ROME – Perhaps one of the most pondered questions of all time concerns the existence of evil – what it is, why it exists, and why a loving God would permit it. Yet despite centuries of stroked beards, no clear answer has been found by philosophers and humanitarians who have delved into the topic.
This week psychiatrists, neurologists and priests took up the discussion again from a scientific view, asking whether there are such things as “good” and “evil” brains – and how, if at all, this intersects with faith.
According to Professor Stephen Stahl, who spoke during a Nov. 22 masterclass on psychopharmacology, the study of the impact of drugs on the mind and behavior, held at Rome’s Pontifical Regia Apostolorum University, there really is no clear answer to the question.
In an interview with Crux, Stahl, adjunct professor of psychiatry at the University of California in San Diego and an honorary fellow in the psychiatry department at the University of Cambridge, said the real question, from a scientific point of view, is “what’s the difference between being sick and being evil?”
“There are people who do bad deeds and they’re not really responsible for it because they’re so sick,” such as people with schizophrenia or hallucinations, he said, yet cautioned that this is not necessarily evil but “psychotic.”
Evil, he said, is something no one can really diagnose, but is widely understood to include forms of “evil behavior,” such as terrorism. They correspond closely with individuals who suffer from a psychiatric condition called “anti-social personality disorder,” Stahl said, meaning the people who give the term “psychopath” its medical definition.
Stahl, who is one of the leading researchers in psychiatry and psychopharmacology, and who will soon be publishing a book titled, Evil, terrorism and psychiatry, said real psychopaths are people who “don’t have a conscience, they don’t have empathy, but they can manipulate others and they can often be charismatic.”
Noting how around four percent of men and two percent of women suffer from the condition, he said the number is higher in prisons, because it’s easier for people who operate without a conscience to do things that land them there.
However, Stahl jested that those “are the stupid psychopaths,” while the “smart psychopaths” are politicians or people who end up as CEOs of companies.
“There is an over-representation of psychopaths who are highly successful because they’re ruthless, and it doesn’t bother them to hurt people to get to the top,” he said, adding that many terrorists are also in the group.
The real psychopaths, he said, are the ones who stay behind and call the shots, allowing others to take the blame if things go wrong.
Stahl said the behavior of priests and founders of religious orders or movements accused of various scandals and cult-like activities in recent years also in some ways aligns with the description of a psychopath.
Actions carried out by people who don’t have a conscience is close to a definition of evil, Stahl said, adding that in his view, evil “is more of a religious idea, but there is some overlap” with science.
Looking at the Catholic concept of the “seven deadly sins,” Stahl said many of them reflect real psychiatric disorders, such as sloth, which he said “is really probably a major depressive disorder. [These are] people who really just have no motivation, a lack of desire to take care of themselves.”
“Sometimes the way traditional religion has defined psychiatric disorders has been in moral terms,” he said, describing the discussion on evil and psychiatry as a tapestry in which “there’s a thread of brain going through it but there’s a thread of morals that go into it, and you can see it from both perspectives but it depends on the prism you’re looking through.”
Father Alberto Carrara, Coordinator of the Italian Research Group in Neurobioethics and a professor of philosophic anthropology and neuro-bioethics at Rome’s Pontifical Regina Apostolorum University, said that from the perspective of a believer, sin still has a role to play.
From a Christian view, evil “is the limitation and fragility that manifests itself, or can manifest itself, in psychiatric pathologies, which come from these wounds.”
Speaking to Crux, Carrara, who is also a fellow on the UNESCO Chair in Bioethics and Human Rights, said human nature “is wounded by sin, by evil,” and as a consequence of this wounded and fallen nature, mental and psychiatric disorders can develop.
Using the example of a guitar, he said not all of a person’s chords are always in tune. Noting that 25 percent of the population suffers from some sort of mental pathology or illness, with around two percent developing into a serious psychiatric pathology, he said faith tries to “illuminate” this phenomenon from the perspective of Christ, who came to save mankind from sin, “but it takes and welcomes scientific information, in this case, the data of psychiatry.”
According to Stahl, there ought to be a natural partnership between science and faith communities, but “too often scientists are basically not thinking in those terms. They’re so interested in the one tapestry they weave, just about rational and scientific, without really having a moral perspective.”
On the other hand, “sometimes the people with moral perspective don’t know their science very well,” he said, explaining that because of this, “it’s a very good marriage when they work together, because you can be secular to the point of trying to sterilize what you’re doing, but human suffering is something that has moral dimensions, it’s not just biological.”
Stahl said this convergence is especially useful on tough questions such as free choice when it comes to treatment, with psychiatrists often asking themselves when it is acceptable to “force” treatment on someone, and up to what point should a person be allowed to refuse treatment if they are potentially a danger to themselves or others.
In his comments to Crux, Carrara said the prisms of brain-versus-morals “must be complementary,” because “both together illuminate the human being,” and both in their own way seek to alleviate suffering, “which the Church tells us is important.”
Carrara, who is currently carrying out research on consciousness, addressed where the line is drawn between a person’s awareness of their actions and when mental illness begins.
The answer, he said, “is not simple, because the conscience contains multifaceted dimensions. We speak of conscience in a polysemous way, which has different levels and stratifications and complexities,” and there is also the question of exactly how much a pathology “can diminish this area of self-awareness.”
Noting there are both neurological and psychiatric syndromes which can potentially alter the state of a person’s consciousness and the perception they have of themselves and their environment, he said what is at stake in these cases is “integrity of the person.”
Carrara said practitioners must read psychiatric, genetic and neuroscientific data with a specific person in mind, since not everyone is the same and pathologies can manifest differently.
“It needs to be taken case by case, we cannot make a catalogue,” he said.
In terms of ethical parameters, Carrara said human dignity is first.
Among other things, this means making an evaluation of the risks versus benefits of a given treatment, he said, since there are both disorders and drugs “which alter and modify one’s personal identity.”
Another key ethical question, he said, involves social justice and “fairness of treatments,” since not all people have access to therapy or the right drugs.
“Not every case is mathematical, but every case must be taken in its globality,” he said, adding that because of this, “medicine is an art.”