Similarly, the theory of body/soul interaction and etiology of mind described here can lead to conclusions that might be offensive, therefore leading many people to reject it a priori. One of the points to this theory that might first offend people is the strong reductionist stance regarding human behavior and thoughts. Folk psychology likes to believe that we are totally free in all that we do, that nothing except for some “ideal me" guides my behavior. The position taken here, however, assumes that most of our thoughts and behavior are a function of our heredity and environment working together to mold us. There is very little that “I" freely choose, since my brain chemistry so strongly affects everything about me.
This is a very serious issue, and is not easy to circumvent. However, as discussed in the previous chapter, there is room for the soul to influence the production of neural nets, thus affecting our behavior and our thinking. While this capacity may not be as great as we would like to believe intuitively, that does not make it untrue. Take for example, the fact that, cosmologically, the earth is not the center of the universe. While at one time, this was a shocking blow to the human ego, we eventually got used to the idea, and were able to form new ideas about ourselves given this new paradigm. Within the paradigm that we are not as free as we would like to believe, there may be similar routes of comfort. The traditional Calvinists, for example, may not be at all uncomfortable with this idea, since they already have concepts which limit human freedom. The non-Calvinists, in attempting to integrate this new idea into their thinking, must synthesize the absurd idea of total free-will with the absurd materialist idea of total lack of free-will, into an idea which incorporates empirical data with faith propositions.
Moreover, this issue of free-will is uniquely dominant in democratic societies. While most people at some level desire to be free, and to choose their own way of life, Western cultures have turned autonomy into a religion of its own. Without total autonomy, we are not truly human, or so some would like us to believe. This however, is absurd, given the communal nature of humans (Tubbs 1996:101). No human can live in total autonomy, since that would mean total social and emotional detachment from the rest of humanity. Though the idea of pure autonomy is really not a strong force in American politics or philosophy, there is still an inherent pressure to believe that the ideal human has the capacity to be fully autonomous. Common sense, however, should show us that this is neither a possible, nor a desirable goal. People depend on other people for physical survival and for emotional support. From a Biblical perspective, we are not an aggregate of autonomous Christians, but a community of believers, united into one body, the Church (Pannenberg 1991:53).
With this idea of the foundational aspect of community to the human personality structure, the idea of the autonomous person should fall out of theoretical possibility. Moreover, it should be easier to accept the idea that we are inherently not as free as we would like to think, and that we are controlled by numerous forces to which we would like to think we are impervious. The denial of the fact that we are controlled by external forces is a denial of human finitude; observation shows us that tragedies occur which can destroy a person psychologically, and/or physically, thus exemplifying human frailty and susceptibility. It is also a denial of human materiality, which causes us to be subjected to a physical universe corrupted by sin. Further, it minimizes the radical nature of God’s grace, assuming that the only forgiveness we need is from sins we consciously commit and of which we consciously repent. The grasping at full (or even substantial) human autonomy leads to the conclusion that both justification and sanctification are in our own power, thereby nullifying the purpose of the cross. Thus we see a theological necessity for limiting of human agency (Allik 1987).
If we assume the proposition that there is very little in us that actually makes truly free decisions, then there are several further implications that arise. One issue is the questionable status of sin. Is sin still a coherent concept if we remove free-will from human behavior? One possible answer is the suggestion that there is no individual sin, but sin has now become communal, similar to the communality of the body of Christ. This kind of sin is structural, and is present in governments and communities in the form of racial hatred, political and economic tyranny, etc. While this idea is present in the Bible, especially in the Old Testament, it is not the predominant Scriptural view. Traditionally, sin in the Biblical perspective has been thought of as something that individual people “commit," and will be responsible for at some later time, possibly in some form of eternal judgment.
This latter perspective of sin is not necessarily incompatible with the theory of body/mind/soul interaction proposed in the previous chapter. An effort was made to show that some element of free-will exists in human behavior, even though it may not be as great as most people would like. Given the radical unity of body and soul previously described, we must conclude that sin is not purely a physical thing, nor purely a spiritual thing, but is a result of the combination of soul and body acting in a way that maligns God, or God’s ways. While a discussion of the nature of sin is beyond the scope of this paper, one example of such behavior considers that it is in God’s inherent nature to love. Therefore, to hate is necessarily to sin. If I hate my neighbor, I sin. Sociologists tell us that racial hatred is something that is passed on in families. However, as in most behavioural and attitudinal studies, there are no absolute correlations to any given set of factors, which leads us to the tentative conclusion that there is some element of free-will in deciding to hate or not to hate.
Given the above theory of soul/body interaction, it is the environment and heredity that shapes the foundation of behavioral and attitudinal possibilities, while the soul gently acts to mold neural nets making certain behaviors and attitudes more likely than others. This implies that there may be instances when we act in ways that are by definition sin, but for which we may not necessarily be accountable, since the acts are put in terms of probabilities. In actuality, this seems to be an inevitable conclusion, given the theory as stated. Whether this makes the theory untenable is another question.
I find only three possible defenses for this position (other than those mentioned above regarding the necessary limitations of human agency), none of which is without problems. The first is the idea that God understands in a personal way the nature of acts which seem sinful, but which are not sin. Take for example God’s destruction of a significant portion of the Israelites in response to a census taken by David in 2 Samuel 24. This narrative, in which God kills seventy thousand people because of David’s sin, seems to directly contradict God’s nature, which is to punish only the person who commits the sin, not the innocent bystander.1 Based on a literal interpretation of this passage, one can see that God’s actions may appear sinful if God were following The Law that God created. God’s actions are not, however, governed by Law, but by Spirit, and thus God’s actions are not as predictable and as explicable as we would like for them to be. This argument certainly does not prove that acts which appear sinful are not necessarily subject to judgment, but it at least gives some possible leeway and precariousness in human judgments about sin.
A second defense is that when one becomes a Christian, one’s life isn’t automatically sinless. In anyone’s journey to spiritual wholeness, there is no moment when all behavior and thought become perfect. Rather, any changes that are made are gradual (sanctification), and subject to relapse. Moreover, that person is not immune from developing other bad habits, some of which are sinful. But are these sinful acts therefore counted against us? Are the previous acts of sin counted against us? No, since God’s grace casts these things as far as the East is to the West, as long as we continue to “walk in the light."2 At what point God decides no longer to cast away our sins, is not something humans can know. But it is an example of behavior that is technically sin, but for which we are not judged.
