BackgroundIn the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort, participants underwent magnetic resonance imaging (MRI) of the brain, heart, and abdomen, that generated incidental findings (IFs). The approach to managing these unexpected results remain a complex issue. Our objectives were to describe the CAHHM policy for the management of IFs, to understand the impact of disclosing IFs to healthy research participants, and to reflect on the ethical obligations of researchers in future MRI studies.MethodsBetween 2013 and 2019, 8252 participants (...) (mean age 58 ± 9 years, 54% women) were recruited with a follow-up questionnaire administered to 909 participants (40% response rate) at 1-year. The CAHHM policy followed a restricted approach, whereby routine feedback on IFs was not provided. Only IFs of severe structural abnormalities were reported.ResultsSevere structural abnormalities occurred in 8.3% (95% confidence interval 7.7–8.9%) of participants, with the highest proportions found in the brain (4.2%) and abdomen (3.1%). The majority of participants (97%) informed of an IF reported no change in quality of life, with 3% of participants reporting that the knowledge of an IF negatively impacted their quality of life. Furthermore, 50% reported increased stress in learning about an IF, and in 95%, the discovery of an IF did not adversely impact his/her life insurance policy. Most participants (90%) would enrol in the study again and perceived the MRI scan to be beneficial, regardless of whether they were informed of IFs. While the implications of a restricted approach to IF management was perceived to be mostly positive, a degree of diagnostic misconception was present amongst participants, indicating the importance of a more thorough consent process to support participant autonomy.ConclusionThe management of IFs from research MRI scans remain a challenging issue, as participants may experience stress and a reduced quality of life when IFs are disclosed. The restricted approach to IF management in CAHHM demonstrated a fair fulfillment of the overarching ethical principles of respect for autonomy, concern for wellbeing, and justice. The approach outlined in the CAHHM policy may serve as a framework for future research studies.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/nct02220582. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient’s interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians (...) have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. (shrink)

With the publication of the final report of the WHO Commission on the Social Determinants of Health, it becomes clear that there is considerable convergence between a policy agenda rooted on social epidemiology and one rooted in a concern for human rights. As commentators like Jonathan Mann have argued, concern for human rights and the achievement of social justice can inform and improve public health. In this article, we ask a different question: what does a health perspective adds to the (...) enduring fight for a more just world? We consider three possibilities: (1) that public health, in an inversion of Mann's argument, actually provides useful tools for specifying social injustice; (2) that, contrary to the usual critical stance and assumption of weakness, the institutions of public health bring powerful capacities to the practical promotion of social justice; and (3) that health as a banner mobilizes people who would not be mobilized to act in the name of social justice. (shrink)

With the publication of the final report of the WHO Commission on the Social Determinants of Health, it becomes clear that there is considerable convergence between a policy agenda rooted on social epidemiology and one rooted in a concern for human rights. As commentators like Jonathan Mann have argued, concern for human rights and the achievement of social justice can inform and improve public health. In this article, we ask a different question: what does a health perspective adds to the (...) enduring fight for a more just world? We consider three possibilities: (1) that public health, in an inversion of Mann's argument, actually provides useful tools for specifying social injustice; (2) that, contrary to the usual critical stance and assumption of weakness, the institutions of public health bring powerful capacities to the practical promotion of social justice; and (3) that health as a banner mobilizes people who would not be mobilized to act in the name of social justice. (shrink)

