Does Dying Hurt? | Unveiled

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Does Dying Hurt?</h4>

Theories suggest that fear of death is an innate, everyday reality for every single human being. It’s stronger in some than in others, but all of us are in some way guided by the inescapable knowledge that none of us are immortal. Our days are always numbered. But what will it really be like when we reach our final hour?

This is Unveiled, and today we’re answering the extraordinary question; does dying hurt?

We’ve covered Terror Management Theory in past videos. It’s a key consideration for today’s question though, so, in short; Terror Management Theory says that all of us are always acutely aware of the fact that we are going to die. That doesn’t mean that we’re all absolutely terrified all of the time… it’s just that the prospect of death shapes what we do and how we think. Sometimes it’s obvious, such as a natural reluctance to move too close to the edge of a tall building… because death is just that little bit more likely if you do. But, at other times, it’s much subtler, such as an inclination (or disinclination) we might have towards certain foods, or sports, or even ideas. At some level, all of us are in-built to seek what’s best for our survival… even those of us who you might describe as a daredevil. Even beneath blatant recklessness, there lurks some degree of want and need to prolong our lives and not shorten them. Or, so the theory goes.

For some, though, fear of death is more specific than simply an anxiety over the unknown that awaits us. And it’s the physicality of death that really keeps them up at night. You might ask yourself things like: How will I die? Will I know when I’m dying? And, most unsettling of all, will it hurt?

For “how will I die?”, without a time machine to use in a particularly macabre fashion… we clearly can’t see into the future. So no one knows how they’ll die, although it is a question with a statistical answer. According to data gathered by the World Health Organization for up to (and including) the year 2019, the leading cause of death worldwide is heart disease, accounting for around sixteen percent of all deaths. That’s followed by stroke, accounting for around eleven percent; and then chronic obstructive pulmonary disease - which includes a number of lung conditions - at around six percent. All three are considered noncommunicable, which means that they’re not spread between people, and together they amount to one third of all deaths on Earth. We’ve seen in recent years how the numbers can quickly change, with the emergence of something like COVID-19. We’ve also seen new trends set in, such as an increasingly high ranking for Alzheimer’s Disease and dementia in the numbers for some countries. And, in general, there are differences (sometimes dramatically so) in the data from country to country. But the WHO effectively reckons that any one person alive in the twenty-first century is thirty-three percent likely to pass away through heart disease, stroke, or a lung condition. As morbid as that conclusion is, it’s also important information as it’s then used to guide scientific research and to allocate resources in the future. 

In terms of “Will I know when I’m dying?”, from the point of view of conscious experience, it’s a question that we tackled in another recent video. It follows on from this one, so be sure to hang around! For now, though, we can say that there is some evidence to suggest that, under some conditions, a dying person might be aware of what’s happening to them. Yes, that’s a pretty vague and non committal answer… but, clearly no one who is dead can tell us whether they knew what was happening to them. For the most part, what we do know comes from the testimony of those who have a near death experience.

But, finally, will dying hurt? Again, there are a number of ways this question could be answered. Taking into account all of the causes of death that the WHO considers, there is usually a strong likelihood of at least some degree of pain at some stage. Hospital stays, prolonged treatments, sudden injuries; all have the potential to “hurt” in the time before the moment of death. There are some mitigating circumstances, such as the possibility of shock negating pain in, say, a fatal car accident… but, and to continue a theme, there’s really no way to know whether that really is what happens. A dead person would either have to come back from the dead to tell us - impossible - or they’d have to have been connected up to various high-spec brain scanning equipment during that car accident - unlikely.

Much of the firmer data we have comes from various studies into palliative care - end of life care given to those with terminal conditions. In general, it’s shown that when the circumstances are such that death can essentially be managed and prepared for in this way, then reports of pain decrease. One 2017 article - published on “The Conversation” and written by three researchers at the University of Wollongong in Australia - draws on evidence taken from the Australian Palliative Care Outcomes Collaboration. The authors explain that fatigue is actually the most often reported complaint among those receiving palliative care - with 13 percent of patients citing it at the beginning of care, and eight percent at the end. In contrast, 7.4 percent reportedly cite pain at the beginning, with that figure dropping to 2.5% at the end. Based on those numbers, you’re then much more likely to feel tired as your death approaches, rather than in pain. With only a two or three out of one hundred chance of feeling significant pain in your last moments. Of course, not everyone faces death under these conditions. Palliative care isn’t always available and, in cases where death happens quickly and unexpectedly, it obviously hasn’t happened at all. While we can say, then, that any pain there is can seemingly be reduced in some scenarios… we can’t say that death is never painful.

