Chapter 5: What Is the Moment of Death?

A woman's heart stops in a hospital bed. The monitor screams a single flat note. A nurse calls the time. But is the woman dead?

Not yet. Not by a long way. Her heart has stopped, but her brain cells are still firing. Her lungs have quit, but her kidneys hold residual blood flow. The cells in her corneas will stay alive for hours. The bacteria in her gut will outlast her by days. Death, it turns out, is not a switch that flips. It is a process that unfolds.¹

That fact matters for everything this book has to say. If death were an instant, the encounter we're proposing would have no place to happen. But death is a process. It takes time. And within that time, I believe, the dying soul meets Christ.

This chapter asks a question that sounds simple but isn't: What do we mean by "the moment of death"? We need an answer from medicine, from philosophy, and from theology. Only when we've heard from all three can we define the window in which the encounter takes place.

The Medical Reality: Death as a Process

Modern medicine does not recognize a single instant of death. Instead, doctors work with a layered system. Each layer marks a different stage in the body's shutdown.²

Clinical death is the stage most familiar from emergency rooms. The heart stops. Breathing ceases. But the person can often be brought back. CPR, defibrillation, and emergency drugs can restart the heart within minutes. Thousands of people have been clinically dead and returned to tell about it.⁴

Brain death is different. When the brain loses all electrical activity, including the brainstem reflexes that drive breathing and heartbeat, the medical community considers the person legally dead in most countries. This is the stage at which organs can be harvested for transplant. Recovery from true brain death is, by standard medical consensus, impossible.⁵

Biological death comes last. Cells throughout the body die at different rates. Some tissues hold on for hours. Others break down within minutes of losing oxygen. Full biological death is the point at which the body can no longer sustain any cellular function. It is a slow wave, not a clean break.⁶

Here is the key point: most near-death experiences happen during clinical death, not brain death. The heart has stopped. Breathing has ceased. But the brain has not yet gone fully silent.⁷ This is the window in which NDErs report their experiences: the tunnel of light, the life review, the encounter with a being of overwhelming love. They are in the dying process, not beyond it.

Some cases push the boundary further. The most striking is Pam Reynolds. In 1991, surgeons at the Barrow Neurological Institute in Phoenix induced hypothermic cardiac arrest to remove a giant basilar artery aneurysm. Her body temperature was lowered to 60°F. Her heart was stopped. Her brain was monitored by three independent tests: her EEG flatlined into complete electrocerebral silence, 100-decibel clicks pumped into her ears produced no brainstem response, and no blood flowed through her brain. Her attending surgeon, Dr. Robert Spetzler, later said on national television: "If you would examine that patient from a clinical perspective during that hour, that patient by all definition would be dead. At this point there is no brain activity, no blood going through the brain. Nothing, nothing, nothing."⁸

And yet she reported vivid, detailed observations of the surgery. She described the pneumatic bone saw as looking like "an electric toothbrush" with "interchangeable blades" kept in what looked like "a socket wrench case." When Sabom checked with the manufacturer, the description matched the Midas Rex instrument with startling precision. She recalled a specific conversation about her femoral arteries being too small. She reported an extended encounter with deceased relatives and a transcendent being of light. Detail after detail was verified against the surgical record.⁹

Reynolds's case suggests something remarkable: conscious experience may persist even when the brain has ceased measurable activity. For our purposes, her case shows that the dying process holds more room for experience than standard physiology would predict.

Sam Parnia's AWARE studies at the University of Southampton confirmed the pattern on a larger scale. In a multi-hospital prospective study, cardiac-arrest survivors reported structured, coherent experiences during the period when their hearts were stopped. Some included verified perceptions of events occurring while they were clinically dead.¹⁰

The medical evidence, taken together, tells us two things. First, death is a process with stages, not a single event. Sabom puts it well: the problem with defining death lies not in our lack of tools, but in the concept itself. There is no single, definable moment — only a process of dying.⁶ Second, conscious experience can apparently occur during this process, even at stages where we would not expect it. Both facts matter deeply for the moment-of-death encounter.

I want to be careful here. I am not claiming that NDE reports prove the soul survives the body. That is a philosophical conclusion, not a medical one. What the medical data show is more modest but still important: the dying process holds more room for experience than we once assumed. The window between clinical death and biological death is not empty. Something is happening in that window. The question is what.

