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When Does `Personhood` Begin? Teaching how neural development might inform the abortion issue. R. David Andrew Professor, Centre for Neuroscience Studies, Queen`s University, Kingston, ON, Canada K7L 3N6 [email protected] If the human brain was simple to understand, we’d be too simple to understand it. - Anonymous medical student If the human brain was simple to understand, we’d be too simple to understand it. - Anonymous medical student [email protected] RATIONALE The public and our lawmakers can use input from neuroscientists to make better informed decisions on abortion policy. An important question needs to be addressed: When does complexity? the developing brain take on human This presentation was created to provide information to students and the lay public about fetal brain formation and when `human` characteristics come on-line during fetal development. [email protected] The neocortex is comprised of several layers of nerve cells that cover the cerebral hemispheres. It is a vast interconnected network of several billion neurons. neocortex While the neocortex is only a few millimetres thick, flattened out it covers 3 square metres of brain surface. [email protected] Neocortex under the microscope Most of our cortex (the covering of the brain) has formed recently in evolution…hence the term ‘new’ or `neo`cortex Characteristics: • Pyramid- shaped (red) and star-shaped nerve cells arranged in 6 layers • Many nerve processes course vertically through neocortex • Appearance and function of neocortex varies depending on the region [email protected] Neocortical Histology Different staining techniques reveal different neuronal components of the 6 layers. -from Nolte, The Human Brain, Mosby Elsevier The neocortex and information flow… [email protected] First, `Primary` neocortical regions (in color) receive sensory information (seeing, hearing, touch, pain) about our surroundings. [email protected] - Netter`s Concise Neuroanatomy, Saunders Then… `Primary` sensory areas relay information to their own `association` areas about sight (blue), hearing (purple) and touch/pain (green). - from Nolte, Neuroscience, Elsevier [email protected] Then… the association areas relay their information (black and blue arrows) to higher association areas. These areas then send their highly integrated sensory and emotional information to the motor regions (red arrows) that control our muscles. [email protected] In this way, we respond to complex sensory information with the proper motor actions. -from Nolte, Neuroscience, Elsevier To summarize… Receives sensory information [email protected] Integrates that information Controls appropriate motor responses -from Nolte, The Human Brain, Mosby Elsevier The computations of the vast cellular network that comprises the neocortex are responsible for our distinctly human traits: • complex language • precision movements of the hands and eyes • incredible memory storage • the power of forethought How do we know this? 1) Certain neocortical regions have clear relationships with these human traits… [email protected] For example, certain neocortical regions are indispensible for language… Broca‘s area contains motor programs with instructions for speaking Wernicke‘s area contains neurons for the formulation of language Destruction of Wernicke's area leaves Broca's area unchecked, so that words can be produced without regard for their meaning. -from Nolte, The Human Brain, Mosby Elsevier [email protected] Frontal neocortex is associated with mood, planning, social skills In the patient above, the frontal cortex was damaged by an explosion that blew an iron bar into his head. The subject lived, but with severe disturbances to his mood as well as his abilities to make plans and to properly socialize. [email protected] -from Nolte, The Human Brain, Mosby Elsevier Frontal neocortex is also associated with… (judging emotional states) [email protected] -from Nolte, The Human Brain, Mosby Elsevier 2) We lose our intelligence and memory when large areas of neocortex are damaged. For example, the victim of Alzheimer’s disease suffers a progressive degeneration of the neocortex. So many nerve cells eventually wither away, that the brain’s surface literally shrivels up. The result is a slow but steady fading of memories that once spanned an entire lifetime. neocortex While no one would argue that a patient with advanced dementia is no longer a human being, their four distinctly human traits noted earlier are severely compromised. [email protected] 3) Human traits cannot arise unless the neocortex develops. Some babies are actually born without a neocortex. By a cruel developmental accident, the cells destined to become neocortical neurons fail to flourish. The result is a newborn brain as smooth as a rabbit’s or rat’s. These Lissencephalic (smooth-brained) infants remain profoundly mentally retarded. [email protected] 4) Really smart animals have lots of neocortex Consider why your dog does not watch World Federation Wrestling or access the Home Shopping Network. It’s because only the most highly evolved animals possess the extensive neocortex required for such complex tasks. The proliferation is most obvious in the primates (monkeys, humans) and cetaceans (whales, dolphins), the