May 1, 2007
Neuroethics and the Person: Should Neurological and Cognitive Criteria Be Used to Define Human Value?
By Hassert, Derrick L
AbstractWithin neuroethics, functionalism attempts to define personhood by equating the concept with a set of functional, neurological and/ or cognitive criteria. While this approach is often fueled by a desire to identify those traits that are distinctly human, by necessity it often removes the label of "person" from human beings at early stages of development, the developmentally disabled or those who have suffered neurological insults. This approach is contradictory to the older notion of affirming the person as a living member of the human species. Within Aristotelian and Thomist approaches to personhood, the human central nervous system can be addressed within the context of the potentialities of the human being, not as a system that needs to reach a stage (or actualization) of development in order to make an organism distinctly human. Functionalist approaches to human cognition, behavior, and neuropsychology are less ethically problematic if they affirm the existence of human nature and its value prior to examining function.
Keywords: Neuroethics, Thomist, Aristotelian, Cognitive, Soul, Personhood, Human Nature
Introduction: When Did You Become a Person?
The question posed above is fraught with ethical, moral, philosophical, and religious implications. How we answer this question, and the foundations upon which that answer is based, will guide our decision making in numerous areas. When scientists and ethicists even speak in this manner-"When did you become a person?"- there is an underlying premise that there could have been a time during which you, as a distinct biological entity, were in existence while your status as a "person" was in substantial doubt. Author and neuroscientist Steven Rose presents the logic behind this position:
Is a newborn baby already human? Yes, but not quite. In important ways she is not yet a person with independent agency, but a prehuman in the process of becoming a person. Like many other infant mammals, the infant human is born only half-hatched, altricial. Several years of post-natal development...are needed before a person, let alone a mature person, begins to emerge...1
In a piece condemning President Bush's banning of therapeutic cloning and limiting federal funding for embryonic stem-cell research, cognitive neuroscientist Michael Gazzaniga comments similarly:
The president's view is consistent with the reductive idea that there is an equivalence between a bunch of molecules in a lab and a beautifully nurtured and loved human who has been shaped by a lifetime of experiences and discovery. His view is a form of the "DNA is destiny" story. Yet all modern research reveals that DNA must undergo thousands if not millions of interactions at both the molecular and experiential level to grow and develop a brain and become a person. It is the journey that makes a human... .
What is at issue...is how we are to define "human life." Look around you. Look at your loved ones. Do you see a hunk of cells or do you see something else?
We all automatically confer a higher order to a developed biological entity like a human brain. We do not see cells, simple or complex - we see people, human life. That thing in a petri dish is something else. It doesn't yet have the memories and loves and hopes that accumulate over the years.2
In this analysis, in that human beings are not born as "complete" and mature human beings, they are not to be afforded the status of persons. Therefore, the organism develops into its status as a full- blown human being and full-blown person; such a status is not simply inherent in the existence of the organism as a member of the species Homo sapien. To accept this position we must also accept that a certain level of neurological and cognitive development must be reached in order to attain and merit being designated humans and persons. This is what is commonly described as a "functionalist" position, wherein an organism must possess certain functional capacities for worth or value to be ascribed to that organism. Rose and Gazzaniga take this position to a logical conclusion: You cannot be deemed a person, let alone a full human, unless you have reached some level of functional development as evidenced by advanced cognitive neuropsychological capacity. This manner of elucidating the concept of personhood is a relatively new development; dictionaries usually define a person simply as a "living human being" and it is this older concept that has historically shaped legal and ethical thought.3 This essay is meant to address the functionalist stance on the question of personhood, the relationship of this stance to equivocating the concepts of mind and soul in theology and philosophy, and how these elements have influenced thinking on the relationship between neuropsychological functioning and human value.
The Brain: Organ of the Mind or the Organ of the Soul?