The Philosophical Question: When Does the Person Leave?

Medicine tracks the body. Philosophy asks a different question: When does the person cease to be present?

This book affirms substance dualism, the view that the human person is a composite of an immaterial soul and a material body.¹¹ The soul is not a product of brain chemistry. It is a distinct reality, the seat of consciousness, will, and personal identity. When the body dies, the soul survives. It enters the conscious intermediate state and eventually faces the resurrection. This has been the church's settled conviction for over fifteen hundred years. As Michael Wilkinson observes, "Christian tradition is practically univocal in its presumption of some form of anthropological dualism," grounded in the biblical presentation that humans survive death through the continuation of the soul.

On this view, death is the separation of the soul from the body. The body's failure is the occasion; the soul's departure is the event.¹² And that departure is not identical with any single medical marker. Clinical death does not necessarily mean the soul has left. Brain death may or may not correspond to it. The separation of soul from body is a metaphysical event. No monitor can detect it.

J. P. Moreland argues that the soul is a simple, non-composite entity that bears the person's essential properties. It uses the brain as an instrument but is not reducible to it.¹³ John Cooper's Body, Soul, and Life Everlasting — widely regarded as the most thorough biblical defense of dualism in the literature — makes a complementary case. Cooper works through the Old Testament, the intertestamental period, and the New Testament to show that Scripture progressively discloses a conscious intermediate state between death and resurrection. If the Bible teaches that we continue to exist "with the Lord" after bodily death but before the general resurrection, then human nature must be so constituted that we can exist temporarily without our bodies. Dualism is not a Greek import. It is what Scripture requires.¹⁴ If they are right, then the person survives the brain's shutdown. The soul is still present during the dying process, even when the body has begun to fail.

This has a direct implication for our thesis. The encounter with Christ occurs while the soul is still connected to the body but the body is dying. The soul is conscious. It is aware. And it is moving toward the threshold. The encounter happens in this in-between space.

For a fuller treatment of substance dualism and its relationship to NDE evidence, see Chapter 8.

Boros and the Interior Architecture of Dying

No thinker has taken the interior dimension of dying more seriously than Ladislaus Boros. The Hungarian Jesuit philosopher, writing in the early 1960s, argued that the moment of death is not an empty passage. It is the most loaded moment of a person's entire existence.¹⁵

Boros's key insight is that death has an inside. Medicine sees the outside: the failing organs, the dropping vital signs, the flat monitor. But the dying person has an interior experience. Boros called it the moment of "total self-encounter." For the first time in the person's existence, the soul encounters itself fully, without the limits imposed by bodily life.¹⁶

Boros distinguished three stages in the process. Clinical death is the cessation of essential bodily functions. Relative death is the state in which the soul can no longer express itself through the body. Absolute death is the metaphysical moment when the soul actually leaves the body and existence reaches its final state.¹⁷ The final decision, he argued, happens at absolute death. It occurs neither before nor after, but in death itself.

Notice how Boros's philosophical picture aligns with the NDE data. NDErs do not report a flash and a blank. They report a developed, sequential experience. They describe a life review, a meeting with a being of light, conversations, and choices. The typical NDE has internal structure. It takes subjective time. It has a beginning, a middle, and a turning point. Boros, writing before modern NDE research existed, predicted exactly this kind of experience on purely philosophical grounds.¹⁹

We will return to Boros at length in Chapter 16. For now, his contribution to our question is clear. Death is not an empty instant. It is a moment charged with consciousness, freedom, and encounter. The "moment of death" is a threshold, not a wall.

The Theological Question: What Does Scripture Say?

The Bible does not give us a medical textbook. But it does give us a way of understanding death that supports the model we're building.

In Hebrew, the basic word for dying is muth (mûth), which covers the whole range from the act of dying to the state of being dead. The Old Testament treats death primarily as the cessation of breath. When God forms Adam, he breathes into him the breath of life (nishmat chayyim); Adam becomes a living soul (Gen 2:7). When that breath departs, the person dies.²⁰ The image is of something leaving. Death is departure.

