Editor’s note: Founded by Dr. Sam Parnia, the AWARE (Awareness During Resuscitation) study seeks to discover whether “out-of-body experiences” really happen and, if so, how resuscitation practices can be improved so that more people can be revived after being clinically dead. Here are answers to questions about the AWARE study and the Human Consciousness Project of which it is part.
What is the Human Consciousness Project?
It is a multidisciplinary collaboration of international scientists and physicians who have joined forces to research the nature of consciousness and its relationship with the brain.
What is the purpose of the AWARE study?
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AWARE is the world’s largest study that will investigate what happens to the human mind and consciousness during clinical death and the relationship between consciousness and the brain. This project is currently being coordinated among 25 major medical centers in Europe and the United States and will be expanded to more centers in the future.
What does it hope to prove?
The study intends to provide a scientific understanding of what happens when we die and in particular, what happens to the human mind and consciousness during clinical death. Recent scientific studies of the brain during cardiac arrest and clinical death have consistently demonstrated a “flatline” brain state, yet 10 to 20 percent of those who are resuscitated back to life people report lucid well-structured thought processes with reasoning and memory formation. In some cases, there have also been reports of the ability to “see” and “hear” precise details relating to events that had occurred during the period of clinical death. If verified through large scale studies, these detailed perceptions may indicate a high level of consciousness in the absence of detectable brain activity during the early part of clinical death, at the very least. The AWARE study aims to determine whether the mind and consciousness can continue to function for a period of time during clinical death or whether the human mind ceases functioning as soon as the heart stops beating and the clinical criteria of death have been met.
Where will the study be conducted?
At present, the study will be predominantly conducted in major medical centers throughout the United Kingdom and the U.S., as well as one center in Austria and France.
Who is leading the AWARE study?
Sam Parnia, M.D., Ph.D., in collaboration with leading scientific and medical experts from major medical centers in Europe and the United States.
Will it be peer reviewed?
When completed, the results of the study will be published in a major peer reviewed medical journal. However, the protocol for the study has already been extensively peer reviewed by multiple internal hospital committees as well as ethical and institutional review boards.
When will the results of the AWARE study be released?
It is anticipated that the results of this study will be released in 36 to 60 months (2012-2013).
Why study what happens when we die?
Traditionally, many of the major questions that mankind has faced have been tackled by philosophy or theology. However, in the last few centuries, science has gradually begun to seek, and has been able to provide to a certain extent, answers to such questions. One of the areas still eluding science’s grasp has been the question of what happens when we die, as well as the nature of the human mind and consciousness and their relationship with the brain.
From a social perspective, we know that each one of us will one day face our moment of death. Therefore, it is imperative that we provide scientific answers to the question of what happens when we die.
From a medical point of view, latest discoveries have provided doctors with the ability to push back the boundaries of death and reverse the process of death once it has started. With ever improving scientific discoveries, we will be able to bring even more people back to life from clinical death. In order for the medical profession to treat its patients more appropriately and to address many of the ethical dilemmas that arise from medical and scientific progress, it is paramount for physicians to be able to provide a scientific understanding of what happens to the brain and body, and more importantly, the human mind and consciousness, during death.
What is clinical death? Is there a difference between clinical death and death as is generally perceived in society?
From a medical point of view and contrary to common social perceptions, death is not a specific moment. It is actually a process that begins when the heart stops beating, the lungs stop working, and the brain ceases functioning — a medical condition termed cardiac arrest. From a biological point of view, cardiac arrest is synonymous with death. Initially, however, after the heart stops and the person has clinically died, there is a period of time, ranging from a few seconds to an hour, or possibly even longer, in which emergency medical efforts may succeed in restarting the heart and reverse the dying process. After that period of time, there is such extensive damage to the cells of the body that no efforts to restart the organs of the body will succeed and irreversible death sets in.
There was an 18-month pilot project. Can you explain more about that?
As with any large scale multi-center collaboration, there are complex procedures that need to be followed and a practical methodology that needs to be established in order to allow the study to progress properly. During this pilot phase, we have successfully tested and developed the appropriate methodology that can now be extended to all the centers involved in the study.
Are there any interesting technologies that will be used with the AWARE study?
The AWARE study is the first study in the world to use a direct measure of blood flow to the brain in order to determine the relationship between circulation of blood in the brain and consciousness during cardiac arrest and clinical death. During the pilot phase, we explored different technologies and found that cerebral oximetry is the optimal technology for use in the AWARE study.
How does the technology work?
INVOS Cerebral Oximeter is an FDA-approved device that uses light waves to detect changes in brain oxygen levels and circulation of blood to the brain.
Is this the first time this technology has been used?
No. INVOS Cerebral Oximetry has been used in many intensive care settings all over the world as an indicator of brain blood flow. It has also been used on a small scale in the cardiac arrest setting. This will be the first time, however, that it will be used on such a large scale in a cardiac arrest setting and the first time that the results obtained from this technology will be correlated to the activity of the mind and consciousness during clinical death.
Are there other uses for this technology?
This technology can be used in any critical care setting in order to monitor effective blood flow to the brain and to provide clinicians with a “real time” indication of whether certain treatments have been effective or whether such treatments need to be altered. This technology also holds great promise in terms of potentially improving the manner in which patients who have undergone cardiac arrest and clinical death are resuscitated back to life.
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