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The search for the new pineal gland: brain life and personhood.

The concept of "brain life," sometimes offered as the criterion for determining when personhood begins, cannot tell us what we want to know about persons. Neurological facts will not automatically yield ethical conclusions.

Three centuries ago, G.W. Leibniz began to think philosophers might someday abandon their groundless discussions and settle down to work with the straightforward proposal, "Let us calculate!" Leibniz is not unusual in this respect: there have been other philosophers before and after him who hoped that with a precise enough language they could be finished with metaphysical speculation and establish definite, unassailable truths. This hope continues to grip some philosophers, along with others who generally have less theoretical concerns.

As an example, take the current discussion surrounding what has come to be called "brain life." Many involved in this discussion hope that the objective data gathered by neurological research will determine when the human fetus becomes a person and therefore provide a scientific conclusion to some of today's most important debates in bioethics. Whether neurological research can actually provide that conclusion is the subject of this essay.

Are some abortions, and not others, ethically permissible? Should research on human embryos be forbidden? What about transplanting fetal tissue? The concept of "brain life" would seem to go a long way toward providing an unambiguous answer to these questions: once the brain is "alive," so the "brain life" argument runs, then a person exists; and a person, at the age of seven weeks or seven years postconception, has rights that must be respected.

While the "brain life" argument does appear to solve many problems, we will nonetheless contend that "brain life" is neither a defensible nor a useful notion. Contrary to its advocates, it is not the result of, nor is it based on, scientific research. Neither does "brain life" have an intrinsic link with "personhood." The analogy with "brain death" is admittedly intriguing, but for reasons that are suspect. Far from being based on objective data, the arguments that favor adopting the "brain life" concept are in fact metaphysical; and, like all metaphysical speculations, they tend to obscure other, less abstract ways of discussing an issue. Here in the case of "brain life" it is the relevant social questions that are obscured.

Our arguments aim specifically at undercutting the analogy between establishing death by brain criteria and the proposed criteria for "brain life." After discussing these proposed criteria, we will examine what we take to be the metaphysical foundations of "brain life" and offer reasons for its rejection.

Brain Life: Neuromaturation

The process of fertilization initiates a remarkable set of biological developments resulting typically in a fully formed human organism, with a brain capable of directing activities that range from very abstract to most concrete. Very early on, from the fifteenth to the thirtieth day after fertilization, the process of neurulation--the formation of the neural tube--sets the stage for the development of the whole nervous system. The first neuron circuits appear around eight weeks, and the reticular formation, through which electrical signals travel down the spinal cord, develops soon after. Mylenation, which begins around the fourth month, is critical in helping to form the integration of the nerve tissues. Finally, around the twentieth week, the thalamus becomes connected to the cortex, and the nervous system is then physically integrated. Though much more development is necessary for complete neural maturation, the essentials of the reticulo-cerebral complex are in place by midgestation.

Perhaps the most striking aspect of neuromaturation, at least from the standpoint of our argument, is that the central nervous system is among the first systems to begin and probably the last to complete development. Many neurobiologists argue that the reticulo-cerebral complex continues to develop even into preadolescence. We will return to this point concerning the gradual development of the complicated physiological system supporting the human brain.

Using Brain Life Criteria: Four Arguments

The use of the concept of death by brain criteria has given rise to arguments for the analogous use of the concept of the birth of the brain, or "brain life," as a means of determining either the beginning of personhood or some other morally relevant stage in fetal development. We outline in this section four of the leading "brain life" theories.

John M. Goldenring first proposed the concept of "brain life" in a dissertation entitled "Death, Life and Abortion: The Implications of the Fetal EEG." He argues that the "fetus is biologically a human being at the point at which its brain begins to function."(1) Once the fetal brain is functioning, then "one cannot advance any logical argument to show that that fetus is not a living human being, at least from the point of view of medicine."

For Goldenring, the critical point of such brain formation is the eighth week, when the brain as a whole is integrated. This provides the basis for the symmetry between "brain life" and the death of the brain as a whole. Thus Goldenring stresses the central nature of the brain in defining a human being throughout life. While he says that biological facts do not resolve ethical questions, he nonetheless maintains: "The brain-life theory simply stated is: 'Whenever a functioning human brain is present, a human being is present." Many others have followed Goldenring's lead.

