Limitations of neurocentric models for near-death experiences

We read with great interest the recent proposal by Martial and colleagues (Martial, C. et al. A neuroscientific model of near-death experiences. Nat. Rev. Neurol. 21, 297–311; 2025)¹ for a neuroscientific model of near-death experiences (NDEs). We commend the authors for integrating multiple neurophysiological and putative evolutionary perspectives. However, we respectfully submit that their model, though ambitious, omits key phenomenological features that are central to the core NDE experience and overextends certain neurochemical correlates into causal explanations.

In establishing their neurocentric model, Martial et al. attempt to reframe many defining features of NDEs^2,3. NDEs characteristically involve a distinct constellation of features that sets them apart from dreams, fantasies, hallucinations or epileptic phenomena. These features include veridical out-of-body observations (often corroborated by medical personnel); transitions to ‘otherworldly realms’; panoramic life reviews (including re-experiencing past events from multiple vantage points); and encounters with deceased (but not living) relatives or ‘beings of light’⁴. Many experiencers also undergo lifelong transformative changes in personal values and a marked loss of fear of death^2,4,5. Such features appear with remarkable consistency across cultures and times^2,4,6, and merely equating them with phenomena on the spectra of hallucinations or stress-induced fantasies misses precisely what distinguishes NDEs in terms of their specificity, coherence and intensity⁷.