That said, there are other studies and anecdotes to suggest that pain still isn’t the predominant sensation. Instead, the exact moment of death is painted as something like a clouded, even subdued point in time. For those experiencing it, it may appear as though they fall in and out of a conscious state, and are therefore unaware of any pain even if they should be in pain. The journalist Jennie Dear is the author of the 2019 book, “What Does It Feel Like to Die?” - in which she draws upon her own experience following the passing of her mother. Writing for “The Atlantic” three years earlier, in 2016, she quotes a professor of nursing, Margaret Campbell, who says; “Roughly from the last two weeks until the last breath… people become too sick, or too drowsy, or too unconscious, to tell us what they’re experiencing”. In the same article, Dear cites the palliative care specialist James Hallenbeck, who compares the mystery of death to passing the event horizon in a black hole - an ultimately unknowable experience. Nevertheless, Dear explains how there often is a predictable sequence of events; including the loss of hunger, thirst, and speech, and then the senses vision, touch and hearing, in that order. Again, throughout it all, and especially if pain medication is being used, the patient is often thought to be at peace, and perhaps even wholly unaware.

Clearly, for anyone on the outside looking in, there are a number of aspects to death that seem as though they might be painful; or that seem to hint that the dying person is experiencing discomfort. In some cases, though, that’s not thought to be true. Dear writes that the so-called “death rattle” - when a person begins audibly labored breathing - isn’t believed to be distressing for those that go through it. Apparently pained expressions on the faces of dying people can sometimes relate instead to an apparent dreamlike, unreal state of being that many encounter toward the end. And many physical reactions, such as twitching and stiffening, are involuntary and, again, might even go unnoticed by the person who’s actually experiencing them.

Ultimately, however, this is a question that’s impossible to answer with certainty. Death is arguably the greatest unknown of all, but also a wholly unique experience every time it arrives. It can be long or short, expected or sudden, the result of a statistically probable disease… or caused by something altogether different. Whether or not it hurts depends on exactly how all of those things play out… although, thankfully, there is evidence to suggest that it more often isn’t painful than is.

At the beginning of this video, we mentioned an in-depth look at whether or not you know you’re dying when it happens. That episode will follow on directly from this one right now, so be sure to keep the video running! 

As the old adage says, there are only two things that are certain in this life; death and taxes. With taxes, you’re certainly more than aware when they happen due to a sudden and saddening drop in available funds. But, with death, is there any comparable moment of realization?

This is Unveiled, and today we’re answering the extraordinary question; when you die do you know that you’re dead?

Until such time as immortality is possible, the creeping specter of death haunts us all… but, in the twenty-first century, humankind has grown more and more accustomed to facing it head on. Although for hundreds of years beforehand religion was really the only widespread means through which we might try to understand death, in more recent times science has taken over. Where once we had only Faith, now we have facts, figures, data and studies, as well. And that specter of death has morphed into a whole new beast.

Although definitions vary around the world, the time of death is generally taken as the moment at which your heart stops beating. However, as CPR continually shows, you can be brought back from this particular brink. Brain death is another crucial stage, then, when your cerebral organ essentially gets its power cut off. However, in between heart and brain death, there certainly is a small period of time - from two to twenty, perhaps thirty seconds - during which scientists believe that you might know that you’re dead. It’s usually during this time that near death experiences form, before the person is resuscitated to recount them. But, that said, it’s extremely difficult to know exactly how aware any one person can be, during that particular (and brief) time window. For those who are brought back to life, the near death experience might make some sense in hindsight… but, at the time, when your body is going through the ultimate trauma, it’s not clear how much of it really hits home. It’s not clear if you truly know you’re dead.

Nevertheless, various studies have captured headlines over recent years, with them usually billed as haunting or disturbing experiments to show that perhaps life doesn’t end when you die. Or at least, not exactly. Doctor Sam Parnia - a British scientist and senior figure at the NYU Langone School of Medicine in New York City - is one of the most frequently cited expert voices in the field. Throughout the twenty-first century, Parnia has headed numerous studies looking into that mysterious space between life and death. In 2013, following the publication of his book “Erasing Death” - published as “The Lazarus Effect” in the UK - he gained attention after suggesting that we should be able to resuscitate people even up to twenty-four hours after they’ve died. For Parnia, what many would rather term resurrection, is actually possible if only we applied and developed the science properly. Whether or not you go along with his twenty-four-hour theory, though, if it’s even a little correct… then suddenly we could have a lot longer in which to understand that we are dead.