mammals known for their impressive social interactions and communicative skills [email protected] 5) Ontogeny (fetal development) repeats phylogeny (evolutionary development). That is, the embryonic development of an individual organism (its ontogeny) follows a similar path as the evolutionary history of its species (its phylogeny). Our arms have similar (homologous) components that have evolved different functions in different mammals... [email protected] -from Nolte, The Human Brain, Mosby Elsevier 5) Ontogeny repeats phylogeny…con`d human In particular, the cerebral hemispheres (gray) have expanded greatly in humans… Likewise, most parts of the brain have homologues that have evolved differently in each mammal... rat [email protected] -from Nolte, The Human Brain, Mosby Elsevier 5) Ontogeny repeats phylogeny…con`d It turns out that the development of the neocortex in the human fetus wonderfully reflects … …our evolutionary development, a concept that biologists term “ontogeny repeating phylogeny” The more advanced the neocortical development, the more advanced the animal. [email protected] Increasing intelligence Ontogeny repeats phylogeny…con`d There is some scientific controversy here. The German zoologist Ernst Haeckel oversimplified the concept…and presented some bogus fetal drawings to support it. Nevertheless, any biology student taking undergrad Embryology can site examples (fetal development of the heart, of the major blood vessels, of the kidneys) where the system`s evolutionary history is apparent. See http://en.wikipedia.org/wiki/Recapitulation_theory 6) A 3-month human fetus is not very smart. Why is that? [email protected] 9 months First, the fetal brain grows roughly in proportion to the body... [email protected] 4.5 months gestation 7 months gestation 6 month old infant III V III V 200 μm Second, the neocortical connections among neurons only start forming at ~4 months gestation… [email protected] III V Third, dendritic spines, which receive input from other neurons, only become apparent at ~5 months gestation. Branching patterns of hippocampal neurons of human fetus during dendritic differentiation. Paldino AM, Purpura DP. Exp Neurol. 64:620-31 (1979) [email protected] Note that nerve cell development in neocortex starts in the mid-gestational months, but continues at a phenomenal rate, even following birth… [email protected] -from Nolte, The Human Brain, Mosby Elsevier The cerebellum helps provide smooth, coordinated body movement The cerebellar cortex also starts forming late…at about 12 weeks (~3 months) gestation. Again, it takes many months for the neurons to make their proper connections. -from Nolte, The Human Brain So for the preceding six reasons, the neocortex is considered to be responsible our distinctly human traits of: 9 complex language 9 precision movements of the hands and eyes 9 incredible memory storage 9 and the power of forethought. It is commonly (and mistakenly) believed that the brain is well established early in human fetal development… …actually at 7 weeks gestation, it`s only the size of a pin-head. So where does this idea come from ? [email protected] First, textbooks and websites usually do not accurately portray how small the first trimester brain actually is…the figures are usually illustrated to show detail rather than proportion. Disproportionate Proportionate 25 days Nine months [email protected] Nine months Second, the Internet can spread mis-information… From The Pregnancy Care Center http://www.pcceureka.org/ Day 20 “Foundations” (my quotes) of the brain, spinal cord vague and nervous system are already established. Day 21 The heart begins to beat. Day 28 The backbone and muscles are forming. Arms, legs, eyes and ears have begun to show. Day 30 The heart is pumping increasing quantities of blood through the circulatory system. Day 35 Five fingers can be discerned in the hand. Day 40 Brain waves can be detected and recorded. [email protected] x Brain waves are not detectable at 40 days gestation. Remember, the brain is the size of a pin-head at that time point… In fact...EEG recording in the premature infant indicates that the neocortex is not actively involved in perceiving what we see until gestational weeks 34-36. Colonnese, M. et al. Developmental switch in sensory signal processing in visual cortex prior to the onset of vision. Society for Neuroscience Meetings 2008, abstract 724.8 Third, ultrasound images graphically reveal the little heart beating, fingers and toes developing, and limbs moving in space. Yet these developmental milestones do not require higher brain function. The heart pumps on its own and muscles contract in response to commands from the spinal cord. [email protected] It is not until gestational months 5-6 that our brain regions that drive awareness and the conscious control of movements even begin to hard-wire. [email protected] Many lay people seem comfortable with the notion of a human being instantly created at conception. However this presentation has discussed evidence that our brain`s transition toward `personhood` if you like, is gradual and immensely intricate. In the first trimester there is no neocortex. By the third trimester, the fetal neocortex is accelerating toward the unimaginable complexity seen in the full-term infant. It is the development of