LETTER TO THE EDITOR Response to: Near-death experiences and the importance of transparency in subjectivity, ontology and epistemology Daniel Kondziella 1,2 and Charlotte Martial 3,4 1 Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen 2100, Denmark 2 Department of Clinical Medicine, University of Copenhagen, Copenhagen 2100, Denmark 3 Coma Science Group, GIGA-Consciousness, University of Liège, Liège 4000, Belgium 4 Centre du Cerveau 2 , University Hospital of Liège, Liège, Belgium Correspondence to: Daniel Kondziella Department of Neurology, Rigshospitalet Copenhagen University Hospital Copenhagen DK-2100, Denmark E-mail: daniel_kondziella@yahoo.com We thank Dr Stripp for his interest in our paper 1 and for sharing his thoughts about it in a sophisticated and polite manner. We have received a great number of critical com- ments about this paper, most of which were sent privately to the authors and most of which were much less civilized, testifying to the fact that near-death experiences (NDEs) trigger a profound interest and that associating them with a biological and evolutionary purpose appears to evoke strong emotions in many people. In response to Dr Stripp, we like to reiterate a few of the following thoughts laid out in our paper. There are no data to indicate that the phenomenology of NDEs differs in situations that are (i) associated with a threat to life and impaired brain physiology such as a cardiac arrest; (ii) associated with a threat to life but unimpaired brain phy- siology such as a near-miss traffic accident and (iii) associated with non-life-threatening situations such as drug abuse or fainting. Indeed, as pointed out by K.R. Nelson in his Scientific Commentary 2 on our paper, ‘the term “near-death” borders on misnomer since in half the instances of near-death, individuals are not in medical danger’. 3 The data that do exist indicate that NDEs in all three circum- stances referred above are phenomenologically similar. 4–6 From the phenomenology of the experience, one cannot tell whether what happened was a cardiac arrest or abuse of keta- mine. This similarity suggests that also the brain mechanisms behind these experiences are similar, if not identical. This would make sense because it is a prerequisite for someone being able to report an NDE that during the actual experience they have had sufficiently preserved cerebral function and have survived without major brain damage. Without a functioning brain, how would it be possible to make an experience so rich in details, store it over many years, retrieve it easily and report on it in an eloquent man- ner many years later? Rather than concluding that NDEs made during cardiac arrest are evidence for human consciousness being able to exist outside the brain, the most parsimonious conclusion would be that NDEs are made just prior to the loss of con- sciousness—and hence can be remembered with successful resuscitation. We certainly agree with Dr Stripp (and we say so in our paper) that our study is not absolute proof of the hypothesis that thanatosis is the evolutionary origin of NDEs. We also acknowledge the fact that we may never know for certain whether NDEs have solely a biological meaning or indeed may hint to the existence of an after-life. However, Dr Stripp’s critique about our use of anecdotal evidence, being no different from the anecdotal evidence used by pro- ponents for a transcendental meaning of NDEs, does not seem justified. We use anecdotal evidence for thanatosis and NDE occurring in humans under attack by lions and other large predators to support our argument that such ex- periences indeed can occur in these circumstances: this can hardly be denied, unless one presumes that these people were lying about their experiences. In contrast, proponents of a transcendental meaning of NDEs use anecdotes to sup- port their hypothesis that NDEs are evidence for humans Received December 14, 2021. Revised December 14, 2021. Accepted January 13, 2022. Advance access publication February 12, 2022 Oxford University Press OR The Guarantors of Brain 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. B BR AIN COMMUNICATIONS AIN COMMUNICATIONS https://doi.org/10.1093/braincomms/fcab305 BRAIN COMMUNICATIONS 2021: Page 1 of 2 | 1 Downloaded from https://academic.oup.com/braincomms/article/4/1/fcab305/6527563 by University of Liege user on 18 February 2022