The third defense is similar, in that it relies on Paul’s proclamation in 1 Cor 10:23, that “Everything is permissible, but not everything is beneficial." This can be used to support the idea that since we live under Grace and not Law, acts which are contrary to the Law are not necessarily sin. There may be some instances where acts which appear sinful may not actually be sin, such as in this passage, which refers to eating meat sacrificed to idols. To those with weak consciences, eating such meat was sinful since it was used in pagan rituals. However this passage seems to indicate that the act of eating such meat is not sinful, even though many people view it as sin and there are valid spiritual reasons for condemning such behavior. This is by no means a justification for sinning indiscriminately, or an attempt to deny the existence of sin. My purpose is to propose that, given the limitations to free-will as described above, there may be ways of circumventing the idea that the theory is thereby untenable based solely on the idea that we would have a rather limited personal ability to choose between sinning and not sinning. There may be acts which one performs, or thoughts which enter one’s mind that cannot be controlled because the soul cannot overcome the “hardened" neural nets formed over the previous decades, or because of damage to critical brain structures which prevent the soul from altering the neural networks that have been formed.
While none of this excuses a person’s behavior from a human perspective, the fact of “hardened" neural nets may very well be taken into account in the bigger picture of God’s mercy and redemption when judgment is made on that person. The positing of hardened neural nets and biological/environmental controls does not make a person guiltless, but only allows greater leeway for God’s grace. Further, while this may seem to make people who are in sinful situations totally the victims of forces beyond their control, those individuals are still responsible within their capacity for how they handle the fact that they are behaving in aberrant ways--do they give up and accept that they are destined to sin uncontrollably, or do they revel in their ability to sin; do they feel remorse for hurting people, or do they take actions that may one day help prevent such behaviors from recurring? Each of these responses may be overt actions performed by the body/brain, or they may more subtlely be actions of the soul, causing changes to occur on a strictly spiritual level which may not lead to behavioral changes until much later.
Illustrative of this idea is a description by Stanley Hauerwas on the subject of how the “character" is able to be molded by the soul, despite the limitations placed on us by our materiality (in Tubbs 1996:100):
Thus, the morally important matter for the Christian is “transforming the self to fit the language," or “to become as we see." Character is formed as we learn to see, for truthful vision is a skill which must be developed; we are, after all, by nature creators and lovers of illusion and self-deception. Moreover, Hauerwas avers, we are not really free until we learn to overcome the self-deception and self-absorption clouding our vision of reality. In this respect, the capacity to love can be seen as the condition necessary to real freedom, and the virtue of humility can be seen as freedom’s most necessary habit or disposition. Clearly, too, the skill of free and truthful vision is something attained not just personally but socially.
Taking the model of rehabilitation instead of punishment, we would view offensive behavior as something which needs medical therapy. Of course in the bigger picture, one could say that in many instances the offensive actions may very well come from a person whose soul is evil (if one wants to postulate such a concept as a truly evil person), but regardless, we would not be able to make that distinction, since judging the soul is something beyond human capacity. Rather, remediation of the person’s actions is all we could hope to accomplish. This has been the goal of psychotherapy for decades, but recently, psychopharmacological and surgical treatments have been used with great efficacy. It is the hope of psychiatrists and neuroscientists that effective medical treatments can be found for any number of socially inappropriate behaviors. Alcoholism, a pattern of behaviors which destroys both the individual and people involved with that individual, has been shown to have strong genetic links, and to be related to the inability of the brain to properly metabolize ethanol, thereby causing addiction to the ethanol. Treatments are becoming available which may eventually eradicate alcoholism and its destructive effects. Similarly, initial tests may soon start for a vaccine which may prevent cocaine addiction by preventing the brain from achieving the “high" associated with cocaine use (Slusher 1996).
Violent behavior has in many instances been linked to a genetic malformation in which that individual has an extra “Y" chromosome. Suicidal behavior has been linked to alterations in serotonin, acetylcholine, and dopamine levels in the brain. Electro-shock therapy, and several chemical treatments have shown extreme effectiveness in preventing the depression and confusion linked with wanting to kill one’s self. Obsessive-compulsive behavior, which can lead people to behave aggressively if their cleansing “rituals" cannot be performed, or which can cause aberrant sexual behavior, can usually be attenuated pharmacologically. Frontal lobotomies have in the past been used to effectively treat extremely violent people (though this treatment has currently fallen greatly out of favor because of the radical and permanent apathy these patients usually develop). Hyperactivity in children which can lead to poor school performance and disruptive behavior can be treated pharmacologically with great effectiveness. Medical rehabilitation shows great promise with the treatment of criminal or other socially disruptive behaviors. Regardless, however, the fact cannot be ignored that most criminal acts cannot currently be treated pharmacologically, and of those that can, it is difficult to get the offender to consistently self-administer medications which control their behaviors. This poses a problem for those advocating rehabilitation over punishment.
There are three primary rules in current bioethical issues:autonomy, beneficence, and justice. In applying medical models to the treatment of criminal behavior, we are able to then apply these three rules to criminal behavior as well. One concern we have is to maintain the individual’s autonomy. Historically, discussions of punitive actions against criminals agreed that those who commit crimes have waived their rights to autonomy, since they have broken the rules laid down by their community. But if we assume a priori that they are controlled by forces other than their own free choice, then how can we say that their rights to autonomy have been waived? Given the assumptions that we have made regarding body/mind interactions, we cannot in fact say that they voluntarily committed the crime, so their rights to autonomy remain intact.
While this discussion of autonomy may be interesting on a theoretical level, it does little to advise us on what to do with society’s criminals. The two latter rules are more helpful in these matters. Beneficence (involving first doing good--benefiting the person/situation, and if that is not possible, then at least not harming the person/situation) primarily refers to the individual, but can also be applied to the community. Within the paradigm we have devised, we find that the person is actually not acting autonomously (since his/her own free-will is being overridden by biological and environmental controls), and that beneficence demands that we return autonomy to that person using whatever means is at our disposal, whether medical or social. However, the individual who is committing criminal acts removes autonomy from other people, thus beneficence regarding those victims of crime demands that we try to prevent those offenders from hurting people further. When no effective social or medical treatment is available to stop specific offensive behaviors, and those behaviors reach a certain threshold that threatens the autonomy of the individuals in the community, that person must be separated from the community.
