Terminal lucidity. Improvement before death?

There are many situations where we cannot find any answers. One of these is terminal lucidity. It refers to the clinical improvement experienced by many patients reported as seriously ill moments before their death.

Yes, to those unconscious, comatose, or cognitively impaired people who, in their final moments, experience complete mental clarity, albeit briefly.

Disturbing but real.

Terminal lucidity refers to the return of consciousness in seriously ill patients who were often unconscious or oblivious to reality. These periods of lucidity can range from minutes to hours preceding death.

This moment of clarity may involve coherent conversations, recognition of family and friends, or deep reflection.

Temporary lucidity has been known since ancient times.

Similar cases have been reported since the 1st century BC. Psychiatry has documented many cases since the 19th century. One of the most famous was documented in 1942 by the German psychiatrist Michael von Meduna, who described the complete remission before death of a schizophrenic patient.

Currently, the increase in care for terminally ill patients has allowed for greater documentation of this phenomenon worldwide.

The behavior is repetitive in patients with dementia, tumors, or other extensive brain conditions, who temporarily recovered before dying by showing affection and communication.

What do the studies say?

Studies have found that more than 80% of cases of terminal lucidity occurred within 48 hours of death. It is very surprising that many of these patients had already completely lost the ability to speak or recognize their family members for several years.

How is terminal lucidity explained?

This is an important question. How can a brain with so much neuronal damage over the years recover its functions, even for a moment? Here are some theories.

Neurotransmitter Release.

In near-death states, the brain is capable of releasing certain neurotransmitters (dopamine and endorphin) that reset and briefly stimulate certain neuronal circuits. However, this theory does not explain this recovery of function in patients with severe structural damage.

Inhibitory Disconnection.

Some scientists claim that before death, some inhibitory areas of the brain may stop functioning, thus releasing unaffected areas and allowing them to function momentarily. This would be like the last impulse of the nervous system before it finally collapses.

Theory of Non-Local Consciousness.

Some less orthodox researchers suggest that consciousness is not only limited to the brain but also to other areas, capable of manifesting itself in the final moments.

Lacking scientifically accepted empirical evidence, this theory attempts to open new horizons and provide an answer that has not yet emerged.

Ethical vs. Clinical.

Terminal lucidity can bring ethical dilemmas, as family members may interpret this phenomenon as symptoms of recovery and generate false expectations. Some, with more knowledge, may take advantage of this unexpected opportunity to say goodbye or reconcile, while for others, all that remains is emotional turmoil.

Clinically, healthcare professionals must be prepared to identify and manage the phenomenon of terminal lucidity appropriately, providing emotional support to family members during this sensitive transition.

A boundary between life and death.

Even today, some view terminal lucidity as an intermediate state between life and death, where consciousness emerges free from all physical limitations.

Some religious beliefs, supported by numerous testimonies that confess a great sense of peace, clarity, and transcendence, interpret terminal lucidity as manifestations of the soul before leaving the body.

From a more secular perspective, the phenomenon invites us to rethink the limits of what we understand by “mind,” “person,” or “identity,” especially in patients who have lost all cognitive ability and yet, in their final moments, seem to briefly regain it.

This common phenomenon invites us to rethink concepts we thought were well-established, such as “mind,” “person,” or “identity.” This is especially true when we observe patients who have lost all cognitive ability but seem to briefly regain it at the end of their journey.

Toward the End of Life.

Terminal lucidity remains an open book for thought and reflection. Far from being a residual symptom of a dying brain, it forces us to reconsider our understanding of the body-consciousness relationship.

In Batthyány’s own words, “perhaps what happens at the end is not a disappearance, but a revelation.”

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Bibliographic Reference

1. Chiriboga-Oleszczak, BA (2017). Lucidez terminal. Problemas actuales de psiquiatría ,18 (1), 34-46.
2. Nahm, M., Greyson, B., Kelly, EW y Haraldsson, E. (2012). Lucidez terminal: Una revisión y recopilación de casos. Archivos de gerontología y geriatría , 55 (1), 138-142.
3. Lim, CY, Park, JY, Yoo, KD, Kim, HJ, Kim, Y. y Shin, SJ (2020). Lucidez terminal en el ámbito hospitalario universitario. Estudios sobre la muerte.

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