More recently, Hans-Martin Sass has taken up the "brain life" argument and proposed two critical stages in fetal brain development. Brain life I occurs around the fifty-fourth day after conception and shows "the first living cells, some of which will, as a result of further development, function as vital parts of the human cortex."(2) Brain life II begins about the seventieth day after conception and is characterized by the first formation of synapses, which provide the possibility of "ever growing networks of interconnections." Sass suggests using brain life I as the point "after which fetal life should be morally recognized and legally protected." Brain life I, he writes, "matches the widely accepted criteria for brain death" and, more importantly, does not involve "metaphysical or religious interpretations."

Thomasine Kushner offers a psychological argument for "brain life." She distinguishes between zoe (biological life) and bios (conscious life).(3) Zoe, the root for zoology, refers to the organic structure and organic functioning of an organism. Bios, the root for biography, refers to existence as "the subject of a certain life with its accompanying history."

Kushner argues that "only a functioning brain makes the consciousness possible on which bios depends." Thus the morally significant question is whether the fetus is the subject of a life. Kushner's answer is that

until it has developed a brain capable of consciousness the fetus's biography is not yet started. There is no life (bios) of which the fetus is the subject, although there are lives of which the fetus is a part.

Kushner does not give a specific time when she thinks bios would emerge, though obviously this would be rather late in fetal development.

Carol Tauer distinguishes between two traditional concepts of the person and then proposes a third, based on "brain life." First, there is the person strictly understood: those beings "who are moral agents, who have moral rights, and who are to be respected simply because they exist."(4) Second, there are persons in the social sense: "all those whom our society recognizes as having the status of persons."

Third, there is Tauer's proposal--the psychic person. Such a concept requires two conditions:

(1) the present capacity to retain experiences as 'memories' through the building of pathways in the central nervous system; and (2) the potential to become a person in the strict sense.

Critical for personhood in Tauer's sense is the development of physiological structures to support memory and to permit physiology to influence psychic development. For Tauer, a person emerges with the onset of "brain activity," which occurs during the seventh week of fetal development.

The Metaphysics of Brain Life

Since the one is the contrary of the other, the word death easily calls to mind the word life. Surprisingly enough, this simple verbal association may be the deepest reason behind so many of the calls for the formulation of a concept of "brain life." Throughout the literature on this topic, ethicists and doctors assert that if there is "brain death," then there must be "brain life," as if the one led to the other with logical force. For some, the intuitive connection between the two seems to obviate the need for argument.

Michael Bennett, for example, simply asserts: "The concept of brain death requires implicitly that there be brain life."(5) Hans-Martin Sass also contends that, by analogy with the concept of "brain death," ethicists would be justified in working to define "brain life." Sass, as we noted, does offer arguments in favor of this "symmetry," formal though the arguments might be; but he lacks an explanation as to why the symmetry should be pursued in the first place. And John M. Goldenring suggests that because physicians use a "brain death" criterion for when life ends--they have, he says, a "working definition" of death--they should also know when it begins. This beginning point would seem to be "brain birth." Once again, the analogy carries the weight of obvious fact; it speaks for itself.

It is precisely the desire to produce a consistent, symmetrical account of both death and life that brings in "metaphysics." When we use the term here, it refers to the philosophical urge toward system-building and, more importantly, the resulting and perhaps willful inattention to details that do not fit the demands of a particular system.(6) Many of those arguing in favor of "brain life" first assert that there must be symmetry between the definitions of death and life, and then go on to discuss the ethical issues raised by the symmetry. The metaphysical framework, therefore, determines the questions and the data to be incorporated or excluded--and presupposes that the physiological data are somehow primary.

First, bear in mind the scientific facts of neuromaturation--or at least what neurobiologists know about it so far. Clifford Grobstein, for example, makes the significant observation that "the designation of all events and all stages [in human development] is arbitrary."(7) "Arbitrary" might be too strong a word, but the fact remains that no single essential difference can distinguish one "moment" in neuromaturation from another. Differences there certainly are, but none that by itself requires a distinct physiological category of its own.

