Abstract
Neuroethics, the ethical analysis of questions raised by scientific research on human brains, is concerned with both the ethics of neuroscientific practices and what scientific research reveals about human ethics. Because it was only during the last century that the development of neuroscientific technologies made it possible to study the living human brain, the field of neuroethics is relatively new and open to multidisciplinary perspectives. Within neuroethical discourse, there has been a noticeable absence of theological perspectives: theologians do not attempt to address neuroethics, and neuroethics avoids theology. In this novel and interdisciplinary work, Neil Messer brings a Christian theological voice into neuroethical conversation. Messer’s thoroughly researched book argues centrally that neuroethics makes claims that intersect with the concerns of theology, and therefore that both fields can benefit from the insight and reflection of mutually critical dialogue. Each chapter raises a neuroethical dilemma that is then set in dialogue with a theological perspective, that of ‘a broadly Reformed Protestant tradition’ (p. 11). Messer manages the difficult task of succinctly balancing the presentation of neuroscientific, philosophical and theological conceptual information with interdisciplinary analysis. It is Messer’s coherent integration of this material that allows a non-scientist to join the neuroethical conversation from a theological perspective, while also considering trajectories for future engagement between the disciplines.
As current activity in the International Neuroethics Society demonstrates, the field is broadly comprised of medical practitioners, neuroscientists, psychologists, philosophers, members of ethics boards, lawyers and academics. Neuroethical discourse is immense and has porous disciplinary boundaries, yet Messer faithfully represents this heterogeneity by engaging rigorously and critically with a diverse array of issues across the field. To traverse this landscape, Messer introduces a primarily Bonhoefferian perspective as a counterpart to scientific research that raises questions about free will, moral decision-making, personal responsibility, patient care and brain modifications. He suggests that scientific findings that appear to have significant implications for understanding the human condition may alternatively be interpreted in light of theological reasoning. Although this book incorporates other theological voices, such as Barth and Augustine, it is Messer’s integration of Bonhoeffer’s theology with the causally-deterministic implications of empirical research that makes his work a solid and unique contribution to the field of neuroethics. Without resorting to a complete dismissal of the physicalist presuppositions of brain research, Messer offers theological perspectives that constructively approach the implications of this research from a new angle. For the reader who has struggled to reconcile neuroscientific and theological portraits of the human condition, Messer’s irenic approach is a helpful reminder that humanness can never be fully described by one discipline alone.
Messer acknowledges that theology has not been a welcome disciplinary partner in neuroethical discussions. Although theology is more often neglected than outright rejected, it is neuroessentialist and reductionist approaches to religion that most likely have led neuroethicists to refrain from inviting the theological voice into conversation. To address this problem, Messer examines the methods of three scientific approaches to religion: (1) the cognitive science of religion (CSR); (2) evolutionary theories about religious beliefs; and (3) neuroscientific attempts to locate religion within the brain. While Messer is thoroughly in agreement with the scientific method as a means to acquire knowledge about the empirical world, he contends that these scientific approaches do not fully account for theological reasoning or argument. Instead, he argues that science can better engage with theology as a disciplinary partner where theology can make use of its own resources and methods to address a question (pp. 16–17). This partnership is the goal of Messer’s work, yet he describes his intended interdisciplinary approach as asymmetrical: both science and theology will make a contribution to understanding neuroethics, but theology is given the dominant role. This is a bit surprising, given the initial work that Messer has to do to demonstrate that theology is a viable neuroethical conversation partner. He contends that this asymmetrical approach will ‘redress that balance’ in which the theological voice has been absent from neuroethics, and it will further demonstrate whether theology has suitable resources to contribute to neuroethics (pp. 36–37). It turns out that most of the book’s analysis is equally balanced between neuroethics and the theological perspective. Those readers who are hoping for a ‘theological neuroethics’, in which both fields equitably advance the dialogue, will not be disappointed.
After two chapters that introduce the book and establish its methodology, there are four chapters divided into two pairs according to philosopher Adina Roskie’s distinction between a ‘neuroscience of ethics’ and an ‘ethics of neuroscience’ (pp. 2, 12), and then a conclusion. Messer’s choice to follow Roskie’s division is a helpful schematic for those readers unfamiliar with the scope and depth of the field of neuroethics. Readers who pick up this book expecting to find a theological critique of neuroscientific brain modifications may be surprised to encounter philosophical discourse on free will, psychological studies on moral judgment, and reflections on the sin of addiction. Messer’s use of Roskie’s distinction allows audiences to know which chapters they may be interested in pursuing further: chapters 3 and 4 address the ‘neuroscience of ethics’, raising questions about moral judgment, free will, and responsibility; chapters 5 and 6 focus on the ‘ethics of neuroscience’, looking at disorders of consciousness and brain modifications. While the book as a whole makes the most compelling case for a ‘theological neuroethics’, each chapter can successfully be read as a stand-alone piece and would therefore make excellent reading for weekly seminar discussions.