The Greek New Testament uses thanatos (thanatos) for death and a cluster of departure words for the act of dying. Paul calls his approaching death an analusis (analusis), a loosing or untying, as of a ship from its mooring (2 Tim 4:6). Peter calls it an exodos (exodos), an exodus, a going-out (2 Pet 1:15).²¹ Both images suggest movement. The soul is going somewhere. It is crossing a threshold.

This departure language fits naturally with substance dualism. Death is the moment the soul unties itself from the body and crosses into whatever lies beyond. The body stays behind. The person moves on. And if the person moves on, then the person is still conscious at the point of crossing. Departure implies a traveler who is aware of the journey.

The psalmist gives us another angle. "You will not abandon my soul to Sheol" (Ps 16:10). The Hebrew assumes a soul that goes somewhere at death. It can be abandoned or rescued. It has a destination. The whole structure of biblical death-language treats the soul as an agent, not a casualty. The dying person is someone who crosses over, not something that shuts down.

One more biblical thread is worth noting. The writer of Ecclesiastes says that God has "set eternity in the human heart" (Eccl 3:11). The Hebrew word is olam (ʿōlām). It means something like "a sense of the ages" or "a longing for what endures."²² If God has built into the human soul a capacity for eternity, then the moment of death is precisely where we would expect that capacity to activate. The soul, leaving the time-bound body, touches what it was always made for. We will develop this idea further in Chapter 13 and Chapter 10.

When Does the Encounter Happen?

We can now answer our question more precisely. The moment-of-death encounter occurs in the dying window. It begins after the body has started its irreversible decline. It concludes before the soul has finally separated from the body. It takes place at the threshold.

Think of it this way. There is a window of time between the body's failure and the soul's departure. Inside that window, the person is still a person. The soul is still connected to the body, but the body is no longer capable of holding the soul. In that window, the soul is more conscious than ever, more free than ever, more fully itself than at any previous moment in life. And in that window, Christ meets the dying soul.

This definition has several advantages. It does not depend on pinpointing a single medical instant. It accommodates the range of dying scenarios. And it treats the dying person as a conscious subject, not a passive object. The person is not something death happens to. The person is someone who moves through death toward what lies on the other side.

What About the Edge Cases?

First, what about NDErs? If they experienced the encounter, why didn't they stay dead? The answer is that NDErs did not reach their final encounter. They had a preview. They entered the dying window but were pulled back before the window closed. Their experience gives us a remarkable glimpse of what the dying process holds, but it does not represent the full encounter. The full encounter belongs to those who cross the threshold completely.²³

Second, what about sudden death? If a person is killed instantly in a car accident, is there time for an encounter? The answer requires us to think carefully about subjective time. Even sudden death involves a dying process, however brief. The brain does not shut down all at once. And the subjective time available within even a few seconds of physical dying may be vastly longer than the clock would suggest. NDE research consistently shows that subjective experience can expand radically within tiny windows of physical time. We will examine this at length in Chapter 10.²⁴

Third, what about the person who lies comatose for weeks before dying? When does the encounter occur? Not during the entire comatose period. The encounter happens at the actual moment of death, when the soul reaches the threshold and the body completes its final failure. A person in a prolonged coma may be dying slowly, but the encounter belongs to the culmination of that process, not to its entire duration.²⁵

Two Biblical Windows

Scripture gives us two scenes that hint at the dying process as a spiritually charged interval. Neither is an exact parallel to the model we're building. Both are suggestive.

I don't want to press these texts further than they'll go. Stephen was a Spirit-filled martyr. The thief was speaking to Jesus face to face. Neither case is an ordinary death. But both cases show that Scripture treats the dying moment as spiritually significant. It is a moment when heaven is near, when the veil is thin, when the dying person's consciousness is directed toward Christ. The pattern is consistent with our thesis.

The Dying Themselves Tell Us

There is one more body of evidence that belongs in this chapter, and I think it is among the most moving. It comes not from those who were resuscitated, but from those who actually died.