Michael J. Flower recently made a similar argument, pointing to several transitional stages in human fetal development that represent the beginning of various important neurological processes. Contrary to the implications of Sass's and Goldenring's arguments, the image of a line angling upward on a graph and passing at a well-defined point into the shaded area known as "consciousness" does not apply to this cluster of emerging functions. A more appropriate comparison, at least, would be that of a house under construction: first the workers clear and level the ground, then dig a hole for the foundation, then pour the concrete, etc. A metaphysically inclined observer might ask, "When does a house appear, or when it is born? Is it born when the last shingle is put in place? Is it no longer a house, or a different house, if the owners add a hot tub and tennis court in back?" These questions, like the ones that arise concerning a human fetus, make drawing distinctions seem very difficult, if not completely impossible. As we will argue later, however, the apparent difficulty does not mean that distinctions should not be made. Our point is rather that distinctions should grow out of arguments based on relevant rather than spurious data.

Naturally, "brain life" advocates might object that what we call spurious data are their very real and very hard data. But we are not questioning the scientific work done by neurobiologists, whose methods and objectivity must pass muster with their colleagues. Our point is philosophical: verified scientific results become spurious when ethicists put them to questionable uses, or use them as trumps to solve problems. When ethicists enter the discussion--when ethicists begin to weave together neurological data and conceptual disputes--then the philosophical issues arise. We are arguing that the disputes, precisely because they are conceptual, cannot be settled by appeal to research on the brain and the nervous system.(8) Such an observation might seem to go without saying, but we think it has been forgotten in the debate over "brain life" and other closely related notions.

So, we are suggesting that at the beginning of a discussion about the human embryo or fetus, the question to ask is not, When does consciousness appear? but rather, Why treat the idea of 'consciousness'--or 'brain life'--as the central issue in this ethical debate? No one can assume that the answer to either question is obvious; and, perhaps more importantly for our argument here, no one can assume that the "when" question is somehow fundamental to the "why."

Why bring in "consciousness"? Why bring in "brain life"? Putting these questions first might keep the discussion of abortion, say, or research on human embryos from heading into the thicket of needless conceptual antinomies. Without question, there have been many cases where ethicists have not been so prudent about crossing over into this territory, and have thereby created insoluble problems for themselves. M. C. Shea, for example, establishes a framework in which it seems she must turn to the notion of "brain life" in order to settle the question of "personhood:"

Even if, as many would say, the coming of a new human being is biologically a gradual process, it still remains true that at some point in this process the stage is reached where there can be no doubt that this new life is now fully human. A line still needs to be drawn somewhere.(9)

The perceived need to draw lines leads her to the following claim: "Detection of brain activity ... could be taken to herald the beginning of a new human life." Shea presently transmutes the "could" into a "should." But why does a line need to be drawn at all? Or, if it does need to be drawn, why does it have to be done on the surface of neurological research?

Given the framework that Shea establishes, ethicists would be justified in asking questions that hark back to medieval and early modern discussions about "ensoulment." One such question would be, When precisely does a change of nature occur--from mere biological life to fully human life--in the developing embryo or fetus? It would not be unreasonable then to look for the very second--or micro- or nanosecond--when the change occurs. Like Descartes, ethicists might even ask where in the brain or nervous system "brain life" or personhood appears. And indeed some ethicists have already begun to frame bioethical problems so that questions concerning the "place" of personhood do arise. Hence the return of metaphysical questions, now in quasi-scientific form, about the relationship between the soul and the body.

Even those "brain life" advocates who claim to recognize the difficulties suggested above nonetheless find themselves in a metaphysical thicket. Kushner, for example, seemingly rejects the empirical arguments in support of the "brain life" concept; but then she reintroduces them, in a clever way, by turning to "consciousness" for help. The upshot of Kushner's argument is that the brain assumes exactly the place it has in Shea's argument, only for different reasons; the problems raised by Kushner's argument are nonetheless very much the same. Kushner begins with two notions--"consciousness" and "biography"--that present many difficulties and explains them away by turning to neuroscience. Once she has secured a foundation in neuroscience to her own satisfaction, then she turns back to those notions as though they had all along an explanatory force that must be respected.

Consider only the problems with Kushner's notion of "biography." To begin with, it seems strange that Kushner speaks of "biography" rather than "autobiography," since only others can write a biography. What others can write, that is to say, would seem to have little to do with events occurring within the "interior theater" of a subject's consciousness, if such a picture of mental life is defensible at all.(10) It is not immediately clear, for example, why a writer could not produce a biography of a severely brain-damaged adult; or, and this is not a frivolous idea, why a dog is not a fit subject for biography. If anything, "consciousness" is beside the point: recall Virginia Woolf's Flush, or the chapter in Anna Karenina that Tolstoy writes from the viewpoint of Levin's dog.

