Nerve Cell

"The Decade of the Brain," so designated by an act of Congress, commenced on January 1, 1990, and proceeded with very little public fanfare—the public being almost unconscious of the fact.

But Congress did not act precipitously. Brain-related disorders account for the majority of long-term health costs and hospitalizations, more than almost all other diseases combined, with some fifty million Americans affected by a brain disorder yearly. Alzheimer's disease and other dementias, alcoholism, autism, bipolar disorder, serious brain injury, drug abuse, mood disorders, strokes, and schizophrenia are only a few of the 650 brain disorders that were to be addressed by a decade of advances in brain neurology, genetics, and pharmacology. Yet neither Congress, the public, nor religious and secular leaders realized that mapping the biochemical, molecular, and genetic structures of the brain would have such profound implications for our human identity and our religious understanding of the self.

Many of the distinguishing characteristics of human identity are intimately connected with the working of the brain, including imagination, memory, mood, reason, judgment, and consciousness—the self-awareness that provides a continuity of selfhood across our personal history. Views about these and other cherished values, such as individual responsibility, autonomy, and free will, are turned topsy-turvy in light of new thinking about the organization and function of the brain.

Ever since Aristotle rejected Plato's notion that the rational soul had its seat in the brain in favor of a heart-as-mind position, philosophers and theologians have pondered how the mind and brain work together. The prevailing theory of dualism (ŕ la Descartes), that the mind and brain are separate, comports well with the concept of the immaterial soul that is at the foundation of much religious doctrine. But what if the mind is not separable from the components of the brain? What would a new understanding of brain biology mean for religious traditions and practices?

As scientists sleuthed, dissected, and plotted a course to better understand the separate, but interrelated, modules of the brain, they recast our thoughts about the organization of the brain and its connection to human characteristics, such as reason, emotion, and consciousness. By visualizing brain activity through advanced imaging, such as PET scans, scientists better localized and understood the brain's division of labor. Specific memory, for example, occurs in the temporal lobe whereas memory about performing a skill transpires elsewhere. In this research, consciousness became connected with, if not reduced to the product of, environment, genetics, and physicochemical factors.

Such reduction reintroduces questions. Is the mind a collection of mental processes, or is it spirit beyond the physical brain? How does the brain, as master juggler, integrate the neural signals from the separate modules of the brain, and if the mind and brain are distinct, how do these two interact? Genetic, environmental, and physicochemical theories that describe mind/brain interaction abound—each with its own unsettling implications for religious traditions. For example, theories that give prominence to the effect of the environment on behavior, such as B. F. Skinner's behavioral psychology, see the brain as an empty organ—a passive conveyor of information from the environment. The external environment, not some transcendent immaterial spirit, controls consciousness. Others give prominence to genetics; in this view of the mind/brain relationship, behavior can be explained in the absence of conscious acts either by genes attempting to survive or altruistic organisms operating instinctively by kin selection.

Imagining our consciousness as a vast network of nerve cells, inseparable from the working of the brain, challenges even nonreligious views of transcendence, individual responsibility, autonomy, and free will. If our consciousness arises out of, and depends upon, neurological processes, several disturbing implications need to be considered. If there is a tight connection between consciousness and neurons, then it is possible to manipulate personal consciousness, for example through neural grafting. Does this cross a boundary by moving imperceptibly toward the possibility of mind control? Or, does the skintight link between consciousness and brain make us reimagine what it means for humans to reason and to give informed consent? Most importantly from a moral perspective, where the biological facts show consciousness bonded to biology, what does it mean to make choices, set your will toward the good and honorable, and be praised and blamed, rewarded and punished by friends and the state? Further, are brain diseases principally biochemical imbalances and neurological deficiencies or disorders of the spiritual mind? The answers to these questions may force religious traditions to rethink basic theology and pastoral implications.

The challenges posed by a new understanding of brain biology do not end here. The linkages among consciousness, genetics, and behavior have been controversial for some thirty years, starting with XYY chromosome tests for criminality and antisocial behavior. The controversy continues with studies that suggest genetic linkages to aggression, addiction, sexual orientation, and risk-taking personalities. These behaviors, often the focus of religious and secular approbation or condemnation, most likely require rethinking in the light of neurological facts. The implications of genetics, the brain, and behavior for self-identity and religious doctrine are nowhere more apparent than in the alleged identification of the "gay" gene. If homosexuality is genetic and the gene influences and perhaps regulates the brain, then homosexuality is natural and not learned or chosen. The ripples of this fact reverberate on many levels. If sexual orientation is an immutable natural characteristic, like race, gender, or height, might it require civil rights protections against unwarranted discrimination for jobs and housing? Or, if traditional views continue to disapprove the natural condition, might it pressure those who want children to prescreen and eliminate those fetuses that contain genes considered abnormal? Or again, how will those on the front line of religion and health negotiate traditional moral doctrines and pastoral practices about homosexuality in view of the advances in knowledge about the genetics/brain relationship?

Brain disorders compete amongst themselves and with other forms of illness for research and treatment dollars, generating a host of perennial ethical problems, including those related to equity and justice. Victims and caregivers incur heavy financial burdens from medical treatment, nursing homes, home care, and lost productivity, forcing choices about the allocation of medical resources.

Further successes in treating brain disorders—for example, slowing down a neurodegenerative disease, leading to better health or increased lifespan—intensify the terrible choice of prioritizing available treatments because it is unlikely that all illness can be addressed. Religious traditions will be stretched to provide reasonable guidance in doctrine and counseling for these tough equity choices.

Neuroscience research and the applications that follow will shake the foundations of social thought. The research stimulates renewed questions about the relationship among brain and mind, and may provide credence to some theories of human identity and undermine others. The study of brain chemistry helps explain behavioral patterns, personality, and a range of individual capabilities, such as artistic and mathematical abilities. Of course this knowledge challenges traditional beliefs. For the foreseeable future the facts about the brain/consciousness relationship will not be resolved, but health care professionals interested in body and spirit should consider the implications. Likewise, religious leaders need to imagine how their doctrines about transcendence and human dignity mesh with the emerging factual situation about the workings of the brain.