The Osis and Haraldsson study: doctors and nurses in the United States and India describe what the dying saw

Step 1

Before 1959 · The question

Dying people who saw their dead were scattered stories, with no numbers

A deathbed vision is when a dying person says they see someone or something that others cannot see. It is often a relative who has already died. And the person usually says this figure has come to take them away.

In 1926, a book of stories like these came out, the one by the physicist William Barrett. They were scattered cases that arrived through letters and acquaintances. There were no numbers on how often this happened or in which patients.

Karlis Osis wanted to gather many cases and get numbers. He was born in Latvia in 1917 and earned his doctorate in Munich in 1950 with a thesis on extrasensory perception. This is the idea that a person can know things without using the senses.

Doctors already had an explanation for these visions. To them, they are hallucinations, like the ones caused by fever, morphine, or a failing brain. Osis wanted to check whether that explanation fit the cases.

To do that, he needed many cases. And he thought of the people who see the most dying patients, doctors and nurses.

Step 2

1959 and 1960 · United States · As Osis tells it in the pilot study

Osis sends out 10,000 questionnaires and 640 come back

In late 1959, Osis mailed a questionnaire to 5,000 doctors and 5,000 nurses all over the United States. He split the mailing among general practitioners, hospital doctors, doctors in training, and two kinds of nurses. Within each group, he chose them at random. He asked whether any dying patient had seen people who were not there, and whom. He also asked about visions of another world and about lifts in mood shortly before death.

640 answered, 6.4%. Together, they said they had seen 35,540 patients die. They reported 1,318 patients who saw someone, 884 who saw places, and 753 whose mood suddenly lifted.

Osis and his team went over 190 of those cases with a second questionnaire or a phone call. 135 of them were dying patients who saw someone. Among other things, they asked about the illness, the fever, and the painkillers.

Osis published it in 1961 as a pilot study, a small first trial. He himself wrote that, with so few answers, the results could not be applied to the whole country.

Even so, he thought the data were a good start, and he decided to do another, larger survey.

Step 3

After the pilot study · The plan · As the authors tell it

The authors set out what each explanation would expect to find

Osis and Haraldsson say that, with what came out of the pilot study, they drew up a plan for the new surveys. It set two explanations against each other. The first says that a person goes on existing after death and that, at the end, they perceive something of that other side. The second says that death is the end and that the visions come from a brain that is shutting down.

For each explanation, they wrote down what should be found in the data. We have not found a version of the plan published before the surveys. So there is no way to know whether those predictions were set before they saw the new data.

• If the brain produces the visions, they would be more frequent with high fever, with drugs that affect the mind, or with brain disease. And each person would see what they expect, according to their religion and their country.
• If the visions are something more, they would not increase with those medical causes. And the basic features would be similar in people from very different cultures.

To compare cultures, they chose two very different countries, the United States and India. For the survey in India, Osis teamed up with Erlendur Haraldsson, an Icelandic psychologist born in 1931. Haraldsson had been a professor at the University of Iceland since 1974.

Most of the survey in India was paid for by an inheritance. A man in the United States, James Kidd, left his money to whoever found proof that the soul survives. After a court case, the money went to the American Society for Psychical Research.

The first of the two new surveys was done in the United States.

Step 4

From 1961 to 1964 · United States · As the study tells it

Out of 5,000 doctors and nurses in the United States, 1,004 answer

Osis sent the questionnaire to 2,500 doctors and 2,500 nurses in five northeastern states. These were New York, New Jersey, Connecticut, Pennsylvania, and Rhode Island. Those who did not answer got a second letter.

1,004 answered, 20%. The authors acknowledge that this makes the US sample the most open to question. They checked whether those who answered late reported different things from those who answered early, and they say they did not. They also called some of those who had not answered, and they say these people thought more or less the same.

Anyone who reported a case was later interviewed by phone by the team. There was a guide of 69 questions for each type of case. They asked about the patient, the illness, the fever, the drugs, the patient’s religion, and what the patient saw.

The book places this survey between 1961 and 1964, and on another page it gives the date as 1963. On average, the cases had happened about three years earlier.

Ten years later, Osis and Haraldsson ran the same survey in India.

Step 5

1972 and 1973 · Northern India · As the study tells it

In India’s hospitals, almost all the staff fill out the questionnaire

In India, mail and phone would not work for a survey like this. Osis and Haraldsson went in person to hospitals in the north of the country, mostly in the state of Uttar Pradesh. They visited cities such as Delhi, Agra, Kanpur, and Benares, almost always large teaching hospitals.

Usually, the heads of medicine and surgery gathered the staff. The authors gave a short talk, handed out the questionnaire, and collected it on the spot. 704 doctors and nurses filled out the questionnaire, almost everyone they approached. The interviews were done in person, at the hospital or at the interviewee’s home.

Between the two countries, they gathered 1,708 questionnaires. About half of the people who filled them out reported a case. From these, they did 877 interviews, 442 in the United States and 435 in India.