Perhaps one of the most important points of distinction to be raised in any discussion of neuroethics from a philosophical or theological perspective is the distinction between the concept of "mind" and that of "soul," for they often relate to how we form a concept of personhood. Too often the two words "mind" and "soul" are conflated or carelessly confused. In much of the more recent philosophical and theological literature that addresses the concept of the soul, it is often argued that the word itself is outdated and irrelevant and that concepts such as mind or spirit are synonymous with it.4 In other literature it is argued that the term soul should be used to describe those qualities that "make us human," such as creativity, intelligence, interpersonal communication, etc. This teaching of "soul" as a collection of properties will sometimes go hand-in-hand with an implicit denial of human nature, a denial that there is anything essentially unique about human beings.5 For all practical purposes, the neuroscientists cited above have collapsed the concept of humanity into possessing a fully developed brain. If the "soulish" or human elements that are dependent on the functioning of a fully developed central nervous system are not present then the organism is not human. In principle, the "soulish" or advanced cognitive properties are there for all organisms to possess if they evolve to a certain functional point and attain the ability to form personal relationships or make voluntary moral decisions.
Other mammals, if enhanced through biological or genetic manipulation, could become functionally indistinguishable from the normal functioning of "current" humans. Since there is no such thing as a unique "human nature," there would be no logic in withholding religious fellowship and human rights from such creatures, for they would now possess the "soulish properties" that define humanity in its complete, developed, or mature form. Also, there is nothing in this approach to preclude one from saying that very young children, the severely retarded adult or child, the neurologically impaired, or anyone else who lacks the "soulish" functional properties are outside of the realm of religious fellowship or human rights. Since they have not achieved, or perhaps have lost, the functional capacities that define "soulishness" or "personhood" they are not afforded this title nor the rights traditionally linked with it.
In this line of thought "soul" or "soulishness" is a set of functions that emerges from neurological functioning (the functions arise from a specific arrangement of physical interactions), rather than a human nature or essence that provides the foundation for the emergence of distinctly human neurological functioning: First you have the neurons, the neurons start working, and "the soul" emerges.6 As is fairly evident, this position is nearly identical to that presented above by both Steven Rose and Michael Gazzaniga: Both positions are based on the organism achieving a certain developmental state. What is as troubling as the soul "emerging" is the equation of "soul" with a set of functions or processes, something cognitive psychologists might refer to as "mind." This is the same faux paux Descartes made, but one that Aristotle and Thomas Aquinas did not: In Aristotle the mind is a subset of abilities defined by the essential nature of the creature (the soul). J.P. Moreland and Scott Rae rightly summarize that
Descartes reduced the soul to the mind, and now we have a mind- body problem instead of a more preferable soul-body problem. For the Thomist the mind is a faculty (a natural grouping of capacities) of the soul that may require certain physical states of affairs to obtain before it is present; in fact, it is the soul that is responsible for the development of the brain and nervous system, and, more generally, the body.7
To restate the preceding in the simplest terms: You have a human mind and a human brain because you are a living human being. The Apostle Paul used the words "soma psuchikon" to describe the human being-a physical body informed by human nature. The concept of person in the older sense (a living human being) is intimately tied to the assumption that there is such a thing as underlying human nature (soul); the person is an individuated part of humanity.