Such objections would not be answered by appeal to the notion of "autobiography," either: in this context, such an appeal only reintroduces the problem of "consciousness" under a different name. Kushner would apparently reduce autobiography to the reflections of the brain on itself--as though the human being were no more than a self-aware brain floating in a vat. Once more, then, an ethicist has assumed that the hard facts having to do with the brain--with events occurring "inside the head"--solve all the difficulties associated with vexing philosophical notions.

A similar bias in favor of the connection between "consciousness" and the brain looms large in the argument made by Tauer. She claims that only those beings who have a sense of self or "self-consciousness" are "full members of the moral community" and makes the same use of this claim as Kushner does of "biography." Like Kushner, Tauer offers no justification for her claim. Using a different formulation of it, Tauer writes: "It is only I as an experiencing whole who can even begin to have moral value," and she goes on to argue that the capacity to be an "experiencing whole" is rooted in the permanent neural pathways developing in the fetus. Here too, as with Shea and Kushner, the brain provides the physiological foundation of concepts that for centuries philosophers have argued over, such as "self," "consciousness," and "experience." "Personhood" is a comparatively new concept in philosophy, but it finds a solid foundation here, also.

Modern Philosophy and the Lure of Consciousness

Why do so many ethicists and doctors think the circuitry of the brain will provide a solution to ethical problems? What are the arguments in favor of the "brain life" concept supposed to prove? In a strict sense, what they prove, it seems, is that ethicists can define human being, personhood, life, and consciousness so that they are all linked to the emergence of complex neurological functions. But a more important question remains: Why would ethicists be led to define these terms so that they are linked to events inside the head and, in particular, the brain?

The "facts" themselves do not provide an answer; hence our turn to history. Here, the Greeks are of little help--they simply did not conceive of the mind as somehow located in the head or the brain. In fact, the "mind" as many contemporary philosophers conceive of it would have been a foreign and even incomprehensible idea to Plato or Aristotle.(11) The discussion of the mind as a personal, interior world begins with Saint Augustine, who imagined his mind to be an immense cavern full of dark, mysterious tunnels.(12)

Philosophers often associate the idea of mind-as-consciousness with Rene Descartes, but they have been misled.(13) For even though Descartes did place his "first philosophy" on the foundation of individual thought, he assumed that his thinking was located in a self that was in some way a "thing"; and indeed some of his critics charged that the assumption was unjustified. Nonetheless, Descartes' self (as he thought of it) was something more than what Kushner and the others seem to understand by "consciousness," although, as we will argue, he was bedeviled by the problems they also face.(14)

The philosopher who began the fully modern discussion of "consciousness" and even "personhood" was John Locke, in the second edition of his Essay Concerning Human Understanding. Locke accepts Descartes' claim that the thinking self is the first certainity. What he cannot accept is the idea of a substantial self, some "thing" that persists throughout changes in the mind's thoughts, emotions, and perceptions. Hence Locke's notion that the self was nothing more than "consciousness." The reaction that followed the publication of this edition provides some measure of how strange Locke's contemporaries found the argument about "consciousness." For the most part, Locke's eighteenth-century readers could not understand what exactly "consciousness" was. Pierre Coste, who translated the Essay into French, had to perform verbal contortions to convey the sense of "le mot Anglois" in French; the word conscience was not sufficient to the task. Isaac Watts, an English commentator on Locke, called his notion of the self "a strange and novel opinion."(15)

The intervening three centuries have not made Locke's opinion any less strange or any clearer, yet many contemporary philosophers continue to assume there is something produced by the circuitry of the brain that can be neatly captured in the term consciousness. The history of modern philosophy must have something to do with how self-evident the notion of "consciousness" appears to some: after all, there is an at least three-hundred-year-old tradition in the West of working from the "inside out," from the mind to the world. Though once a problematic notion, consciousness is now taken for granted by many of the participants in the "brain life" debate. Yet this generally accepted notion itself requires critical examination.

The Consequences of the Urge for Symmetry and Simplicity

Besides cultural history, there is another reason for the attraction to the "brain life" concept, a reason that has to do with the desire for symmetry discussed earlier.