It is at this point that both justice and beneficence coincide. Since there is no way to determine whether criminal acts are committed from evil intent or from lack of free-will, it seems most just to assume that the acts are committed out of lack of free-will. Therefore the punishment motif for criminal acts is unjust. The most just response, in the absence of effective treatment, is humane separation from society. This line of reasoning would therefore justify a prison system, but would demand reforms in the treatment of the individuals kept there. Effective use of whatever funds are available (based on inherent limitations of economic resources) to assure the safety and health (physical, emotional, social, and spiritual) of prisoners is demanded by both beneficence and justice. Moreover, many people are coming to the conclusion that efforts need to be put into both preventive measures for keeping people out of jail, and for alternatives to jail, such as half-way homes, or community service programs. The final conclusion to this is that autonomy, beneficence and justice are best served by putting funds into research and development of medical and social programs which prevent criminal acts from occurring. Prevention is inevitably cheaper than treatment and containment, thus promoting social justice regarding effective use of funds, is safer and healthier for the community and the individual, thus promoting beneficence to both parties, and promotes autonomy by establishing greater control over one’s own behavior.3
It is possible that the therapies mentioned above could either positively or negatively influence the soul. Being imprisoned in an harsh, degrading environment may lead not only to overt behavioral changes (learning new criminal behaviors, etc.) but may also adversely affect the development of the soul. Similarly, other environments such as a spiritually alive church or family may energize the soul, and give it a greater capacity and desire to please God. It is at this point that ministry may take place. Ministry, in this model, is the capacity of an individual to positively affect another person’s soul. In an ideal situation, this may take place when one person has been so blessed as to be able to allow their soul to form loving, motivated neural nets, which then allow them to behave in ways that help other people’s souls to be more at peace with God, with their communities, and with themselves. Similarly, this ministry may energize a person’s soul and give it a desire to turn to God, and to have a passion for serving God.
So in addition to therapy on a physical level, using drugs, genetic alterations, and surgeries, there is also the aspect of soul-therapy, involving personal contact with other souls. This may be one reason that psychotherapy and counseling, while the empirical data supporting its efficacy is not very strong, is still so accepted and demanded. Since aberrant behaviors are typically learned over several years, and are in part a function of biological determinants, counseling would seem to have little theoretical hope of producing behavior or thought changes in the face of such great barriers. The effects, however, may not be as obvious as gross behavior changes, but may occur at the level of the soul. The changes that take place at this level are inevitably bound to be slight since we have already established that the soul has very little influence on behavior. The changes that occur, however, may be more long-term, and more significant than just immediate behavior change.
An important point here, is that empirically, if psychotherapy produces changes in a person’s behavior, it tends to be fairly immediate, but often falls back into the previous patterns, thus appearing to have few long-term results. This is the major support of those who claim the ineffectiveness of the psychotherapies. However, the changes that occur, if they occur at the level of the soul, may not be changes that can be measured using current paradigms based on empirical data.
If we admit that we can affect the soul by acts that occur on a physical level, then are we able to justify such overt acts as psychopharmacotherapy, neurosurgery, or even transplantation of neural tissue? Taking the most controversial of the topics in an attempt to validate all three neurotherapies, I will attempt to justify neural transplantation. Before attempting this, I should note that full brain transplantations seem preposterously unfeasable at this time, if ever. However neural tissue transplantation currently is used for such things as putting cells that produce dopamine in an area where a disease has destroyed dopamine neurons that had previously existed there. Such treatments have been moderately successful in alleviating some symptoms of Parkinson's. Similar treatments may one day prove useful in alleviating symptoms of Alzheimer's disease by transplanting acetylcholine producing cells. However, in order to prove my point, I will take an extreme case and tentatively assume that one day we may be able to replace areas of the brain that are crucial for thought processing.
Assuming the validity of the mind/brain/soul theory as stated, then we see ourselves as a mass of chemicals related by way of quantum physics and spirit to a soul. The chemicals that form the brain arrange themselves in particular ways that allow the production of neural nets which produce thoughts and behaviors. Replacing the original neural tissue with some other substance (other human neural tissue, non-human neural tissue, or electrical circuitry) necessarily alters the neural networks that have been produced. This, however, is not necessarily a bad thing. If a person had learned poor coping mechanisms, or has altered brain anatomy/physiology, then replacing these "bad parts" would be beneficial to both the individual and the community if it resulted in more culturally appropriate behaviors, or in more personal control over one's thoughts.
Some people question the ethics of this kind of radical therapy, since it may very well change who the person "is" thereby "killing" the original person. This is the case unquestionably, if we define the person as a combination of his/her soul, mind (neural nets) and body in a strong sense. However, the case as stated here goes too far, and ignores obvious ways this occurs all the time:we are continually losing massive amounts of skin cells every minute; our body physiology is constantly changing (though within narrow margins); and as we grow and experience the world the microanatomy of our brains changes dramatically from one second to the next, thus producing the capacity to learn. We are never quite the same person as we were the day before.
Medically altering brain anatomy by tissue transplantation or grafting seems to be little different than this, especially considering the wide acceptance of altering brain physiology using chemicals currently used to treat mental illness. The only difference is that tissues that are not normally present in the body are being introduced. But considering that these tissues are also chemicals, similar to drugs that are administered orally or intravenously, this narrows the differences even further.
No matter how minor the changes are that we make, we will always be altering who the person is if we alter their behavior or thought processes, since those phenomenon are critical for our definition of personhood. Additionally, this may very well alter our souls, since it will alter how the soul can affect the brain, and vice-versa. But this is what we do with counseling, yet we are Biblically mandated to counsel, if we take counseling (whether lay or professional) to be one aspect of bearing another's burdens. Every interpersonal interaction in which we engage affects a person's brain, and mind, and soul. Whether this influence is through socialization, or through medical intervention, there is little difference, given that medical treatments would be focused on allowing the brain to achieve normal homeostasis, thus allowing the soul greater access to influence brain function.