All the accounts are secondhand. They are not told by the patient, who in most cases had died. They are told by the doctor or nurse who was with the patient, and they are told some time later.

The first thing they looked at was whom the dying said they saw.

Step 6

1977 · What they saw · As the study tells it

The dying see mostly relatives who have died and religious figures, who come to take them away

There were 471 cases of patients who saw someone and died afterward. 216 were from the United States and 255 from India. Another 120 patients saw someone when they were very close to death, and they recovered. The rest of the 877 cases were visions of places and lifts in mood shortly before death.

• Whom they saw. Among the cases with this information, almost half saw a person who had died and 30% saw a religious figure. Only 18% saw a living person. Almost all the dead who were identified were close relatives. The most frequent was the mother.
• Why they came. In 65% of the cases with this information, the patient said the figure had come to take them away. If the doubtful cases are left out, such as a figure that came to comfort, the share is 69% in the United States and 79% in India.
• How long they lasted. About half of the visions lasted five minutes or less.
• When they died. 62% of the patients died within 24 hours of the vision.
• How they reacted. 41% became calm or happy. 29% reacted with fear or sadness, mostly in India.

One of the people interviewed described the case of an 11-year-old girl with heart disease. According to this account, the girl said she saw her mother in a white dress, and that her mother was coming to take her on a journey. Her mother had died giving birth to her. The girl died four hours later.

The authors write that no patient checked who the figure was, and that no figure gave any proof of who it was. Nor did the study check whether any patient learned something from the figure that they could not have known some other way.

The next question was whether these visions came from fever, drugs, or a sick brain.

Step 7

1977 · The medical causes · As the study tells it

According to the doctors and nurses, most of these patients had no high fever and no strong drugs

For each case, the authors asked what drugs the patient was taking, what fever they had, and what illness. This is what the doctors and nurses answered.

• Drugs. 61% of the patients with this information were taking no sedatives or painkillers. Another 19% were taking so little that, according to the person caring for them, it did not affect their mind. Of the rest, 11% were somewhat affected, 8% quite a lot, and only 1% heavily.
• Fever. Only 8% had a fever of 103°F or higher, which is 39.4°C.
• Illness. 12% had an illness that can cause hallucinations, such as a brain injury or a kidney failure that poisons the blood.
• Consciousness. About half were awake and clearly oriented when they had the vision.

Then they compared the groups. According to the authors, the patients on drugs did not see more figures from the other side than the rest. And those with brain damage saw them as often or less. In the pilot study, the patients with brain disease had more confused visions, which were more about things of this life.

All of this comes from the memory and judgment of the person who cared for the patient. The study does not say that it was checked against the medical records. And it did not measure oxygen in the blood or brain activity.

The other test in the plan was still to come, comparing the two cultures.

Step 8

1977 · The two cultures · As the study tells it

In India, more religious figures come and more patients refuse to go

The two countries were alike in the basics. In both, most of the figures were dead people or religious figures, and most came to take the patient away. But there were clear differences.

• Who comes. In the United States, patients saw mostly relatives who had died. In India, they saw mostly religious figures. Some saw a Yamdoot, the messenger of the Hindu god of death.
• Men or women. In the United States, 61% of the figures were women, and in India, 23%.
• Whether they wanted to go. In the United States, 41 patients said the figure had come to take them away, and only one refused to go with it. In India, 155 patients said the figure had come to take them away, and 53 refused to go with it. That is one in three.

Christians tended to see angels, Jesus, or the Virgin Mary. Hindus tended to see their gods or the messengers of death.

The authors also point out that part of what each religion teaches was missing. Christian patients did not speak of a last judgment, and almost no one saw hell. Hindus did not speak of reincarnation. For Osis and Haraldsson, this means that the patients see something they were not taught. They themselves acknowledge that deciding whether culture weighs a lot or a little is a matter of judgment, not of measurement.

With all this, the authors drew their conclusion.

Step 9

1977 · The conclusion · As the authors tell it

The authors believe the data support life after death

Osis and Haraldsson conclude that the medical explanation does not fit their data. In their view, what best explains the cases is that the dying perceive something of another world. They write that Osis started out with a critical attitude and that both of them changed their minds as the data came in.

They acknowledge several limits. They did not talk with the patients, but with the people who cared for them. The cases were told some time later. And in the United States, only one in five answered.

They looked for any group of doctors or nurses who exaggerated, and they say they found none. What they found was the opposite. Young doctors reported fewer cases than experienced ones. And patients kept quiet about their visions in front of a doctor or nurse who did not believe them. That is why they think their data are missing visions, not that they have too many.

The book came out in 1977 with an introduction by the psychiatrist Elisabeth Kübler-Ross, known for her work with terminally ill patients. To her, the book was one more confirmation of life after death.

The question from the beginning remains: is what the dying see produced by the brain, or is it something more? Let’s look at what is known and what isn’t.