The ultimate challenge for psychology as a human science inheres in accessing the experience of the other. In general, the field of psychology has perpetuated the epistemological dualism of distinguishing between the realm accessible by external perception and the realm accessible by inner perception, and hence between the subjective and the objective , regarding the "first person" perspective as a legitimate means of access only to one's own private experience, while insisting that all others' experience must be observed from a (...) neutral "third person" perspective. By reflecting on his participant-observational encounters with the animal other of the Bonobo, the author attempts to demonstrate in this paper the possibility of a third approach between the antinomy of methodological subjectivism and methodological objectivism as a way out of the dilemmas posed by epistemological dualism. The alternative proposed is the "second person" framework of observation, which, by invoking empathic seeing as its means of accessing the private space of the other and creating the space of the "in between", allows for intersubjective engagement in an experiential gestalt consisting of "myself and the other", and offers the possibility of testing one's ‘own' experience of an intersubjective moment in dialogue with the other. In so far as it infers the focusing of consciousness on embodied experience and expression, and the synthesis of receptive and proprioceptive consciousness in "experiaction" , the "second person" perspective restores inner reality to the realm of the observable, and thus reclaims observation as the method of psychology, and behaviour as its subject matter. The notion of empathy and intuition as a reliable and valid mode of access to the psychological life of others is substantiated theoretically with reference to inter alia Husserl's concepts of "coupling" and "co-constitution", Merleau-Ponty's notions of "inter-corporeality" or "carnal intersubjectivity" and of "the intertwining and the chiasm" of the "Ineinander" as constitutive of the "flesh of the world", Laing's postulation of the possibility of "interexperience", and the sense of union with the object of perception implied by Scheler's term "Einsfühlung" as the essence of intersubjective encounter. (shrink)

Richard Thaler and Cass Sunstein, in Nudge: Improving Decisions About Health, Wealth, and Happiness, assert that rejecting the use nudges is ‘pointless’ because ‘[i]n many cases, some kind of nudge is inevitable’. Schlomo Cohen makes a similar claim. He asserts that in certain situations surgeons cannot avoid nudging patients either toward or away from consenting to surgical interventions. Cohen concludes that in these situations, nudging patients toward consenting to surgical interventions is uncriticizable or morally permissible. I call this argument: The (...) Unavoidability Argument. In this essay, I will respond to Cohen's use of the unavoidability argument in support of using nudges during the process of informed consent. Specifically, I argue that many so-called ‘unavoidable nudges’ are, in fact, avoidable. Although my argument is directed toward Cohen's use of the unavoidability argument, it is applicable to the unavoidability argument more generally. (shrink)

No one who attended the 2010 national public health law conference hosted by the Public Health Law Association and the American Society of Law, Medicine & Ethics could miss the sense of excitement and momentum. The revival of this annual public health law meeting, with the support of the Robert Wood Johnson Foundation, the energetic leadership of the PHLA president and board, ASLME’s expert guidance, and a rousing address by Dr. Tom Frieden, Director of the Centers for Disease Control and (...) Prevention, symbolize the continued commitment of a wide range of important individuals and institutions to the proposition that law is of substantial importance to public health. But there is more than just symbolism to be excited about. CDC’s public health law program continues to champion efforts to promote the use and understanding of law as a public health tool. (shrink)

No one who attended the 2010 national public health law conference hosted by the Public Health Law Association and the American Society of Law, Medicine & Ethics could miss the sense of excitement and momentum. The revival of this annual public health law meeting, with the support of the Robert Wood Johnson Foundation, the energetic leadership of the PHLA president and board, ASLME’s expert guidance, and a rousing address by Dr. Tom Frieden, Director of the Centers for Disease Control and (...) Prevention, symbolize the continued commitment of a wide range of important individuals and institutions to the proposition that law is of substantial importance to public health. But there is more than just symbolism to be excited about. CDC’s public health law program continues to champion efforts to promote the use and understanding of law as a public health tool. (shrink)

In this essay I discuss a novel engineering ethics class that has the potential to significantly decrease the likelihood that students will inadvertently or unintentionally act unethically in the future. This class is different from standard engineering ethics classes in that it focuses on the issue of why people act unethically and how students can avoid a variety of hurdles to ethical behavior. I do not deny that it is important for students to develop cogent moral reasoning and ethical decision-making (...) as taught in traditional college-level ethics classes, but as an educator, I aim to help students apply moral reasoning in specific, real-life situations so they are able to make ethical decisions and act ethically in their academic careers and after they graduate. Research in moral psychology provides evidence that many seemingly irrelevant situational factors affect the moral judgment of most moral agents and frequently lead agents to unintentionally or inadvertently act wrongly. I argue that, in addition to teaching college students moral reasoning and ethical decision-making, it is important to: 1. Teach students about psychological and situational factors that affect people’s ethical judgments/behaviors in the sometimes stressful, emotion-laden environment of the workplace; 2. Guide students to engage in critical reflection about the sorts of situations they personally might find ethically challenging before they encounter those situations; and 3. Provide students with strategies to help them avoid future unethical behavior when they encounter these situations in school and in the workplace. (shrink)

In this essay, I suggest that a slightly modified version of Freedman’s formulation of the clinical equipoise requirement is justified. I begin this essay with a brief discussion of the equipoise r...

