Setting the Terminal-Lucidity Record Straight

“Charles Murray doesn't need my help debating Steven Pinker, but as the author of the principal book on terminal lucidity, I offer a few observations (Letters, Nov. 1).

 

Contrary to Mr. Pinker, grieving relatives aren't the only ones reporting cases of terminal lucidity. In the international study I led, many instances were corroborated by physicians, nurses or hospice staff. Our findings are consistent with a 2024 scoping review compiling dozens of clinical reports, and with Sandy MacLeod's 2009 prospective study. These stories aren't sentimental hogwash; they are clinical observations from structured care environments.

 

Mr. Pinker invokes brain complexity as a kind of explanatory wildcard. But complexity cuts both ways: The intricate coordination of neural circuits is exactly what widespread cortical and hippocampal atrophy destroys in advanced dementia. If these systems are irreversibly degraded, we wouldn't expect terminal lucidity to occur. Yet it does.

 

The notion that "if one circuit deteriorates, another circuit it suppresses can rebound" isn't an explanation. To account for terminal lucidity, one would need to show how patients with profound, long-term cognitive silence suddenly regain autobiographical memory, fluent speech, emotional nuance and recognition. These aren't flickers of arousal or wishful misreadings. They are complex, integrated behavior.

 

From an evolutionary standpoint, it's puzzling that a functionally rich, high-energy cognitive state would emerge only at the threshold of death, when it offers no adaptive advantage. If it could happen, why not earlier when it might help survival, caregiving or bonding?

 

A good scientific theory should predict and explain what is observed. Mr. Pinker's materialism does neither. Terminal lucidity may or may not support dualist interpretations. But it clearly challenges the assumption that consciousness in dementia vanishes in lockstep with brain deterioration. Serious anomalies demand serious inquiry, not reflexive rejection.

 

Alexander Batthyany

 

Vienna

 

Prof. Batthyany is author of "Threshold: Terminal Lucidity and the Border Between Life and Death."” [1]

 

1. Setting the Terminal-Lucidity Record Straight. Wall Street Journal, Eastern edition; New York, N.Y.. 06 Nov 2025: A16.