The issue in many people's minds is whether we are usurping God's natural order by directly replacing cells with which we were naturally born with things that weren't originally there. This emphasis on doing what is "unnatural" has had a major impact on both bioethics and religious thinking in general. For example, to take an absurd, but clear analogy, let us take Bob, who has just died from an heart attack, and Fred, who has just been diagnosed with a new virus that only attacks the pre-frontal cortex. Is it unethical to take Bob's pre-frontal cortex (we will assume that we have already established that Bob had previously given consent for organ transplantation, and had an adequately functioning pre-frontal cortex; the situation would be the same if we postulated a microchip that performed prefrontal cortical functions that could be placed in a human brain) and put it into Fred’s head?
I contend that this a viable, ethical option, because the subject of our primary spiritual concern is the soul. Granted, the body plays an integral role in who we are as persons, and how we express the desires of our souls, but we can primarily see the body as a lens through which the soul is seen. We have already shown that the body acts as a very poor lens given the restrictions of genetic and environmental influences, but regardless, we see the body as not the primary chooser of motivations for the soul. The picture that has been presented here is of a soul that is judged for who it has become over the course of the lifetime with the physical body, and how it has developed given the influences (positive and negative) of the body. Whether this description is ontologically true, is not ascertainable, but as a metaphor, it certainly seems apt.
Given this, then we see that we do not directly affect a person's spiritual judgment by changing the neural nets within that body, we only affect the relationship between the body and the soul. What we do is force the soul to interact with a different set of neural nets in our attempt to fix neural nets that have led to aberrant behavior patterns. So by considering the soul as the core of the person and the body as essential periphery, we avoid the issue of whether or not we are killing the original person in the process of altering brain structure or physiology. This discussion of transplanting neural tissue, therefore, applies not only to this radical (and currently untenable) form of therapy, but to any therapy which alters the way a person behaves or thinks. This line of discussion leads us to a theological justification for counseling and other forms of interactional psychotherapies, and for chemical and surgical psychoneurotherapies.
As a final note, involuntary “mind control," if an acceptable definition could be found for this, would highly be unethical (unless the patient’s behavior was extremely dangerous and was intractable to other kinds of therapy), as it would remove autonomy from the individual. A quick example of a definitional problem is whether or not we would consider giving lithium to a manic patient mind control. These patients often want to remain in their manic states, and can be very productive during manic states. They can at other times, however, be delusional, hallucinate, and be violent, which is one reason why it is felt their manic states should be attentuated. But if the patient, while in a non-manic state (and therefore is assumed to be competent) wants to return to a manic state where s/he can be more productive than normal, having only the side effects of appearing eccentric (at best), then is forcing them to take lithium therefore mind control? A more obvious and frightening form of mind control is foreshadowed in an experiment that was successfully performed in 1985 (Belmaker 1995). In this study, being more motor control than mind control proper, the researchers used electromagnetic stimulators placed around the skull to induce electrochemical impulses directly in the motor cortex to cause primitive involuntary muscle contractions. While far from being “thought control" or control of complex behavioral patterns, studies like these give us reason for serious discussion on how to apply scientific research, and how to keep those applications from being used unethically and illegally.
This shift has led to several bioethical issues regarding the moral status of people who have severe brain damage. Brain death is currently an accepted criterion for death, and is diagnosed based on the absence of all brain stem and cranial nerve reflexes. In these situations, the cortex may be perfectly functional, but damage to the brainstem is so extensive that it is unable to keep the body alive. Thus, without artificial respiration, circulation and dialysis, the body quickly degenerates. The brain death criterion is legally accepted as death in these cases because even with artificial help, the body continues to deteriorate, usually ending in full body death in a few days. A condition very close to this is coma. Comatose patients typically have damage to the brain stem (particularly to the reticular formation), causing total unresponsiveness, and little brain wave activity. Severe coma often progresses to full brain death.
In 1975, Robert Veatch proposed that permanent loss of the neocortex be a criterion for death, since it is almost unanimously held among neuroscientists that the neocortex is the part of the human brain which is essential to being human (Bernat 1994:119). This definition of brain death would become important when considering persistent vegetative state (PVS) and anencephalic patients, whose brain damage is mainly in the cerebrum (the cortex plus some other areas such as the thalamus and basal ganglia). Anencephalic babies are born with essentially no cortex at all. Death as defined by cerebral loss would mean that these two types of patients would be considered legally dead as soon as a definite diagnosis of PVS or anencephaly was made, so could therefore be immediately removed from life-support.
Those who believe that neocortical death is appropriate for defining death usually assume three propositions (Downie 1990:222):
Intuitively this may sound like a reasonable cause for rejecting Veatch’s proposal for death. However, I support his view of death on both philosophical and practical grounds. Philosophically, the above three-step argument adequately deals with the objection that the rest of the biological world is considered alive, even though they don’t have consciousness. The first part of the argument assumes that there are abstract qualities that differ from species to species that are essential to that species’ definition. For example, part of being an animal in the wild is having the capacity to catch one’s own food. For a wild cat this requires great speed and sharp claws. If these qualities are lost, that cat is as good as dead. An animal rights activist might very well support euthanizing this animal rather than letting it slowly starve to death, or rather than taking it into captivity, into a foreign and unnatural environment. Similarly, there are phenomenological qualities that are essential in the definition of being human: 1) cognition, 2) emotion, 3) will and 4) social interaction being integral to this definition, all of which are lost in PVS patients. Finally, since there is no current or future capacity for cortical functioning (the most probable area where the soul influences thinking and behavior), then this person is forever cut off from his/her soul (at least until the resurrection), and is dead in a spiritual sense as well as in a neocortical sense.
Another objection to considering PVS patients dead is that this might lead us down a slippery slope of degrading the value of human life. Some feel that if we place our eggs in the cortex basket, that we may eventually regress down the Nazi road to euthanization of the mentally retarded, demented or severely handicapped. This need not be so, however. If we consider each of the four above aspects (cognition, emotion, will and social interaction) as essential for consciousness, then we only lose one, possibly two of those aspects with any other disorder other than PVS or anencephaly.