Many psychological studies of categorization and reasoning use undergraduates to make claims about human conceptualization. Generalizability of findings to other populations is often assumed but rarely tested. Even when comparative studies are conducted, it may be challenging to interpret differences. As a partial remedy, in the present studies we adopt a 'triangulation strategy' to evaluate the ways expertise and culturally different belief systems can lead to different ways of conceptualizing the biological world. We use three groups (US bird experts, US (...) undergraduates, and ordinary Itza' Maya) and two sets of birds (North American and Central American). Categorization tasks show considerable similarity among the three groups' taxonomic sorts, but also systematic differences. Notably, US expert categorization is more similar to Itza' than to US novice categorization. The differences are magnified on inductive reasoning tasks where only undergraduates show patterns of judgment that are largely consistent with current models of category-based taxonomic inference. The Maya commonly employ causal and ecological reasoning rather than taxonomic reasoning. Experts use a mixture of strategies (including causal and ecological reasoning), only some of which current models explain. US and Itza' informants differed markedly when reasoning about passerines (songbirds), reflecting the somewhat different role that songbirds play in the two cultures. The results call into question the importance of similarity-based notions of typicality and central tendency in natural categorization and reasoning. These findings also show that relative expertise leads to a convergence of thought that transcends cultural boundaries and shared experiences. (shrink)

Argumentation as the public exchange of reasons is widely thought to enhance deliberative interactions that generate and justify reasonable public policies. Adopting an argumentation-theoretic perspective, we survey the norms that should govern public argumentation and address some of the complexities that scholarly treatments have identified. Our focus is on norms associated with the ideals of correctness and participation as sources of a politically legitimate deliberative outcome. In principle, both ideals are mutually coherent. If the information needed for a correct deliberative (...) outcome is distributed among agents, then maximising participation increases information diversity. But both ideals can also be in tension. If participants lack competence or are prone to biases, a correct deliberative outcome requires limiting participation. The central question for public argumentation, therefore, is how to strike a balance between both ideals. Rather than advocating a preferred normative framework, our main purpose is to illustrate the complexity of this theme. (shrink)

This article examines the thoughts and works of Catholic philosopher Jacques Maritain and evangelical philosopher Norman Geisler in light of their understanding of Thomas Aquinas’s view of faith and reason.

Reviews the special issue of The Humanistic Psychologist, Psychotherapy for freedom: The daseinsanalytic way in psychology and psychotherapy edited by Erik Craig . The editor brings together a uniquely developed collection of essays, seminars, and interviews delving into foundational as well as clinically-oriented issues regarding the application of Martin Heidegger's philosophy to the fields of psychiatry and psychotherapy. Craig's edition exhibits a cohesiveness not often found in edited volumes, and it manages to be inspiring to the more advanced reader while (...) remaining accessible to the introductory student. 2012 APA, all rights reserved). (shrink)

Explores both the place and displacement of humanistic psychology within institutional contexts ranging from private liberal arts colleges to professional organizations like the American Psychological Association. First, from the perspective of social constructionism, we present the function and marginalization of humanistic psychologists within American academic psychology. Next we consider, from the perspective of A. Schutz's social phenomenology, humanistic psychology's place within academic psychology as "the stranger," both in terms of the fundamental incongruence of "traditional" versus "humanistic" psychological relevance systems and (...) the resulting breakdown of the "interchangeability of standpoints" that normally allows for contemporaries to communicate. The specific nature of these conflicts is then elaborated with reference to M. Heidegger's analysis of the concept of time. 2012 APA, all rights reserved). (shrink)