Hospice nurses Maggie Callanan and Patricia Kelley spent years at the bedsides of the dying. In their book Final Gifts, they document a pattern they call "nearing-death awareness." Dying patients, still conscious but hours or days from the end, begin to speak of things no one else in the room can see. They talk about seeing deceased loved ones. They describe a light. They say things like "I need to get ready to go" or "They're waiting for me."²⁷

Karlis Osis and Erlendur Haraldsson conducted cross-cultural physician surveys in the United States and India. Their study asked doctors and nurses what they had witnessed at the bedsides of dying patients. The results were striking. They found the same pattern across religious and cultural lines. Dying patients reported visions of deceased relatives or religious figures, experiences of peace and beauty, and a sense of being called or summoned. Hindu patients saw Hindu figures. Christian patients saw Christ or angels. But the pattern itself held firm across both cultures. The consistency suggests that the phenomenon is not a product of expectation or cultural conditioning. It is something that happens in the dying process itself.²⁹

One closely related phenomenon deserves a brief mention. Terminal lucidity is the surprising return of mental clarity in patients who have been cognitively impaired, sometimes for years, shortly before death. Dementia patients who have not spoken in months suddenly recognize family members, hold coherent conversations, and say goodbye. The phenomenon is well-documented — researchers have identified at least 83 published cases spanning 250 years of medical literature — and deeply puzzling to materialist accounts of consciousness.³⁰ We will explore its implications for the special case of the mentally handicapped in Chapter 31.

The combined testimony of nearing-death awareness, deathbed visions, and terminal lucidity all point in the same direction. The dying window is not empty. It is full. Conscious experience persists. Encounters occur. The soul is active at the very edge of death.

Standing at the Threshold

We began with a simple question: What is the moment of death? The answer is richer than we might have expected.

Medicine tells us that death is a process with distinct stages, not a single event. Philosophy tells us that the soul, being immaterial, is not extinguished by the body's failure but continues as a conscious subject through the dying process and beyond. Boros tells us that the moment of death is the moment of total self-encounter, full consciousness, and full freedom. Scripture tells us that death is a departure, a crossing, and that God has placed eternity in the human heart. And the dying themselves tell us that the window is real. They see something. They meet someone. They are not alone.

This is the threshold on which the rest of this book stands. If death were an instant of nothingness, there would be no room for an encounter with Christ. But death is not an instant of nothingness. It is a passage, and the passage takes time. Within that time, on the dying person's side, God acts.

In the chapters that follow, we will examine the near-death experience literature in detail (Chapter 6 through Chapter 10). We will explore how time itself bends at the edge of death (Chapter 13 and following). We will return to Boros and develop his hypothesis with the care it deserves (Chapter 16). And we will lay out the full dynamics of the encounter itself (Chapter 19).

But all of it rests on what we've established here. Death is a threshold, not a wall. The dying are conscious. The window is real. And in that window, the One who holds the keys of death and Hades is waiting.

Notes

↑ 1. Sam Parnia, Erasing Death: The Science That Is Rewriting the Boundaries Between Life and Death (New York: HarperOne, 2013), ch. 1. Parnia's central argument is that death is a process that can be interrupted and reversed at various stages. See also his AWARE studies: Sam Parnia et al., "AWARE—AWAreness during REsuscitation—A Prospective Study," Resuscitation 85, no. 12 (2014): 1799–1805.

↑ 2. The distinction between clinical death, brain death, and biological death is standard in critical care medicine. For a theological engagement with these categories, see John W. Cooper, Body, Soul, and Life Everlasting: Biblical Anthropology and the Monism-Dualism Debate (Grand Rapids: Eerdmans, 2000), ch. 3. Cooper argues that the biblical teaching of the intermediate state requires an anthropology in which the person can exist temporarily without the body — which in turn makes the soul's survival of each medical stage theologically coherent. For the historical sweep, see Michael A. Wilkinson, Crowned with Glory and Honor: A Chalcedonian Anthropology (Bellingham, WA: Lexham Academic, 2024), ch. 1.

↑ 3. Boros himself proposed a similar threefold distinction: clinical death (cessation of essential bodily functions), relative death (the soul can no longer express itself through the body), and absolute death (the soul leaves the body and existence reaches its definitive state). See Ladislaus Boros, The Mystery of Death (1965; repr., Rhinebeck, NY: Monkfish, 2020), note 3 to Part I, §1.

