The most direct test of the near-death experience's most extraordinary claim, that some patients perceive real, verifiable events from a vantage point outside their body during a period when the brain should not be capable of forming or storing memories, was the AWARE study (AWAreness during REsuscitation), a multi-hospital project led by critical care physician Sam Parnia and published in the journal Resuscitation in 2014. The study placed hidden visual targets, images visible only from a vantage point near the ceiling, in resuscitation areas across participating hospitals, reasoning that a patient who genuinely left their body and looked down would be able to report the target after recovery. Very few of the surviving patients who reported any near-death experience also reported an out-of-body component specific enough to test, and none of the placed visual targets were reported correctly, though Parnia noted one case in which a patient described real events during the resuscitation with apparent accuracy through means the study could not fully rule out or confirm, a single, methodologically contested data point rather than a systematic finding.
Critics, including cognitive neuroscientists who reviewed van Lommel's study, argue that "flat" brain activity during cardiac arrest is measured too coarsely to rule out brief bursts of neural activity, and that anoxia, surging neurochemicals, and after-the-fact memory reconstruction offer plausible physiological accounts without requiring consciousness to operate independently of the brain. The subjective reality of near-death experiences is not disputed; whether they show consciousness surviving apart from brain function remains an open, contested question.