Some of Messer’s theological perspectives align quite closely with his chosen neuroethical interlocutor’s perspective. One example is Messer’s rather surprising endorsement of psychologist Joshua Greene’s neuroscience of moral decision-making. Greene’s functional imaging studies underlie his controversial claim that utilitarianism should serve as a ‘metamorality’ to overcome group ‘tribal’ morality (pp. 39–42). While Messer identifies problematic ways in which these studies devalue human moral reasoning (pp. 47–50), he suggests that Greene’s scientific research may be ‘an unexpected ally to the theological suspicion of the human project of ethics expressed by theologians such as Bonhoeffer and Barth’ (p. 40). Messer contends that, if Greene’s data accurately reflect a human tendency to justify moral intuitions after they are made, this finding can be interpreted through the theological lens of a sinful tendency to become sicut deus (like God). In other words, the human desire to rationalize choices within a moral framework is attributable to the fallenness of human nature, rather than to the ‘good’ human creatureliness that God intended. Like Greene’s contentious claim for a metamorality, Messer’s critique of ethics as an innately fallen human endeavor is not without its own problems. While Messer argues for overcoming the sicut deus tendency through a Christ-like alignment with the will of God, he does not provide a meaningful way to distinguish the will of God from a post hoc moral rationalization. Thus, Messer’s theological interpretation is no less debatable than Greene’s proposition. Messer does not believe that neuroscientific studies will demonstrate the need to supersede the human ethical project, yet he posits that a Bonhoefferian theological account ‘will of course endorse Greene’s final precept, [namely] to give charitably as a way of partially overcoming the inbuilt weakness of sympathy with distant strangers’ (p. 69). Although Messer does not accept Greene’s claim for a utilitarian metamorality, his theological perspective resounds with appreciation for Greene’s project: Messer and Greene share a desire for neighborly harmony that overcomes judgmental conflict through collaboration and conversation.
While the book’s theological perspective primarily stays within the Reformed Protestant tradition, Messer also explores Pope John Paul II’s magisterial documents on life-sustaining treatment in order to address the neuroethics associated with ‘disorders of consciousness’ (DoCs). Within these Catholic documents, the language of persons as ‘bearers of rights’ is significant for moral discussion: at stake in neuroscientific studies of people with DoCs are questions about human personhood. After surveying recent neuroscientific studies on persons with DoCs, Messer raises difficult questions about how to care for persons who live in a liminal state of ambiguous conscious awareness. Because consciousness is not necessary for life processes, the criterion of personhood is frequently brought into ethical debates over end-of-life care. Yet Messer contends that personhood is not a helpful conceptual category for determining medical treatment, since individuals who are impaired or disabled may be capacity-limited but still retain personhood. In order to bypass the language of personhood and rights, Messer turns directly to Scripture. He proposes Jesus’ parable of the Good Samaritan as a paradigm for ethical action towards patients with DoCs, implicitly drawing a parallel between the parable’s question, ‘Who is my neighbor?’, and the contemporary question, ‘Is this patient a person?’ Both questions are answered with a call to act with ‘love and mercy’ (p. 141). For caregivers of patients with DoCs, this may include caring for the body, reducing pain and discomfort, and making prudent end-of-life decisions. Despite Messer’s call to compassion and patient-centered treatment, it is not clear how a Good Samaritan ethic assists in the serious matter of determining when it is appropriate to remove a patient from life support. For example, if two moral caregivers disagree regarding prudent end-of-life care for a patient, the parable ceases to be helpful. Yet the shortcomings of a Good Samaritan ethic could be remedied in conversation with resources beyond the Bible, the Reformed Protestant tradition, and Catholic magisterial documents. By taking advantage of the multidisciplinary nature of neuroethical dialogue, it may be possible further to develop the Good Samaritan paradigm with input from other disciplines so that it can be a more effective ethical tool for critical medical decision-making moments.
As new neurotechnologies and cognitive enhancement remedies become increasingly available and less stigmatized in the Western marketplace, more voices are joining the chorus of opinions on whether such brain modifications are ethical. Messer adds a theological perspective to these voices by addressing the ethics of neurotechnologies, including pharmacological cognitive enhancements, transcranial and deep brain stimulation, brain-computer interfaces, neural stem cell therapies, and medications that may inadvertently modify the brain. Messer aligns his position on brain interventions with that of political philosopher and bioethicist Michael Sandel, who draws a sharp distinction between cognitive therapy and enhancement. For both Sandel and Messer, brain enhancement is morally questionable, since human arrogance threatens to motivate a desire for god-like perfection. Moving beyond Sandel’s distinction between therapy and enhancement, Messer offers several diagnostic questions to determine how a proposed cognitive modification fits the Christian narrative. The first question is exceptionally helpful for interpreting neurotechnologies theologically: it asks whether a cognitive modification attempts to restore the imago dei or to become sicut deus. I see this as useful for sorting through the ethical ambiguity of new neurotechnologies that are rapidly moving from the medical context into the everyday sphere. For example, one recent innovation is MIT’s ‘AlterEgo’, an intelligence-automation headset that allows an individual to communicate via computer without audibly speaking or using detectable movements. Using Messer’s diagnostic criterion, it is possible to envision this device’s potential to restore the imago dei for individuals who, due to illness or accident, have lost their ability to talk using vocal cords. However, if this technology were placed on an unwilling wearer, such as a criminal or a prisoner of war, the owner of the ‘AlterEgo’ would become sicut deus, capable of hearing and (mis)interpreting their private self-talk. This application of Messer’s diagnostic question to contemporary neurotechnology demonstrates the way in which cognitive modifications can be delineated for a uniquely theological neuroethics. Thus, Messer’s theological framework makes a distinct contribution to neuroethics by offering an alternative to the therapy and enhancement dichotomy.
By demonstrating ways that a theologian can bring rigorous, informed scholarship into meaningful discussion with neuroscientific research, Messer has opened the door for other theological perspectives to contribute to important discussions on growing topics such as military applications of neuroenhancements, the use of neuroimaging in law and criminal justice, equity in access to neurotechnology, and the interaction between neuroscience and animal ethics. Messer’s in-depth interdisciplinary dialogue is a summons to theologians to engage with neuroethics and to push the dialogue into areas beyond those discussed in his book.