↑ 4. Jeffrey Long with Paul Perry, Evidence of the Afterlife: The Science of Near-Death Experiences (New York: HarperOne, 2010), ch. 1. Long's Near Death Experience Research Foundation (NDERF) database contains over 4,000 self-reported NDEs. His follow-up study, Jeffrey Long with Paul Perry, God and the Afterlife: The Groundbreaking New Evidence for God and Near-Death Experience (New York: HarperOne, 2016), reports that 64.8% of NDErs described seeing a light, and 57.8% met or saw other beings, with encounters nearly always involving deceased rather than living persons (ch. 1).

↑ 5. The legal and medical standard for brain death was established by the Ad Hoc Committee of Harvard Medical School in 1968 and refined in subsequent decades. See also the Uniform Determination of Death Act (1981), adopted in all fifty U.S. states.

↑ 6. Parnia, Erasing Death, ch. 2. Different cell types have different oxygen-deprivation tolerances; neurons are the most fragile, while skin cells and corneal cells survive for hours. Michael Sabom, Light and Death: One Doctor's Fascinating Account of Near-Death Experiences (Grand Rapids: Zondervan, 1998), ch. 3, develops the point in clinical detail, drawing on Linda Emanuel's landmark article "Reexamining Death: The Asymptotic Model and a Bounded Zone Definition," Hastings Center Report 25 (July–August 1995): 27–35. Sabom cites studies showing that 20% of patients diagnosed brain-dead retained persisting EEG activity up to seven days later, and that ten brain-dead organ donors showed an average blood-pressure increase of 31 mmHg during organ removal — reactions inconsistent with total cessation of brain function.

↑ 7. Pim van Lommel, Consciousness Beyond Life: The Science of the Near-Death Experience (New York: HarperOne, 2010), ch. 7. Van Lommel's landmark prospective study in The Lancet (2001) followed 344 cardiac-arrest survivors; 62 (18%) reported NDEs during clinical death.

↑ 8. Michael Sabom, Light and Death: One Doctor's Fascinating Account of Near-Death Experiences (Grand Rapids: Zondervan, 1998), chs. 3–5. Sabom, a cardiologist, documented the Reynolds case in meticulous clinical detail. Reynolds was instrumented with arterial blood-pressure monitoring, a Swan Ganz catheter for pulmonary pressures, EEG electrodes on her scalp, and 100-decibel click-speakers inserted into her ears to test brainstem function. Her core body temperature was tracked by thermistors in her esophagus and bladder, and a thin wire embedded in the surface of her brain monitored its temperature. Over twenty doctors, nurses, and technicians from four separate surgical teams were present. Sabom notes that during hypothermic cardiac arrest, all three clinical tests for brain death were satisfied simultaneously: silent EEG, absent brainstem evoked potentials, and no blood flow to the brain. Spetzler's remark is from a CBS 48 Hours interview reported in Sabom, ch. 3.

↑ 9. Sabom, Light and Death, chs. 3–4. When Sabom first heard Reynolds describe the bone saw as an "electric toothbrush" with "interchangeable blades," he was skeptical. Over a year later, he contacted the Midas Rex Company in Fort Worth, Texas, and received a user manual with photographs. The match was striking. Reynolds's description of a "socket wrench case" accurately described the Midas Rex instrument tray. She also accurately recalled a female cardiac surgeon's conversation about the femoral arteries being too small on the right side — a problem that occurred while Reynolds was under deep anesthesia with her eyes taped shut. Dr. Spetzler's operative report confirms that the opening of the craniotomy with the bone saw was "simultaneous" with the femoral cut-downs, placing Reynolds's two veridical recollections at the same point in a six-hour surgery.

↑ 10. Parnia et al., "AWARE" (2014). See also Sam Parnia et al., "AWAreness during REsuscitation—II: A Multi-Centre Study of Consciousness and Awareness in Cardiac Arrest," Resuscitation 191 (2023). The AWARE II study expanded the dataset and documented cases of recalled experience of death (RED) with verified perceptual content.