Traditional just war doctrine holds that political leaders are morally responsible for the decision to initiate war, while individual soldiers should be judged solely by their conduct in war. According to this view, soldiers fighting in an unjust war of aggression and soldiers on the opposing side seeking to defend their country are morally equal as long as each obeys the rules of combat. Revisionist scholars, however, maintain that soldiers who fight for an unjust cause bear at least some responsibility (...) for advancing an immoral end, even if they otherwise fight ethically. This article examines the attitudes of the American public regarding the moral equality of combatants. Utilizing an original survey experiment, we find that the public's moral reasoning is generally more consistent with that of the revisionists than with traditional just war theory. Americans in our study judged soldiers who participate in unjust wars as less ethical than soldiers in just wars, even when their battlefield conduct is identical, and a large proportion supported harsh punishments for soldiers simply for participating in unjust wars. We also find, however, that much of the American public is willing to extend the moral license of just cause significantly further than revisionist scholars advocate: half of the Americans in our survey were willing to allow an unambiguous war crime—a massacre of innocent women and children—to go unpunished when the act was committed by soldiers fighting for a just cause. Our findings suggest that incorporation of revisionist principles into the laws of war would reinforce dangerous moral intuitions encouraging the killing of civilians. (shrink)

The efforts of psychologists as well as laypersons to identify causes and motives of behavior is examined from an existential-phenomenological perspective. The claim made by modern psychology that its epistemological ground consists of an objectively given realm of “facts” is called into question. Psychological explanation is presented as a system of discourse that has its own psychological “motivation.” The traditional concepts of “conditions,” “causes,” and “motives” are critiqued and alternative notions such as “meaning” and “project” are drawn from the literature (...) of phenomenology as a basis for understanding rather than explaining human behavior. Verbal report data are used to illustrate and substantiate claims made about the illusive nature of explanation. 2012 APA, all rights reserved). (shrink)

In this essay, I propose five principles to make U.S. nuclear deterrence policy more just and effective in the future: sever the link between the mass killing of innocent civilians and nuclear deterrence by focusing targeting on adversaries’ military power and senior political leadership, not their population; never use or plan to use a nuclear weapon against any target that could be destroyed or neutralized by conventional weapons; reject “belligerent reprisal” threats against civilians even in response to enemy attacks on (...) one's own or allied civilians; replace nuclear “calculated ambiguity” threats against biological or cyberattacks with “deterrence by denial” strategies; and work in good faith toward eventual nuclear disarmament. (shrink)

This article explores various issues with Pierre Teilhard de Chardin's theology including his view of God, his articulation of a "new religion," and his thoughts about transhumanism. This article published is a commemoration of Monsignor Vincent Foy's contributions to Catholic thought. -/- After having examined many of Teilhard's writings and commentaries that have been articulated by both supporters and detractors, I am persuaded that one should not take an all-or-nothing approach to Teilhard (or any other thinker for that matter). The (...) works of Teilhard are often written in poetic prose and remain obscure, in part because of his mysticism. He uses scientific language which at times is conflated with his evolutionary and spiritual understanding of the world. This article looks at some of the theological missteps of Teilhard's works. (shrink)

The focus of this research paper concerns the dialogue between science and theology. The current state of the dialogue involves a wide range of points of intersection that both pose and provoke questions concerning the very viability and coherence of such a dialogue. In particular, this paper examines the physicist/theologian, Robert John Russell's 'Creative Mutual Interaction' (CMI). The significance of the CMI diagram is that it names the basic interactions between science and theology and theology and science. These interactions are (...) presented as pathways, 8 in all, 5 of which flow from science to theology and 3 of which flow from theology to science. These pathways integrate a number of philosophical assumptions. These pathways can make scientists, theologians, and philosophers more aware of the philosophical assumptions at work between both theology and science. Russell, in his CMI, provides 8 paths to this interaction; 5 pathways where science informs theology and 3 by which theology informs science. In this thesis, I examine a test case of Russell's where he interacts the concepts of cosmology, eschatology, and bodily resurrection as it applies to Jesus Christ in New Testament Studies. (shrink)

In “Nudging, Bullshitting, and the Meta-Nudge”, the author responds to William Simkulet’s claim that nudging is bullshitting (according to Harry Frankfurt’s analysis of bullshit and bullshitting), and therefore nudging during the process of informed consent renders consent invalid. The author argues that nudging is not necessarily bullshitting and then explains that although this issue is philosophically interesting, practically speaking, even if nudging is bullshitting, it does not follow that nudging necessarily renders informed consent invalid. This is obviously true in those (...) situations in which nudging during the process of informed consent is unavoidable. The author concludes with a discussion of the meta-nudge and suggests that physicians can use the meta-nudge to eliminate or decrease the power of inappropriate, problematic, or undesirable nudges. (shrink)