The only valid argument for disallowing the inclusion of PVS patients into the brain dead category is the level of precision in developing prognoses. While few patients who enter a PVS recover with full functioning, many do recover. One study shows that only 59 out of 1373 patients who entered PVS recovered, and none of those who recovered who was over 40 years old became independent in the first year of follow-up (Braakman 1988: 50). A second study shows that of 434 patients in the first three months of PVS, 33% died, 15% remained in a PVS, 28% recovered but with severe disability, and 24% recovered with moderate to good functioning (Multi-Society Task Force 1994:1572). After six months of being in a PVS however, there is only a .5% chance of recovering with good functioning. Of those who enter a PVS, the cost for the first three months is about $150,000, and after that the average annual cost is about $155,000 per patient.
Thus, a significant portion of patients who enter a PVS recover with some functioning, presenting a major difficulty in calling all PVS patients dead. This may change in the next few years, however, as studies are completed which compare brain imaging between those patients who eventually recovered with those who don’t recover. At that time it may be possible to judge with a fair degree of certainty which patients should actually be declared dead, or after what length of time the patients should be declared dead.4
The case is very different for anencephalic babies, who are born without a significant portion of their cerebrum. There are between 1,000-3,000 anencephalic births each year, of whom only half are born alive, over one third die in the first day, and the rest die in the first week (Wildes 1992:21). The status of anencephalic infants is much less controversial than those of PVS patients, if for no other reason than that they die quickly of natural causes (usually from respiratory or cardiovascular distress), rather than “hanging on" for years. The question still remains, however, of whether to consider anencephalic babies dead at birth, or wait until natural death overtakes them. By Veatch’s definition there is no question. These babies have no capacity to ever develop consciousness and are imminently close to death, therefore all medical treatment other than basic supportive care (hygiene, nutrition/hydration, comfort, etc.) is futile. So unlike PVS patients, there is no hope for recovery for anencephalic babies.
I would contend that Veatch’s criterion for neo-cortical death is entirely applicable to anencephalics for these two main reasons: the diagnosis is made much more easily for anencephaly than for PVS, and the prognosis is so certain. These two factors, and the fact that there is no element of consciousness in these babies, leaves little reason why they should be considered alive to the extent that effort is taken to extend or preserve their lives. Of the three major principles in today’s bioethical community (beneficence, autonomy and justice), all are satisfied by such a position (regarding both anencephaly and PVS). Beneficence no longer applies to these patients, because they are not benefiting from life, in the same way that advanced and extraordinary life-saving techniques are often foregone in these patients, since they are not benefiting in the broader scope. Neither is autonomy an issue. Since this patient will never have consciousness, autonomy becomes meaningless. Finally, there are only two significant justice issues regarding these persons. First, does social justice allow us to spend exorbitant funds maintaining the lives of the cortically dead when millions of people go without adequate healthcare? Second, would not justice lead us to desire that some good be brought out of these tragic events, such as allowing organ transplantation from these patients before their organs deteriorate beyond transplantability?
One fear of those who oppose the neocortical definition of death is that those persons with thought or emotional disorders will quickly be put into a situation where they are in danger of being euthanized, with or without their permission, solely because of their mental disorder. The argument is that if we can consider a PVS patient dead because they cannot have coherent thoughts, then how far can we be from declaring a demented person dead? Some point to the Netherlands as a living laboratory when we start allowing euthanasia into our public policy. Edmund Pellegrino points out that not only are the terminally ill now being euthanized by their own free choice, but at least one person who was depressed has requested and obtained euthanasia assistance (taken from an ethics seminar conducted at the Indiana University medical school in Indianapolis, March 25, 1996 by Edmund Pellegrino).
The situation here is substantially different from that seen in the Netherlands. Euthanasia is the “good death" of those who are now alive, or the killing/letting die of those who are by legal definition alive. The response to the neocortically death that is suggested here is not euthanasia, since those people would already be considered dead. Further, neocortical death is qualitatively different from emotional and cognitive disorders because the former situation falls under a medical classification, the latter falls under psychological classification. While cognitive and emotional disorders can be diagnosed and treated medically, they still remain psychological issues because the capacity exists for psychological experience, while PVS patients and anencephalic patients have no current or future capacity for psychological experience. Given this, there seems to be little to support the idea that allowing the neocortical death model into public policy would degrade the rights or status of mentally deficient persons.
There is, however, an important moral factor regarding how we treat the cortically dead. While it might be easy on logical grounds to relegate a cortically dead person to animal status (since they have no access to their consciousness or their soul, and would therefore be able to be used for research purposes just as an alive animal), it does not follow that this would be the appropriate thing to do. Consider the social effect of a person entering a PVS--there is a belief that a tragedy has occurred. Not only for the family of that patient, but for the patient him/herself, who has now lost the capacity to experience or enjoy life, even though the capacity for “living" goes on. So in this situation, we have a perfectly functioning organism, lacking only the capacity for consciousness, similar to many animals. Or more generally, consider a child who is born with a severe brain damage (not anencephaly in this case) who will be able to engage in simple social interaction, but never advance past a mental age of one or two years old. Similarly, a sense of tragedy is experience in such a case (Nelson 1988). It is this communal experience of tragedy which morally separates such patients (in a social/legal way) from animals. No one experiences tragedy when animals are born, even though they never have the capacity for consciousness. An animal never has the capacity to be more than what it is, but the child born with defect, or the adult who becomes permanently unconscious, is unable to fulfill his/her full potential, therefore we feel tragedy for their loss, and for the injustice of such events. Therefore, based on this clear socio-moral distinction between animals and non-conscious or poorly-conscious persons, there should be little headway made by those who wish to relegate our cortically dead to animal status for research purposes.
Also, there is the need to emphasize the need for appropriate care for thought-disordered patients, such as the demented, schizophrenic, etc. If we are placing such a strong emphasis on the loss of consciousness as a criterion for death, then how should we treat those who seem to have lost cohesive conscious functioning? As with any intractable disorder, patients with intractable mental disorders need supportive care and humane treatment. But rather than just waiting for such patients to die as is the case with other kinds of intractable diseases that need constant care, such patients might live on for decades, so a different approach must be taken.
