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Brain Scanning the Las Vegas Shooter: An Exercise in Neurohubris

An article in the February 9, 2018, edition of The New York Times describes a post-mortem examination of the brain of Stephen Paddock, the madman who killed 58 people and injured hundreds more in the Las Vegas shooting in October 2017. The incident is the deadliest mass shooting by a lone gunman in American history.

The examination was conducted by Stanford University neuropathologist Hannes Vogel, M.D. The results were less than remarkable, but totally predictable. According to the Times, Dr. Vogel stated, “With a good deal of screening, I didn’t see anything” that could explain why Mr. Paddock became a calculating mass killer.

What does this exercise in brain scanning reveal? To me, it shows just how far down the path of medicalization we have gone. Everyone knows that a brain scan could never tell us why a person does something, especially something as evil and as tragic as mass murder. At best, a scan could reveal neurological disease, but of course the vast majority of patients with brain disease don’t commit mass murder.

A sociological analysis of this drive to identify the neurological cause of Paddock’s massacre reveals the ongoing medicalization of criminal—and evil—behavior. We are simply not satisfied with the explanation that a person can consciously and volitionally choose to do something evil. Instead, we must find the cause of the person’s conduct—and that cause, apparently, is to be found in the brain.

However, human behavior doesn’t have causes; it has reasons and motivations. When we separate volition from human behavior we deprive persons of agency and responsibility. There is, of course, no MRI or medical technology in the world that can reveal the reasons for human behavior. Only a person can tell us why he did what he did—not his brain.

What are the consequences of medicalizing criminality? When criminal behavior is said to be due to disease (or mental disorder), the offender becomes the victim, their behavior becomes explainable and even defendable, and we deprive the individual of responsibility and accountability for his actions. The criminal becomes sick instead of bad; his victims become the unfortunate targets of illness rather than of the criminal himself.

Let us stop pretending that all the secrets to understanding human behavior are to be found in the brain. Only then can we begin to make sense of these types of atrocities, and to hold those responsible accountable for their actions.

Brain Scanning the Las Vegas Shooter: An Exercise in Neurohubris

Mark L. Ruffalo, LCSW

Mark L. Ruffalo, LCSW, is a psychoanalyst in private practice in Tampa. He serves as an affiliate assistant professor of psychiatry at the University of South Florida, where he teaches courses on psychopathology, psychotherapy, and the history of psychiatry. His practice website is

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APA Reference
, . (2018). Brain Scanning the Las Vegas Shooter: An Exercise in Neurohubris. Psych Central. Retrieved on August 18, 2018, from


Last updated: 10 Feb 2018
Last reviewed: By John M. Grohol, Psy.D. on 10 Feb 2018
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