Freedom of speech long has been regarded as one of the “preferred freedoms” in the United States: one of the freedoms the U.S. Supreme Court deems “implicit in the concept of ordered liberty.” However, what freedom of speech does—and should—mean is a highly charged question in American constitutional law. I will explore this question by examining how several prominent constitutional theorists have proposed particular approaches to free speech law in order to further their political objectives. I will examine the free (...) speech theories of the nation's leading feminist legal theorist , critical race theorists , libertarian , and legal republican . I also will discuss the principal criticisms of each of these theories, whether the courts have been influenced by any of them, and, in conclusion, whether it is possible to advance a nonpolitical theory of free speech. (shrink)

This critical review focuses on Smith's recent revision of his 1988 book: Teilhard and the New Religion: A Thorough Analysis of the Teachings of Pierre Teilhard de Chardin. Curiously, both the revised and original works have been largely ignored. Unfortunately, sometimes the best way to silence critics is to ignore them. This work will look into some of the primary concepts of Teilhard's "scientific theology" and assess Smith's evaluation, including: evolution, the law of complexity and consciousness, the Creative Union, and (...) the Omega Point. (shrink)

1. Introduction. In recent years Brand Blanshard’s formulation of the coherence theory of truth, as he articulated it in The Nature of Thought, has come under formidable attack by Professor Nicholas Rescher of the University of Pittsburgh. In his otherwise excellent book, The Coherence Theory of Truth, later excerpted for P. A. Schilpp’s Library of Living Philosophers volume on Professor Blanshard, he criticizes Blanshard on two main counts.

This paper will explore the evolution of the conceptions of Satan (the devil), and demons throughout the past 3,000 years, in light of an in-depth study of St. Anselm of Canterbury’s medieval text, The Fall of Satan (De Casu Diaboli). Anselm’s brilliant work, De Casu Diaboli, has inspired much reflection into not just the nature of angels and demons but also into our own. It is worth noting that, it is impossible to exhaustively cover a 3,000-year period on such a (...) major topic, but a brief overview of the significant periods will be provided before focusing on De Casu Diaboli. (shrink)

In recent years, there has been a concerted attack on many of the precepts of Western civilization relating to the concept of God, truth, Christianity, morality, sex, the family, and even modern science, especially biology. The concern of this volume is to explore these and other attacks through the tools of philosophy, theology, science, and intuition. It seeks to bring clarity to the ongoing struggle of Western civilization to preserve its values and traditions. -/- The West is crumbling at an (...) accelerated rate. The unfolding erasure of history, objective morality, and truth has paved the way for our current predicament. We are now standing at the precipice of the future of human civilization. The attacks on the human person are unrelenting, malicious, multifaceted, and wide-ranging in their scope and breadth, from the time prior to birth until the moment of death. If you are granted the “right” to live, then you must be prepared for unending assaults on your, mind, body, and soul. Nevertheless, the spirit of man and the greatness of God are infinitely greater than any of these assaults. It is by making sense of nonsense that humanity will be able to navigate out of the West’s current quagmire. (shrink)

The aim of this article is to take the Center for Inquiry’s ((CFI) a highly influential organization in the west), mission statement to task with respect to their critique of supposed extraordinary claims through the application of Carl Sagan’s quote: “extraordinary claims require extraordinary evidence.” Specifically, those which are defensible through rational argumentation (God’s existence) i.e., in order to question whether or not they are actually promoting rigorous critical thought through the utilization of science and reason. A look will be (...) also taken into whether they are actually fostering freedom of inquiry or if they are becoming masterful at insulating themselves from any criticisms against their own respective position. This will be carried forth through the examination of the following: i) emotions and non-belief, ii) the epistemology of Carl Sagan’s quote, iii) philosophy, science and the question of God, iv) the presumption of atheism and its relation to Sagan’s quote, v) proper basicality and Sagan’s quote and vi) Jesus’ resurrection as a test case. (shrink)