Hans-Martin Sass claims that one advantage of the "brain life" concept is that, because of the analogy with "brain death," it lends "conceptual clarity" to certain pressing bioethical debates. With his eye on legislation, Sass further claims that "one single statute" could protect the "moral value of human life from the beginning to the end." But whatever clarity comes from such a unitary concept of "life," it is a clarity that has a disturbing shadow-side.

The concept of "brain life," for example, makes the physiological maturity of one system of the fetus the only morally relevant factor. Granted the significance of the nervous system, it is unclear from a philosophical point of view why primacy should be given to this physical structure. The concept of "brain life" may make the fetus seem real or significant only because there is a scientific criterion that it has met, but such a position assumes incorrectly that metaphysical status can be inferred directly from scientific concepts.

One practical consequence of this metaphysical sleight of hand is to make pregnant women simply irrelevant to the issue of abortion. And women especially might worry about being treated as less than persons when fetuses in utero are treated as if they were fully persons. There are already some prepared to argue that women should be forced to undergo invasive medical procedures or incarceration for the supposed benefit of fetuses. And if "brain alive" fetuses really are persons, then many would argue that women should not be allowed to have an abortion even if their lives would be threatened by bringing a pregnancy to term. Indeed, such an argument would make sense: after all, at the abstract level of "personhood," where the "brain life" debate takes place, nothing justifies taking one innocent life over another; and, if the uterus is merely an "intensive care unit," as Goldenring says, then preserving the new life seems at least reasonable.

To turn to another, closely related consequence: the case for "brain life," dependent for its success on the analogy with brain death, must ignore the social context in which the Harvard Medical School's 1968 ad hoc committee formulated the criteria for brain death. The social context, however, is essential to understanding the full meaning of the criteria. Unlike arguments in favor of "brain life," the brain-death criteria do not have their origin in speculations about the legal and metaphysical status of fetuses. The Harvard committee concentrates instead on two basic problems raised by the prolongation of human life. First, because of improved resuscitative and supportive measures, the heart and lungs may continue to function even though the brain is irreversibly damaged. This increasingly common situation, the committee observes, brings with it several burdens: burdens on "patients who suffer permanent loss of intellect, on their families, on the hospitals, and on those in need of hospital beds already occupied by these comatose patients."(16) Some guidelines were therefore needed to determine when respirator support could reasonably be considered futile. Second, responding to new transplantation techniques, the committee sought to establish when organs could be harvested from bodies whose hearts and lungs were still healthy. It was undoubtedly seeking to forestall endless--and predictable--dilemmas by stipulating a new definition of death based on brain functioning. As the 1968 report drily notes: "Obsolete criteria for the definition of death can lead to controversy in obtaining organs for transplantation." While the Harvard committee's new criteria are certainly not free from an agenda--while they might even be described as metaphysical--they support a very different agenda from the one pursued by the criteria for "brain life."

We think the difference in agendas should be discussed openly, as part of the debate over "brain life," for only in this way can its full social significance be understood. As we noted above, the Harvard criteria aim at protecting not only brain-damaged patients, but also their relatives, doctors, and even other patients; in addition, the criteria allow doctors to obtain healthier organs for transplantation than would be otherwise possible. Indeed, the first state statute to incorporate brain criteria into a legal definition of death (Kansas Session of Laws of 1970, Ch. 378) cites the purpose of obtaining healthy organs from bodies declared dead. In contrast to such a law, the proposed "brain life" criteria seem to aim at protecting the fetus. "Brain life" proponents should at least acknowledge this aim as one of their interests--even, perhaps, as the most important.

Openly discussing the aim of protecting fetuses would require changing, if not abandoning, the case for "brain life." When Goldenring, Sass, and the others present it as based fundamentally on neurological development, and draw an analogy with brain death for support, they seriously misconstrue the significance of the 1968 Harvard committee report and the laws based on it. Quite clearly, the Harvard committee defined a set of biological criteria as death so as to address urgent problems having to do with brain-damaged patients: ethicists of course might still argue over a definition, but at least they would generally agree that a definition, not a scientific datum, is being debated. The same cannot be said about the advocates of "brain life," who treat personhood as a discovery that produces "conceptual clarity." They cloak a philosophical controversy in the robes of science and, thereby, conceal the difficult ethical issues at stake.