Stephen Post contends that just because the demented or retarded patient may have compromised cognitive, emotional and social skills, that does not mean that person totally lacks these capacities. He believes that an attempt should be made to capitalize on the functions that still exist, and to make these patients’ lives as full as possible. For example, the demented patient mainly experiences cognitive and memory deficits. Such patients still have the ability to experience humor and relationships and “require emotional and relational well-being in the concrete present" (Post 1995:143). They can respond to their environments with “pleasure or fear" and “they still carry on conversations of a sort, even if what they utter is muddled and they no longer remember what was spoken just seconds ago" (144). Therefore, “they can be treated in a manner that lessens the moments of terror that must accompany the felt sense of discontinuity and fragmentation of self" (144).
Post commends the emergence of distinct sections of nursing homes called “special care units" (SCUs), which are designed to “enhance the non-cognitive well-being of people with dementia that our culture easily overlooks" (p. 145). He quotes Stanley Hauerwas while discussing the difficulty of finding a balance in treating the mentally incompetent:
people with retardation can receive “oppressive care, a kind of care based on the assumption that the retarded are so disabled that they must be protected from the dangers and risks of life." Their capacities and agency are easily underestimated, so that they are to some extent trained to be retarded. Societies have struggled to receive people with retardation in ways that allows them to flourish. The key to good care is not only to “do for" people with retardation, but to “be with" them, for a readiness to be with them bridges a gap between us and them. (Post 1995: 145)This discussion emphasizes the point that disorders of thought should not be dehumanizing in a philosophical sense, and that we should oppose the inherently dehumanizing effects of such conditions by encouraging the development of the capacities which remain in such people. Conditions which permanently destroy the parts of the brain essential for our humanity, however, disconnect us from relationship with our soul. Some have proposed that this event occurs with any disorder which causes a radical shift from our “normal" patterns. This is too drastic a claim, however. A more reasonable conclusion is that as long as we have a functioning cortex, we have the capacity to both effect, and be affected by our souls. But when we permanently lose all cortical functioning, then that bridge is lost, at which point we become dead.
The only other issue here is the idea of ensoulment. This concept, which proposes that there is a point in time where the soul is placed into the developing embryo or fetus, may or may not be how we obtain our souls, neither of which is relevant here. What seems to be most important, is the fact that this developing organism either becomes united with a soul at conception, or has the capacity to become united with a soul at some later time, and should therefore be protected as a person. The idea of capacity is viable from Scriptural perspective. For example, a person who is not a Christian, would at that time not share in communion with God, and is subject to immediate judgment. However, that person has the capacity to eventually make a change in his/her life, and become a Christian, so God withholds judgment. Similarly, it seems reasonable to me to say that since this developing embryo has a high probability of becoming a human with a functioning cortex and a soul, s/he therefore should have all of the rights we bestow on fully grown humans.
Implications Regarding the Moral Status of Thinking Non-Humans and of Animals
Another conclusion from assuming that the brain is sufficient to produce mind, is that theoretically, some other kind of brain (non-human) or even a physical or virtual machine (such as a computer program) could have a mind. There are several different opinions on this matter by the major theorists. Eccles would say that nothing other than the human brain can produce mind because only humans have a soul (or a soul-like entity). Others, like Penrose, claim that only biological machines could ever produce the effects that we call mind, because of the special components in living cells. Still others feel that artificial minds in computers are inevitable, given the rate at which technology is growing, and the leaps we are making in understanding the mind (Dennett, the Churchlands).
Regardless, given that the possibility of animal or computer minds exist in some people’s theories, such possibilities should be addressed. First, I will assume that animals do not have minds (given the reasons presented in Appendix C, p. 165-67), but have only consciousness. There are some animals that many people believe have minds, such as chimpanzees and dolphins. However these animals are not capable of generalizing experiences from one situation to another, have limited language capacities, and cannot engage in secondary tool/idea use (see Appendix C, p. 167), so even these animals with very advanced cortices and which are highly intelligent, do not have mind in the sense that we have defined it.
Currently (as of 1996) we have only mindless computers and animals, while all cohesively functioning humans have minds. In the event that computers or animals eventually develop minds, a further distinction still exists between persons and non-persons, which is that all humans that are alive are persons (in this technical usage of the term), and that no computers or animals can ever be persons. To a certain this degree, this distinction seems arbitrary and species-centric, and while I cannot deny this accusation, I can attempt to defend it. We have already stated the assumption that humans have souls. From a scriptural viewpoint, a definite distinction is made between humans and animals (humans are to rule over the animals, humans are made Imago Dei, humans will be resurrected, etc.), and based on this, it does not seem unreasonable to assume that this distinction is related to the soul. While both nephesh and ruach are ascribed to animals in the Old Testament (Lev 24:17-18; 1 Kings 3:11; Gen 6:17), it seems that these references are ascribing the life force and the breath of God to animals, not souls in the sense we are using here, especially since neither psuche nor pneuma are used in the New Testament in reference to animals.
As for computers, the distinction is in the ontology of the machine. The human brain has its ontology from God--God creates the genetic coding and reproductive capacities which produce each brain, and each human body. Computers, however, originate from the creativity of humans, not directly from God. Souls come from God, thus their existence relies on creative acts by God, not human creative acts. One might ask whether or not God would give a soul to a mind-ful computer, but that line of thinking seems somewhat unproductive at this point. Regardless, despite the mindfulness of a computer, and how “human" it may seem, personhood is a status that we ascribe to a body-soul unity, the creation of which can only be performed by God (Culliton 1978).
Bioethical considerations come into play at this point, however, where theology leaves off. While we may not ever begin a campaign for the salvation and redemption of chimpanzees and computers, we may however have ethical obligations to them. As for animals without minds, we have stewardship obligations (Gen 1:28). The resources on this planet are limited, and the unnecessary killing of any animal seems to neglect God’s instructions to us (what is necessary or unnecessary killing is not integral to the purpose here, so I will leave further investigation of that issue to the reader). Further, all animals are aware and some are conscious (see Appendix C, p. 164-67), so they all are able to experience pain, while others even experience suffering. This fact has led to giving animals certain legal protections from cruelty, thus granting them rights.