↑ 11. For the philosophical case, see J. P. Moreland, The Soul: How We Know It's Real and Why It Matters (Chicago: Moody Publishers, 2014). For the biblical case, see Cooper, Body, Soul, and Life Everlasting, chs. 2–4. For a comprehensive survey, see J. P. Moreland and Scott B. Rae, Body & Soul: Human Nature and the Crisis in Ethics (Downers Grove: IVP Academic, 2000). The broader scholarly landscape is mapped in Joshua R. Farris, An Introduction to Theological Anthropology: Humans, Both Creaturely and Divine (Grand Rapids: Baker Academic, 2020), ch. 1, who calls Cooper's work "the most thorough biblical defense of dualism" in the literature. Wilkinson, Crowned with Glory and Honor, ch. 1, traces the church's anthropological consensus from the early centuries through the present and shows that substance dualism was the default teaching for over fifteen hundred years; the Chalcedonian Definition's confession that the Son assumed "a rational soul and body" implies a dualism that extends into anthropology.

↑ 12. Cooper, Body, Soul, and Life Everlasting, chs. 3 and 6. Cooper argues that the intermediate state is a conscious, personal existence of the disembodied soul between death and resurrection. His central claim, restated in the preface to the second printing: "Human nature must be so constituted that we — the very individuals who live on earth — can exist at least temporarily while our physical bodies or organisms do not." The Old Testament notion of survival in Sheol, augmented by affirmations of resurrection, is developed by the New Testament into the revelation of fellowship with Christ between each believer's death and the general resurrection at Christ's return.

↑ 13. Moreland, The Soul, chs. 3–5. Moreland distinguishes between "strong" and "weak" emergence and argues that consciousness is best explained as a property of a simple, non-physical substance.

↑ 14. Cooper, Body, Soul, and Life Everlasting, chs. 4–6. Cooper's argument engages the Old Testament anthropological vocabulary, the intertestamental development (1 Enoch 22; 2 Esdras 7), and the New Testament intermediate-state texts (Luke 23:43; Phil 1:21–23; 2 Cor 5:1–10; Rev 6:9–11). His linchpin: if the Bible clearly teaches a conscious disembodied intermediate state, then a version of dualism is entailed by the biblical material. Cooper shows that the Old Testament belief in Sheol was augmented quite naturally by progressive revelation into the New Testament revelation of conscious fellowship with Christ after death — and concludes that "the metaphysical implication of the biblical data is dualism, not monism" (as Farris summarizes it). For the broader scholarly reception, see Cooper's own survey of monist challenges in his preface to the second printing (2000), pp. xv–xxx.

↑ 15. Boros, Mystery of Death, Introduction. The central thesis: "Death gives man the opportunity of posing his first completely personal act; death is, therefore, by reason of its very being, the moment above all others for the awakening of consciousness, for freedom, for the encounter with God, for the final decision about his eternal destiny."

↑ 16. Boros, Mystery of Death, II.8. On ontological indigence: in earthly life, the soul cannot fully possess itself because it is always mediated through the body. In death, this limitation is overcome, and the soul encounters itself in total transparency. On total self-encounter: "The complete positing of the self can only be effected in a complete destruction" (II.7).

↑ 17. Boros, Mystery of Death, note 3 to Part I, §1. This threefold distinction is Boros's own; he notes that Roger Troisfontaines proposes a similar but slightly different system in I Do Not Die (New York: Desclée, 1963).

↑ 18. Boros, Mystery of Death, Introduction and III.2. The theological grounding of the encounter with Christ is developed in Part III, where Boros argues that Christ's own passage through death established "a new universal scheme of salvation embracing the whole human race" (III.6, p. 144).

↑ 19. Boros wrote Mysterium Mortis in 1962; the expanded German edition appeared in 1965. Raymond Moody's Life After Life, which launched modern NDE research, was not published until 1975. The convergence between Boros's philosophical predictions and the phenomenological reports of NDErs is examined in Chapter 16.

↑ 20. The Hebrew mûth (מוּת) occurs over 800 times in the Old Testament in various forms. The connection between life and breath is pervasive: see Gen 2:7; 6:17; 7:15, 22; Job 27:3; 33:4; 34:14–15; Ps 104:29; 146:4; Eccl 12:7.

↑ 21. Paul uses ἀνάλυσις (analusis) in 2 Tim 4:6, a word drawn from the image of loosing a ship's moorings or striking a tent. Peter uses ἔξοδος (exodos) in 2 Pet 1:15, deliberately echoing the exodus of Israel from Egypt. Both metaphors imply movement, agency, and destination.