The te\rm "soul" is neither magical nor mystical, and there is no need to banish it from the lexicon of neuroethics, nor from modern philosophy and theology. It is simply a term that emphasizes a belief that there is indeed a nature peculiar to particular organisms. It is a presupposition or principle that underlies our thinking about humanity and the relationship between humanity and other species. Indeed, neurophysiologist M. R. Bennett and philosopher P. M. S. Hacker suggest that the concept of the soul, when properly understood and applied, can clarify thinking on numerous topics in neuroscience and psychology and help us to avoid the illogical conclusions that often flow from adopting a "brain centered" theory of the organism.8 Let me employ one example to illustrate this tendency: While chiding the ancient assumption of Aristotle that the heart was the seat of thoughts and strong emotional feelings, the noted social psychologist and author David Myers triumphantly proclaims that "science has long overtaken philosophy on this issue. It is your brain, not your heart, that falls in love."9 A moment of reflection will perhaps lead one to imagine-or attempt to imagine-a brain "falling in love." Reflecting further, one might comment that people fall in love-not brains, nor hearts, nor livers, nor kidneys. We may indeed see the chatter of popular science overtaking philosophy (and perhaps theology) here, because this sort of language and these sorts of assertions are commonplace in textbooks and popular discourse. However, the overtaking is being done on the cheap, and, as Bennett and Hacker might point out, science is being confused with philosophy and the philosophy being done is often quite poor. Myers, in attributing love to the brain and not to the person, has provided an excellent example of the very manner of thinking that Bennett and Hacker label the "mereological error."10 This consideration of human behavior is characterized by ascribing psychological, emotional, or personal attributes to the brain, certain parts of the brain, or even to cells of the brain-not to the person. Such an approach leaves us with the brain "loving" or "thinking" or "being conscious," the left hemisphere "speaking," the right hemisphere being "artistic," the hippocampus "learning," the occipital lobe "seeing," or the amygdala "fearing." The whole organism is left out of the equation, and in the contemplation of human thought or behavior these attributes are given over to anatomical regions rather than the organism. B.F. Skinner commented that "cognitive psychologists like to say that 'the mind is what the brain does,' but surely the rest of the body plays a part. The mind is what the body does. It is what the person does."11
Perhaps ethics should also be added to this list of possible areas where employing the concept of soul leads to clarification. When we fail to differentiate between the concepts of soul and mind (cognitive processes or functioning) the result is often the philosophical, moral, and ethical confusion we see from many writers in neuroscience and psychology. The same manner of confusion results when we claim that use of the term soul simply means something nearly identical to higher cognitive processes. This author has heard physicians lecture that "the soul" is nothing more than these higher cognitive processes, to which audience members have rightly raised questions such as "What about my uncle in a coma? Does he have a soul?" or "What about my mother with Alzheimer's? Does she have a soul?" The underlying worry here is that patients suffering from such neurological damage have, in some sense, "lost their humanity." Writing early in the fourth century, the Christian apologist Lactantius succinctly distinguishes between the two terms in order to avoid such confusion and concern:
The soul is not the same thing as the mind. For it is one thing to live and another thing to think. And it is the mind of the sleeping person that is at rest-not the soul. And in those who are insane, it is the mind that is not functioning; the soul continues to function. For that reason, they are said to be out of their minds.12
Humanity as potential and actualization: Neurological and cognitive states in development
Columnist Michael Kinsley, writing on the embryonic stem cell debate, comments that the issue should not be as difficult nor as controversial as it is:
It's not complicated. An embryo used in stem cell research...is three to five days past conception. It consists of a few dozen cells that together are too small to be seen without the aid of a microscope. It has no consciousness, no self-awareness, no ability to feel love or pain. The smallest insect is far more human in every respect except potential.13
By placing the emphasis on current organismic functioning, Kinsley defines humanity in such a way as to make insects (even the smallest) more human than a human organism at the earliest stages of development. The importance is placed on current size, number of cells, and functioning. However, Kinsley also uses a key word that highlights the main reason that so many oppose such research on human embryos, and that is the fact that they possess such potential by virtue of the very fact that they are human embryos. While using the term, Kinsley ignores the ethical value and meaning of this potential, something missed or ignored by Rose and Gazzaniga as well. Similarly, D. Gareth Jones, a neuroanatomist and frequent writer on the issue of neuroscience and its importance for understanding the concept of personhood, remarks that there are those who believe that:
[T]o be a human being is to be a person, an identity that holds even at the very earliest stages of human existence. Hence, in human embryos personal abilities, including self-awareness, choice, and creativity, are all potentially present from the earliest stages of development; they are not added at some later stage. If this position is accepted, we have to conclude that a nervous system is never relevant for an understanding of personhood...14
Upon reading comments such as those from Kinsley and Jones, one is left with the impression that participants in debates might be talking past one another in discussing what constitutes "personhood,""potential," and even "humanity" due to a lack of a common vocabulary. Whereas one group may be using the older definitions of "person" the other is speaking in the manner used by Rose and Gazzaniga. The same words are being employed, but now the meaning behind these words has shifted for one group but not for the other. At the very least, the functionalists may not be listening carefully to what critical philosophers and theologians are saying, because in many instances those critical of "brain centered" or "cognition centered" theories of what characterizes personhood take very seriously what the scientists are saying-they simply do not come to the same conclusions as those who base "personhood" upon neurological development.