Moreover, given the close biological ties that bind humans and animals, and the many ways we humans have become emotionally attached to animals, it seems counter-productive to cause animals unnecessary suffering. It is common knowledge that the more violence we witness, the more likely we are to act in violent ways, and that we become more desensitized to suffering. Violence that we perpetuate, or allow to be perpetuated on animals, degrades the respect for life that God gave us. While these acts may very well be performed by persons with damaged neural networks, it is important that society makes efforts to heal those neural nets, prevent future cruelty from occurring, and prevent situations which promote desensitization (such as discouraging unnecessary acts of violence to humans and animals alike).
Similarly, if computers were to develop awareness, similar rights should be granted to them. At this point the distinction between life and non-life comes into play. Computers are not alive, therefore cannot be killed. Subtle distinctions occur in nature which blur the lines between life and non-life, for example viruses--are biological viruses alive? And if so, how can we say computer viruses are not alive since their purposes and actions are much the same? There seems to be a fairly clear consensus that one of the requirements for life is the presence of nucleic acids. Since computers currently are not nucleic acid based, then they cannot be considered alive. Further, little thought is given to killing animals that lack awareness, such as bacteria. Similarly, if computers were to be developed which utilize nucleic acids (such computers are currently being theorized because they would have unique advantages over current computers), to destroy such a computer would hardly be a matter over which to become upset. Programs that run on such computers would only be virtual machines--so even if a program produced mind in a nucleic acid based computer, it would be the program that was alive, not the computer, so throwing away the computer would not be the same thing as killing a mindful being.
One final question remains--what is the status of the program which produces mind? Turning off the program would be similar to producing unconsciousness in a human. Could such an act be considered assault if mindful programs were given legal rights? This is a very real possibility, one for which I have no easy answer. The only guidance I can see at this point is to return to the concept of personhood. Biblically, the program could never be a person, so could not have the same status as an human. Legally, the Constitution refers to “persons" and the definition of persons has several meanings within current law--corporations can be persons, non-white races used to be considered only partial persons, unborn humans currently have no personhood status, etc. Regardless, even non-persons have some rights under current law, for example the rights given to animals. Similarly, such rights could conceivably be granted to mindful programs, however granting them full personhood seems so absurd given current technology, it is futile to consider the matter further at this point.5
In this vision we see the Holy Spirit permeating every corner of the universe, and filling every “body" (atoms, molecules, cells, organs, creatures, planet, etc.) with energy. Without this field all of creation would be motionless and lifeless. The Holy Spirit not only gives energy in a physical sense to the universe, but spiritual energy as well--when we see ecstatic displays of emotion, prophecy, power, etc., in the Old and New Testaments, we associate them with the Holy Spirit. In the chaos of the physical world (caused by both entropy and the indeterminacy of quantum physics--see chapter three) the Holy Spirit provides us with direction and purpose in an immediate and real way by acting on our souls and spirits and minds and bodies with the unified, cohesive, pervasive presence that characterizes a field. The blessing, however, is that this field, unlike the fields postulated by physics, is not a force that acts by laws and cannot be mindlessly reduced to a mathematical equation. This field is the Spirit of the living God, and is active and mind-ful and Divine. He both acts on and is acted upon, both affecting us, and is affected by us.
Loder and Niedhardt’s model of spirit fits with the picture we have formed here (see chapter four). They submit that spirit is the relationship between two distinct things, and unifies them without destroying their diversity (Loder 1992:10). While their model of a bipolar asymmetrical relationship seems useful in describing our relationship with the Holy Spirit, they seem to say that the Holy Spirit is merely a relationship between us and God. This reduces the Holy Spirit to a function and an abstraction rather than retaining the Holy Spirit’s personhood within the Trinity. Rather, I propose that there is indeed a relationship, and we can rightly call it spirit, but that the relationship is between our bodies and souls, and between our souls and the Holy Spirit. These relationships are characterized by energetic (physical and spiritual) interactions deriving from the Holy Spirit, and as the Spirit energizes us (as a body and soul unity) we live, and move, and have our being (Acts 17:28), thereby producing thoughts and actions and feelings which reciprocate to the Holy Spirit in a constant interaction.
It is in this way that the Spirit can influence our souls, and can act directly on our bodies. Just as our souls utilize quantum physics to influence our thoughts within this model, the Holy Spirit can utilize the same modality. Moreover, since our souls are finite as humans, we experience lapses in how our souls interact with our bodies when certain kinds of neural damage occurs. However since God is infinite, God has no such lapses, and has constant access to our thoughts regardless of the damage that occurs. In such a way God continues to know us and is related to us, both physically (body/brain/mind) and spiritually (soul), and can care for our needs even when that body-soul gap becomes impassable to us as humans.
When we worship God, we allow our spirits to reign in us, energizing our soul and body. We focus our thoughts on God, which aligns our minds with spiritual things, thus allowing our souls to have greater access to our neural nets. Worship invites the Holy Spirit to come work on us, changing us and renewing us. In the process of worship, we not only invite better spiritual communication within our body/soul unity, but physically we strengthen the neural nets that make further worship more likely, more beneficial, and gives us freer continued access to our souls and vice-versa. In any act of spiritual focus, whether meditation, prayer, worship, etc., we work to silence the background noise that continually bombards our senses, and try to allow our soul and the Holy Spirit to work with less obstruction together with our mind and body to develop and strengthen the relationship we have built with God. It is by this process that we decrease the asymmetricality of the bipolar relationship between us and our souls and between us and the Holy Spirit, allowing them to have greater and greater control over our bodies. Eventually, at the resurrection, the proper unity will be fully restored, and we will enjoy true fellowship with God.
In the creation of the human brain/body/soul, God called it good, and allowed us to be ourselves, whether that meant turning to evil, or turning to God. In our choosing evil, we allowed death to flood into life and separate us from ourselves: our souls from our minds and bodies, our bodies from life, and our souls from God. In thinking about how humans are different from other animals, and how we are the same as animals, we see what we would be without the power of God’s grace to allow the fellowship between us and God that keeps us from becoming creatures entirely based on instinct and neurological impulses. We can see what we need to rise above in the barbarism of the animal world, and we are allowed to see God, to see to what we should aspire. We are given the power to achieve such aspirations, but in ways that are subtle and mysterious and miraculous.