↑ 22. The Hebrew ʿōlām (עוֹלָם) in Eccl 3:11 is variously translated "eternity" (ESV, NASB), "a sense of past and future" (NLT), or "the timeless" (NKJV). The word denotes indefinite duration, either past or future, and here suggests that God has built into the human soul an awareness of, and longing for, what transcends ordinary time.

↑ 23. This distinction between the NDE as preview and the final encounter as the real thing is important throughout this book. NDErs were pulled back from the threshold. They experienced part of the dying process but did not complete it. Their testimony tells us what the early stages of the encounter may look like, but the full encounter includes the final decision, which NDErs were not given the chance to make permanently.

↑ 24. On time-dilation in NDEs, see Bruce Greyson, After: A Doctor Explores What Near-Death Experiences Reveal About Life and Beyond (New York: St. Martin's, 2021), ch. 5. The philosophical and empirical case for subjective time-extension during the dying process is developed in Chapter 10 and Chapter 13.

↑ 25. This position is consistent with Boros's distinction between the prolonged dying period and the actual "moment of absolute death." The encounter is located at the threshold of absolute death, not distributed across the entire decline. See Boros, Mystery of Death, note 3 to Part I, §1.

↑ 26. On Stephen, see Acts 7:54–60. The Greek ἀτενίσας (atenisas, "gazing intently") in 7:55 suggests focused, deliberate seeing, not hallucination. Stephen's dying words, "Lord Jesus, receive my spirit" (Acts 7:59), parallel Christ's own "Father, into your hands I commit my spirit" (Luke 23:46). As Farris notes, both texts use πνεῦμα (pneuma) and "point us in the direction of personal persistence after somatic death" (Introduction to Theological Anthropology, ch. 1). On the thief, see Luke 23:39–43. The promise "today you will be with me in paradise" locates the thief's entry into Christ's presence at the moment of death itself, not at some later judgment.

↑ 27. Maggie Callanan and Patricia Kelley, Final Gifts: Understanding the Special Awareness, Needs, and Communications of the Dying (New York: Poseidon Press, 1992), especially chs. 5–8. Callanan and Kelley document dozens of cases of dying patients who described seeing light, deceased relatives, or religious figures and who spoke of "getting ready" or "going home."

↑ 28. The distinction between nearing-death awareness and NDEs is significant. NDErs are resuscitated and report retrospectively. Patients with nearing-death awareness are actively dying and report in real time. Their testimony is a direct window into the dying process, not a reconstruction after the fact.

↑ 29. Karlis Osis and Erlendur Haraldsson, At the Hour of Death: A New Look at Evidence for Life After Death, rev. ed. (New York: Hastings House, 1977). The study surveyed over 1,000 physicians and nurses in the United States and India and found consistent deathbed-vision patterns across both cultures, regardless of religious background. For a broader assessment of the evidential weight of deathbed visions, including the cross-cultural data, see J. Steve Miller's Columbia International University doctoral dissertation, "Deathbed Experiences" (2019), chs. 2–3, which evaluates the dying-brain hypothesis against the afterlife hypothesis across multiple lines of deathbed evidence.

↑ 30. On terminal lucidity, see Michael Nahm et al., "Terminal Lucidity: A Review and a Case Collection," Archives of Gerontology and Geriatrics 55, no. 1 (2012): 138–42. The 83 published cases span conditions including brain abscesses, tumors, strokes, meningitis, dementia, Alzheimer's disease, and schizophrenia. Alexander Batthyány's multi-phase prospective study found that "even severely demented patients may experience TL to a degree which mimics full recovery of cognitive function," with no correlation between the severity of dementia and the occurrence of terminal lucidity. In 84% of cases providing a time of death, terminal lucidity occurred within the last week of life, with 43% occurring within the final day. For an extended review of the evidence and its implications for physicalist accounts, see J. Steve Miller, Deathbed Experiences as Evidence for the Afterlife, vol. 1 (Acworth, GA: Wisdom Creek, 2021), ch. 4. The phenomenon poses a serious challenge to reductive materialism, since patients with severe neurological damage should not be capable of recovering coherent mental function on a purely physicalist account. The implications for the mentally handicapped are explored in Chapter 31.