Considering the aforementioned quotation from Jones, let us evaluate the position that if we accept a human being as a "person"- even at the earliest stages of development-because distinctively human traits are potentially present in the organism, "we have to conclude that a nervous system is never relevant for an understanding of personhood..." Theologians, philosophers, and ethicists who espouse the view that even at the earliest stages of life human beings are persons-due to potentially present traits-do indeed acknowledge the importance of neurological functioning. Almost all developing humans, at the embryonic stage, have the potential traits of consciousness, creativity, and the capacity for love because they are human-they are not rat embryos nor are they any other type or kind of embryo but human.15 Unless there is some grave developmental defect or chemical or physical insult, the human organism will continue to progress through various stages of development and maturation both before and after birth. Due to this fact they will in all likelihood develop a central nervous system, and this central nervous system will itself develop and progress in the complexity of its functional capacities, never reaching a true static state, always changing in response to the world around it and allowing for the capabilities that are uniquely human. Many of the potentialities will then be actualized. However, many people may never fulfill all of the potentialities that they have as human beings, due to a whole host of economic, social, psychological, and neurological/biological factors, but we still value them as we do all other humans. The very potential for this nervous system-with all of the wonderful abilities that it allows-was there from the very beginning because it was a human nervous system developing within a human being.
The Anglican theologian Lindsay Dewar, specifically addressing the issue of moral theology, commented that "To prevent something good from developing is morally hardly distinguishable from destroying the end product when it has come into being."16 This conclusion is based upon an element of Aristotelian and Thomistic thought usually worked out in scholastic moral theory, that the worth of a thing is dependent not upon the actualization of potential, but upon the potential itself that rests within the nature or essence of a thing.17 A human being, having a certain nature, has certain potentialities based upon this nature. Knowledge of and concern for the human nervous system is in no way foreign to this line of thought-indeed any physician would of course wish to know how best to foster and maintain the health of the brain during all stages of development before and after birth and how to avoid or prevent damage to this very delicate arrangement of cells and chemicals. We know that basic intelligence, proper moral development, artistic and musical ability, \etc., all depend on a properly functioning nervous system and its relation to the other systems of the human body, and that accidents and brain damage can rob people of these abilities. Even if these abilities are diminished by disease or external trauma, we should still view these individuals as persons because they are indeed still living human beings.
Kinsley and Jones have used and seemingly rejected the language of "potential" but have failed to fully examine why it is being used in the context of biomedical ethics, or how others have used it while also addressing and incorporating current findings in neurology and psychology. In examining the bioethical reasoning of Moreland and Rae, mentioned above, we see that the functioning of the nervous system is not an afterthought and that most Thomists do indeed believe that a properly functioning brain is irrevocably linked to our proper cognitive functioning as human beings. However, where many Aristotelians and Thomists part company with the functionalist approach is the assumed dependence of the metaphysical nature of a human being, and hence the human being's worth and classification as a person, on some level of neurological development and cognitive processing. This functionalism tends too much towards adopting a moral philosophy of imparted worth, a worth decided upon by external functional evaluation.