In thinking about language, and how it is one of the primary ways that we are uniquely human, we are reminded that Jesus is the Logos, which can help us to see why language, use of propositional symbols, secondary ideas and rational thought makes us Imago Dei, and therefore persons. In being allowed to participate in the nature of God in this way, he shares God’s Being with us, along with the many other gifts with which he permeates us, such as life and joy and love. We can consider how it is language which allows us to communicate ideas to one another (as well as to ourselves in the politics of our internal mental processing) and to God. It is with language that we can touch each other’s soul in ways that no neurological surgery or pharmacotherapy could ever do. While language can be used either to bless or to curse souls and God, it is the nature of the Logos to glorify God, to retain cohesiveness, and to bring life and fullness (John 5:19; Col 1:17; 3:4; 2:10). This therefore should be our model as we strive to walk in the ways of the Logos in our relationship with God and with other persons.
In thinking about quantum physics, we are reminded of the mysterious ways of God, and God’s unfathomable superiority over us. We once thought we knew how the universe worked because we could predict such things as the rotation of the earth on its axis using Newtonian physics. We then had the blessings of Einstein’s insights into relativity, followed quickly by Bohr’s and others insights into nuclear structure and quantum physics. Just as the Newtonian bulwark eventually showed cracks which forced us to see the structure of the universe in ever more complex ways, so the current bulwark of quantum physics is showing cracks, possibly leading us to deeper insights into how God structured the universe. Changes in our physical paradigms will undoubtedly change the way we view ourselves in relation to God’s creation, and will challenge our faith in ways similar to how the Newtonian paradigm challenged the Medieval Christians. But with these challenges created by greater insights into physical structure and patterns, God has also blessed God’s people with prophets who have been able to infuse the bland, harsh, godless facts with meaning, purpose and vitality, as seen by early Christian scientists, like Newton himself (who considered his greatest accomplishments his Biblical commentaries), Descartes, and Pascal. We, likewise, should strive to press meaning and God into the chaos of modern life, steeped in the lifelessness and coldness of technology.
In thinking about our brains, we come to Goedel’s recursive paradox. How can the brain think about itself? How can the brain construct a substance (mind), which deconstructs itself, and not be destroyed in the process? Rather than be destroyed, the mind seems to feed on this recursive process, and we experience growth through introspection. In thinking about our own nature, and about the meaning of what we experience daily, and about our relationships with other persons (including the Ultimate Person, God), we find depth and strength. While thinking about our brains in regard to quantum physics may be mere folly in the larger scope of God’s universe (considering that God laughs at the folly of our best wisdom), it is not necessarily useless. If it can help us to see ourselves and others in ways that conform better to scientific and biblical descriptions, then the task of thinking about such issues has been accomplished. Even if it is not so much the actual discoveries found in the process of thinking about science and theology, it is in spending time being challenged to consider our relationship with God, with each other, and God’s relationship to God’s creation that makes life interesting, and which brings us closer to at least the possibility that we are vaguely discovering truth. It is with this hope that I encourage you to think about such issues. Not just for the vague possibility of coming closer truth, but that the process will make us stronger Christians, better able to retain a vital relationship with God in light of the complex and distressing challenges of science, and better able to stand together as a Christian community to infuse dignity and fullness into the lives of those who have been made to feel dehumanized and godless by complex and distressing times. In such a way, God may be able to use our foolishness to build up the kingdom.
2. What this means, I will not attempt to answer. The point is that, whatever salvation is, it does this: it allows God to overlook our sin and not count it against us, so that we can remain in communion with God.
3. This final statement assumes that the soul wants to behave in socially appropriate ways. If, on the other hand, it ends up that souls tend to want to behave in socially inappropriate ways, then we would be forced to limit that individual’s autonomy in order to promote the greater good (protecting other people’s autonomy). The methods and preferred results do not differ (therapy designed to limit violence, obsessions, etc.), only the metaphysical implications and an emphasis on communal beneficence over individual autonomy.
Implications Regarding Our Relationship to the Holy Spirit
Coming into the final section of this paper, we arrive at the only point where attention is given to systematic theology. The Holy Spirit becomes the primary player in the dynamic connection between us and God. In the conception of human nature as a body with a brain which produces mind, and which also interacts with our souls, we find that the Holy Spirit acts on every aspect of this unit. Wolfhart Pannenberg conceives of the Spirit of God as
the supreme field of power that pervades all of creation. Each finite event or being is to be considered as a special manifestation of that field, and their movements are responsive to its forces. (Pannenberg 1991:46)
Further, he characterizes aspects of human transcendence: “In the biblical story the spirit is simply the dynamic principle of life, and the soul is the creature which is alive and yet remains dependent on the spirit as the transcendent origin of its life" (43).CONCLUSION
In the process of bringing together such diverse fields as quantum physics, neurobiology, philosophy of language, neural net theory, and theology, we have created a picture of the mind and soul which makes room for empirical data, recent models of brain functioning, and faith propositions. In doing so, a challenge has been set forth to see humans as very material and fragile creatures, susceptible to disorders of thought that can control our minds and our behavior to the extent that we act in ways offensive to us and to others, sometimes without our knowledge or autonomous choice. At the same time, we can see ourselves as creatures susceptible to the chaos of the quantum world, the interaction of which with our physical bodies, with our souls, our minds, and the Holy Spirit creates a beautiful chorus of spontaneity and energy that can become joy, sorrow, insight, ruts, passion, weakness, worship, despair, and the entire range of human emotions, intellect, abilities, and spirituality that make life interesting for us and for God. Footnotes
1. While there is no doubt that innocent people suffer for acts committed by other people, these seem to be more a natural chain of events and of the result of a world dominated by darkness, unrelated to direct acts by God. The incident mentioned here implies that God took direct action against God’s people. One can bring two lines of defense for God in this situation. First, God is sovereign and can do as God chooses. Second, no person is innocent, and it is only by God’s mercy that God doesn’t destroy us all anyway. The thrust, however, of this passage, seems to imply that God’s action here is not in response to the sin of the people, but of one man, David. Moreover, while we can agree that God is sovereign, must we also therefore agree that God has free reign to do anything God chooses, for example to lie? I think not, for it seems that God’s “law" of love is in conflict with acts of mass killing in most circumstances, with this particular instance not being of significant depth to justify God’s actions to my human understanding.