrest interacted with the patient before or afterwards (a significant possible confound). It does reveal that the patient, at least, had an interaction with the bald man in blue scrubs the following day: “he was the man that…(I saw) the next day…I saw this man [come to visit me] and I knew who I had seen the day before.” This clearly introduces an alternative possible means through which the patient could have learned details about their experience, as does the possibility that they lost/regained partial consciousness when members of the team that they identified were still present, but the study doesn’t concern itself with discussing such mundane alternative accounts.

Sadly, thanks to the inaccurate media summaries and Dr. Parnia’s inevitable promotional efforts, this study will probably enter the popular consciousness as ‘some scientists proved that there is life after death and out of body experiences are real’. But in reality, this study was unable to provide even a single compelling case or real ‘objective’ piece of evidence that OBEs represent accurate memories and/or that consciousness can exist independently from the body. People often have real, deeply transformative experiences when they recover from a cardiac arrest but these are not evidence of an afterlife or a metaphysical mind, just of the remarkable resilience and the deep desire for meaning that often follows traumatic events.

Original Article: Parnia, S. et al. (2014), AWARE—AWAreness during REsuscitation—A prospective study, Resuscitation. DOI: 10.1016/j.resuscitation.2014.09.004