Conclusion: Human uniqueness presupposed in biomedical research
Biomedical research is based upon philosophical foundations that cannot be demonstrated using scientific research rooted in the experimental method. In the very process of trying to help other human beings over saving the lives of other species we are affirming that human life has the greater value, and it is unique. The realness of humanity is taken as a foundation for our actions, whether or not this realness is explicitly stated. Human life has value. This is a presumption that underlies almost all research into human neurological functioning, and it is not a statement that is open to scientific evaluation, regardless of the tendency of many within the scientific community to confuse ethical and moral questions with scientific questions. Consider this passage from a textbook dealing with the clinical applications of neuroscience:
...should aborted fetal tissue be used to repair the faulty mechanisms that regulate such neurodegenerative diseases as Parkinson's disease? Should society treat criminals differently if (or when) neuroscience finds that the underlying brain mechanisms for such behavior are malfunctioning? These and others issues should be addressed as scientific questions.18
This is a common refrain from many who view moral intrusions into science, whether they come from secular humanists or theists of different varieties, as unwarranted and "unscientific" or "anti- scientific"-a hindrance to scientific progress. This approach should be thoughtfully and critically countered, in that these issues cannot be logically addressed as "scientific questions." By suggesting that science can answer these questions is to extend the methods of science into areas where they cannot go. How can science answer the question "Does human life have value?" or "Is it good to alleviate suffering?" or "Is it right to kill a rodent-or a hundred rodents-in order to save the life of a single human?" or "Is the use of fetal tissue from aborted fetuses morally justifiable?"
No amount of experimentation can address these moral questions, and repeated attempts to apply the hypothetico-deductive method will not result in an answer. One can rightly consider information that is gained from the scientific method and factor this into moral decision-making, but the moral choices cannot be made with the scientific method. Metaphysical and moral presuppositions are not open to testing through the scientific method; instead, they are logical and necessary prerequisites to the scientific endeavor as a whole. We presuppose that there is order in organisms and their functioning and that the human mind can comprehend this order inherent in the world around us. We presuppose that it is good to understand the functioning of the human organism, to preserve human life, to alleviate human suffering. We cannot prove any of these things scientifically. We assume their metaphysical reality. Indeed, without these presuppositions science has no philosophical foundation and no moral compass to guide its practice and the application of its findings. The rationale for biomedical research in general and clinical neuroscience research in particular is rooted in the older concept of the person as a member of the human species, possessing value and worth based upon that fact alone.
1 Steven Rose, The Future of the Brain: The Promise and Perils of Tomorrow's Neuroscience, (New York: Oxford, 2005), 113. The title of the chapter from which this quote is taken is "Becoming a Person." The preceding chapter is "Becoming Human."
2 Michael Cazzaniga, "All clones are not the same," Observer19:5 (2006). Italics added for emphasis.
3 For the history of the divergence between the functionalist concept of the person and the traditional concept, see David Albert Jones, The Soul of the Embryo, (London: Continuum, 2004).
4 See Whatever Happened to the Soul? Scientific and Theological Portraits of Human Nature, eds. Warren S. Brown, Nancy Murphy, and H. Newton Malony (Minneapolis: Fortress, 1998); From Cells to Souls: Changing Portraits of Human Nature, ed. Malcolm Jeeves (Grand Rapids, Michigan: Eerdmans, 2004); What About the Soul? Neuroscience and Christian Anthropology, ed. Joel L. Green (Nashville: Abington, 2004).
5 See the paraphrased comments of Fraser Watts in Warren S. Brown and Malcolm A. Jeeves, "Portraits of Human Nature: Reconciling Neuroscience and Christian Anthropology," Science and Christian Belief 11:2 (1999): 139-150.
6 "The soul is the music made by an ensemble of players (the various lower-level cognitive abilities) who perform together to create the capacities for interpersonal dialogue as well as self- awareness and internal self-reflection (intrapersonal experiences). Played out in relationship to God who chooses to be in dialogue with his human creatures, the cognitive capacity for personal relatedness embodies spirituality." From Warren S. Brown and Malcolm A. Jeeves, "Portraits of Human Nature: Reconciling Neuroscience and Christian Anthropology," Science and Christian Belief 11:2 (1999): 139-150.