the neocortex in the last half of gestation that is absolutely essential for our human qualities to emerge. [email protected] Clearly the period when we acquire our `personhood` is not a discrete time point, but spans many weeks during mid-gestation. It is not a sudden event. By using our understanding of brain development, neuroscientists are well positioned to inform lawmakers and the public on abortion guidelines. Why is no one asking? [email protected] Neuroscientists speak The anti-abortion movement's members would have us believe that their concern for fetal life is derived from a broad base of respect for human life and a concern for human pain, suffering, and violence. The production of the film The Silent Scream is an attempt to dramatize those concerns by illustrating alleged fetal pain and suffering during an abortion procedure. The perception of pain is a complex biological and psychological phenomenon that involves states of "consciousness" which can probably never be fully understood or known for certain stages of fetal development. Relevant to this inquiry are certain neurobiological and biobehavioral facts concerning states of "consciousness" and "pain" perception during fetal development that should be known by all concerned citizens. Patricia A. Jaworski has produced an audio tape, "Thinking About the Silent Scream," in which she interviews several internationally renowned neuroscientists on fetal brain development, the alleged fetal perception of "pain," and alleged fetal "personhood." Some of the highlights of those interviews are summarized in the following paragraphs. Dr. Michael Bennett, chairman of the neuroscience department of Albert Einstein Medical School, when asked whether a brain exists at conception and whether there can be a person without a brain, answered with an unequivocal "no!" to both questions. It was pointed out that the human brain has approximately 100 billion brain cells and that there are an estimated 100 trillion connections between neurons in the brain. This extraordinary neuronal "interconnectivity" provides the neurostructural foundation for complex perceptions and "personhood" and takes many months and often years to fully develop and function. Dr. Patricia Goldman-Rakic, professor of neuroscience at Yale University Medical School (deceased), emphasizes that brain neurons do not exist prior to four weeks in utero, that the peak period for brain neuron development is from two to five months in utero, and that the existence of neurons, per se, does not indicate the existence of a developed, functioning brain. Once the brain cell is born, there is a long process of migration of brain cells that occurs mainly from two to six months in utero during which the brain cells move (migrate) to their final destination in the brain. An even longer process of development makes possible the "interconnectivity" of brain cells which is absolutely essential for sensation, perception, conscious experience, thought, and behavior. The formation of brain synapses that make possible brain cell communication does not begin until about the third month in utero, and most are formed after birth. …CON`D ….CON`D Dr. Clifford Grobstein, former chairman of the Department of Biology at Stanford University and now at the University of California at San Diego, highlights the complexity of brain development by noting that the brain does not develop uniformly. For example, certain parts of the brain develop earlier and some later. The cerebral neocortex that is responsible for complex perceptions is one of the last to develop. Dr. Dominick Purpura, dean of Albert Einstein Medical School, has been studying human brain development since 1974 with his research on mental retardation. Dr. Purpura emphasizes that there are a minimum number of neurons and synaptic connections that are necessary before the qualities of "humanness" and "personhood" can be developed and that this capacity begins to occur in the middle of the last trimester. Thus, about twenty-eight to thirty weeks in utero is the minimal time for the beginning of this capacity—"It can't begin earlier," according to Dr. Purpura. Dr. Purpura also emphasizes that critical changes are seen in the fetal brain wave pattern at thirty-one weeks when the brain waves become more organized and, thus, meuninglul; the first signs of sleep and wakefulness are not observed until a few weeks later. It is emphasized that all cells have electrical potentials and that the mere presence of such signals, per se, does not mean that the capacity for complex perceptions or "personhood" exists. How these neuronal signals become organized and reflect underlying neuronal and structural organization is fundamental to understanding the basic neurobiological pnnciple that structure precedes function. Thus, it can be concluded that neither pain perception nor personhood exists at conception and that the capacity for personhood may only begin at twenty-eight to thirty weeks in utero. ----------------------------------------------------------------------------------------------------------------------------------------Appendix C in Doerr, Edd and Prescott, James W. (Eds.): Abortion Rights and Fetal 'Personhood', 2nd Ed. Long Beach (1990); originally published in The Humanist, September/October l986.