Parnia is also the director of the Human Consciousness Project, based at the University of Southampton in the UK. Among other things, it was responsible for the AWARE Study - taking a deep dive into the near death experiences of cardiac arrest survivors. We took a closer look in another recent video. Following on from his body of work, Parnia has previously campaigned for the term near death experience to be changed to actual death experience, as well, so committed is he to the notion that death is never just one moment. And, finally, Parnia has previously indicated a somewhat radical view on the nature of consciousness, in general, arguing that it might not be produced by the brain, only hosted by it. If true, that would potentially mean that the entire human experience, not just death, could actually be linked to forces outside of our physical bodies.

The stance taken by Sam Parnia, many of his associates, and many other independent researchers, certainly asks us to question what (and when) we really think death is. The vast majority of research seemingly shows that it might (even will) be possible to know that you’re dead for at least around the first twenty seconds post your last heartbeat. But, beyond that, analysis of NDEs has been interpreted to hint at something more. And, if we ever can bring people back to life whole hours after their heart has stopped - as Parnia has suggested we should be able to do - then suddenly we could live in a world where multiple people within it have spent large portions of time, even whole days, technically dead and departed from it.

Naturally, then, talk of death in these terms can take us to questions of the soul. What is it? Where is it? And does it survive when your body is no more? Again, while ideas on the soul have more traditionally been left to theology and philosophy, modern science has become increasingly interested in properly defining it. For centuries, the soul has proven notoriously difficult to pin down. Many have tied it in with ideas on the conscience, on morality, and with a species-wide understanding of what’s right and wrong. Others have attempted to definitively explain it not only through the lens of human life, but through life in general. In the loosest sense, the soul is some kind of seemingly collective essence through which the general experience of reality takes shape. But, that’s all just way too ambiguous to satisfy most scientists… and, as such, one theory argues that the problem might be properly solved via quantum mechanics.

The theory of Orchestrated Objective Reduction (or, Orch OR) was formulated and published in the 1990s, by the British physicist Sir Roger Penrose and the American scientist Stuart Hameroff. The model was then updated in 2014, and has become increasingly prominent ever since. At its heart, Orch OR might reasonably be considered one of the most radical and controversial ideas of our time. It argues that, rather than being the product of neurological connections, consciousness is generated via vibrations in microtubules - tiny protein strands - inside neurons. One of the key takeaways from the Orch OR theory, however, is that it could mean that consciousness continues indefinitely after the physical body fails. Here, what might be called the soul is merely quantum information. Throughout our lives, that information is channeled through our brains and experienced through our bodies… but when our lives end, the information doesn’t disappear. Instead, it’s more like it gets released. The brain no longer hosts it, but it does still exist. Somewhere. What happens next is still a little sketchy, even within the Orch OR framework… but advocates suggest that there could be a link to broader ideas on the soul and afterlife.

In terms of our title question, could this then be a mechanism through which you would know that you’re dead when you are dead. Possibly. But, on the other hand, and as is so often the case with theories surrounding death, we perhaps can’t know for sure until we’ve passed away. When viewed from an Orch OR point of view, it could be that near death experiences are essentially a fluctuation in the vibrating microtubules that we all have inside us. The quantum information they carry very nearly gets released, but ends up retethering to our physical selves just in time… and we survive. Or, at least, we survive in our current form. But, actually, there’s still more to come, and so when we do eventually exit our bodies… we will, in some sense, know about it. Then again, and bringing it all the way back to the more basic, macro-level physicality of life and death, without our brains to interpret that information, could it ever exist as anything like a traditional thought or feeling? Perhaps not.

What do you think about this particular life-and-death problem? Clearly, from a scientific perspective, tracking down the answer is still a work in progress. But, at the same time, we’ve arguably never understood what really happens quite as thoroughly as we do now. For some, contemplating post-death knowledge is comparable to trying to remember our pre-birth understanding; it matters very little if life is simply bookended by nothingness on either side. But, for others, this is an ongoing and major philosophical and physical debate.