We turned in the previous section to the history of modern philosophy to explain why the "brain life" advocates place so much importance, along with a particular interpretation, on neurological data that alone could not explain the case for "brain life." What we are suggesting here is that the relevant social history must also be taken into account. Like all philosophical arguments, the case for "brain life" has a history, as much social as philosophical, against which it must be set to be fully understood. Yet the "brain life" advocates, hoping to make a scientific case, ignore the history and emphasize the neurophysiology, where an answer seems to lie. Nonetheless, the very idea of turning "inward" (toward "consciousness") to find a single, incontrovertible answer to a bundle of complex philosophical questions is characteristically modern--and metaphysical. Though people may well desire such an answer, and even "require" it implicitly, the answer does not necessarily exist.

A Metaphysical Trump

Present-day neurology recognizes a very complicated and marvelous picture of the development of embryo and fetus. One cannot study any of the relevant literature without a sense of wonder or awe at this almost incredible process that leads to the adult human. But this process, as amazing and wondrous as it is, does not automatically deliver up a definition of personhood.

First, a general problem from our perspective is the danger of identifying or locating the self within the brain. That is to say, given the arguments of Sass and Goldenring in particular, the brain takes on a role that is central in defining a human being and, consequently, the self. This leads to a scientized Cartesianism, which seems to locate the self "within" or confine it to the brain--the new pineal gland. Such a notion also suggests an exceptionally narrow concept of the self: it totally neglects the body and the social context in which one lives, although these are key dimensions of self-identity. "Brain life," in other words, trades on a solely biological understanding of the self. Such reductionism is based on physiological criteria that are self-referencing and again beg the questions that ethicists need to answer.

Second, pace Sass, we argue that it would be a mistake to base a Uniform Determination of Life Protection Act on "brain life." Such an act, according to Sass, would give "moral recognition and legal protection of human life from the presence of neuroneuronal connections in the pre-subplate or subplate zone to the absence of integrated brain functions, so that somatic death is imminent."(17) The primary error in such a proposal is yet another version of the naturalistic fallacy: moral protection is derived from neurological facts. Further, such a focus on neural criteria singles out for primary relevance the capacity for rationality. While this may cohere well with some traditions, it is not self-evident why only this criterion should have such a privileged position. Finally, there is the danger of assuming that if the developing life-form has not yet reached the legislated threshold, it is valueless. Such is not the case, however, for even though, in the case of the human pre-embryo and embryo, neuroconnections may not have appeared, these entities are still living members of the human species and have some value. Though such value can be overridden, doing so requires argument, not neurology used as a metaphysical trump.

From a strictly physiological point of view, Sass's proposal overlooks all the ways in which the end of life differs from its beginning. To consider just one example: the definition of death by brain criteria is a recognition of irreversible disintegration within the brain, whereas the emergence of brain activity--at whichever threshold one selects--is a sign of progressive neural integration. The disintegration might be instantaneous and final--as a result, say, of trauma--whereas the integration is always gradual, making the idea of discrete stages of neural development very dubious. Thus at a most profound physical level the concepts are neither symmetrical nor analogous. Nonetheless, we do not wish to suggest that physical data are irrelevant to the discussion of this and other related bioethical questions. In criticizing the notion of "brain life," we are arguing not against all uses of metaphysics in bioethical debate, but rather against metaphysics that masquerades as science. The "brain life" advocates behave much like an obstetrician who simply declares an infant with a penis and testicles to be of the male sex. But just as male gender bears socially constructed meanings that distinguish it from biologically male sex, so personhood is distinct from "brain life." Personhood cannot be discovered biologically, as it is a social and moral construct.

We think Flower has it right when he argues that although scientific criteria cannot determine personhood, nonetheless "such prior choices of criteria thereby condition the nature of our moral gaze" by showing us "when there emerges a nervous system of sufficient material complexity to embody those capacities (already) judged as morally pertinent."(18) So the presence of a single biological entity is the physical precondition for the presence of a person; a functioning nervous system is a presupposition for physical activity; an integrated nervous system is required for intellectual activity. But these biological realities neither guarantee the presence of nor constitute the definition of a person.

We have argued that "brain life" is based on notions that are unclear at best, such as "consciousness" and "self." The philosophical urge to discover where these notions "reside" in the body or the brain is not a new one, but in the course of the "brain life" debate it has disguised itself as a scientific project. If science really could find the answer to ethical problems by analyzing the brain, no one would object. But we think those who argue that science can find the answer, or that it already has, are not making a scientific argument at all. The argument is metaphysical, and none of the facts concerning neuromaturation will ever make it anything else.(19)


(1.) John M. Goldenring, "The Brain-Life Theory: Towards a Consistent Biological Definition of Humanness," Journal of Medical Ethics 11 (1985): 198-204.