7 J.P. Moreland and Scott B. Rae, Body and Soul: Human Nature & the Crisis in Bioethics, (Downers Grove, Illinois: InterVarsity, 2000), 200.
8 M.R. Bennett and P.M.S. Hacker, Philosophical Foundations of Neuroscience, (Blackwell, 2003).
9 David G. Meyers, "A Levels-of-Explanation Response," in Psychology & Christianity: Four Views, eds. Eric L. Johnson and Stanton L. Jones (Downers Grove: InterVarsity, 2000), 111. Italics added.
10 M.R. Bennett and P.M.S. Hacker, Philosophical Foundations of Neuroscience, (Blackwell, 2003).
11 B.F. Skinner, "Whatever happened to psychology as the science of behavior?" American Psychologist 42 (1987): 780-786.
12 From David A. Bercot, A Dictionary of Early Christian Beliefs, (Peabody, Mass: Hendrickson, 1998), 625.
13 Michael Kinsley, "The False Controversy of Stem Cells," Time Magazine, May 31 (2004). Italics added for emphasis.
14 See D. Gareth Jones, "The Emergence of Persons" in From Cells to Souls, 14-15. In the reference quoted, Jones is referring to Gilbert Meilaender, Bioethics: A Primer for Christians, (Grand Rapids, Michigan: Eerdmans, 1996). As the title "The Emergence of Persons" implies, defining "person" from the standpoint of neuroscience puts considerable weight on certain functional capacities that are dependent upon neurophysiology. In portions of Jones's work, especially Our Fragile Brains: A Christian Perspective on Brain Research (Downers Grove, Illinois: InterVarsity, 1981), Jones makes statements that seem extremely close to contradicting a position that brain states are important for defining "personhood" or that personhood "emerges." Consider this quote from page 278 of Our Fragile Brains: "All individuals are therefore to be treated as human beings with God-given dignity, regardless of their value to society or of their brain states."
15 Asking the questions "When does the fetus become a person?" or "When does the embryo become a person?" is akin to asking "When does the adolescent become a person?" These are developmental stages that a person goes through, not stages that at some point produce a person. When we set a neuro-cognitive litmus test for "personhood," someone can always move the bar to take the definition away from others.
16 Lindsay Dewar, Outline of Anglican Moral Theology, (Oxford: Mowbray, 1968), 84-85.
17 See F.C. Copleston, Aquinas, (London: Penguin, 1955); John F. Crosby, The Selfhood of the Human Person, (Washington: Catholic University of America, 1996). For its application in biomedical ethics, see Scott B. Rae and Paul M. Cox, Bioethics: A Christian Approach in a Pluralistic Age, (Grand Rapids, Michigan: Eerdmans, 1999).
18 From Kelly Lambert and Craig Howard Kinsley, Clinical Neuroscience: The Neurobiological Foundations of Mental Life, (New York: Worth, 2005), xxv. Italics added for emphasis. Per the comment concerning the treatment of criminals: Even if researchers were to find that a criminal had a pattern of activity that contrasted markedly when compared to "the average" or "normal" brain, would this prove that if one had such neural patterns that it would guarantee "criminal behavior"? Only one case where a person had such a pattern but did not show evidence of the behavior would call this conclusion into question. And even if a criminal had such abnormal activity, would it rule out the possibility that years of engaging in specific behaviors didn't change the brain's activity to produce such a patte\rn?
DERRICK L. HASSERT, PHD
Derrick L. Hassert, PhD, is an Associate Professor of Psychology at Trinity Christian College, Palos Heights, Illinois, USA.
Derrick L. Hassert, PhD, is an Associate Professor of Psychology at Trinity Christian College, Palos Heights, Illinois, USA.
Copyright Bioethics Press Spring 2007
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