(2.) Hans-Martin Sass, "Brain Life and Brain Death," Journal of Medicine and Philosphy 14 (1989): 45-59.

(3.) Thomasine Kushner, "Having a Life versus Being Alive," Journal of Medical Ethics 10 (1984): 5-8.

(4.) Carol A. Tauer, "Personhood and Human Embryos and Fetuses," Journal of Medicine and Philosophy 10 (1985): 253-66.

(5.) Michael V. L. Bennett, "Personhood from a Neuroscientific Perspective," in Abortion Rights and Fetal "Personhood," ed. Edd Doerr and James Prescott (Long Beach: Crestline Press, 1989), pp. 83-85.

(6.) See the remarks that Ludwig Wittgenstein makes about philosophy in Philosophical Investigations, trans. G.E.M. Anscombe (New York: Macmillan, 1953), particularly in [unkeyable] 58 and 116. Also see the discussion about metaphysics in P.M.S. Hacker, Insight and Illusion: Wittgenstein on Philosophy and the Metaphysics of Experience. (Oxford: Oxford University Press, 1972), pp. 179-82. Following Wittgenstein, Hacker makes the point that metaphysics blurs the dividing line between empirical and conceptual problems. As we argue in a later section, the "brain life" debate does the same. We are indebted to Burton Debren for his ideas on this subject.

(7.) Clifford Grobstein, "The Early Development of Human Embryos," Journal of Medicine and Philosophy 10 (1985): 213-36.

(8.) For related points about conceptual confusion, see Wittgenstein's remarks in the Investigations about psychology, p. 232. Also see [unkeyable] 485 in Zettel, ed. G.E.M. Anscombe and G. H. von Wright, trans. G.E.M. Anscombe (Oxford: Blackwell, 1967).

(9.) M. C. Shea, "Embryonic Life and Human Life," Journal of Medical Ethics 11 (1985): 205-9.

(10.) For a discussion of this picture, see Stephen Toulmin, "The Inwardness of Mental Life," in Critical Inquiry 6 (Autumn 1979): 1-16.

(11.) See, for example, the discussion of the modern notion of the mind in Richard Rorty, Philosophy and the Mirror of Nature (Princeton: Princeton University Press, 1979). Also see Bruno Snell, The Invention of the Mind (New York: Dover, 1956).

(12.) Saint Augustine, Confessions, trans. R.S. Pine-Coffin (Harmondsworth: Penguin Books, 1961), pp. 215-52.

(13.) For an example of this association, see Rorty, Philosophy and the Mirror of Nature, pp. 51-56.

(14.) On this point about Descartes' self, see Christopher Fox, Locke and the Scriblerians: Identity and Consciousness in Early Eighteenth-Century Britain (Berkeley and Los Angeles: University of California Press, 1989), ch. 1.

(15.) See Fox, Locke and the Scriblerians, p. 134, note 11; p. 28.

(16.) "Report of the Ad Hoc Committee of the Harvard Medical School Committee to Examine the Definition of Brain Death," JAMA 205 (5 August 1968): 337-40.

(17.) Hans-Martin Sass, "Moral Significance of Neuromaturation," Presentation, International Symposium on the Beginning of Human Life, University of Iowa, 4 November 1990, p. 25. Sass later published a revised text of this presentation under the title, "Brain Life Criteria and Abortion," Medizinethische Materialien 64 (Bochum: Zentrum fur medizinische Ethik, 1991): 1-35.

(18.) Michael Flower, "Neuromaturation and the Moral Status of Human Fetal Life," in Abortion Rights and Fetal "Personhood," p. 71-85.

(19.) Parts of this article are derived from Thomas A. Shannon, "The Moral Significance of Brain Integration in the Fetus," in Biomedical Ethics Reviews: 1991, ed. James Humber and Robert Almeder (Clifton, N.J.: Humana Press, 1991), pp. 123-44, and are used with permission of the editors.
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Author:Moussa, Mario; Shannon, Thomas A.
Publication:The Hastings Center Report
Article Type:Cover Story
Date:May 1, 1992
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