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)

Investigates the resolution of contradictions and ambiguous derogations in a code, by means of the imposition of partial orderings. Although formulated as a study in the logic of norms, it provided the initial ideas for work on the logic of theory (or belief) change, developed by the authors in a series of papers by the authors and Peter Gardenfors beginning in 1985.

Traditional approaches in philosophy of biology focus attention on biological concepts, explanations, and theories, on evidential support and inter-theoretical relations. Newer approaches shift attention from concepts to conceptual practices, from theories to practices of theorizing, and from theoretical reduction to reductive retooling. In this article, I describe the shift from theory-focused to practice-centered philosophy of science and explain how it is leading philosophers to abandon fundamentalist assumptions associated with traditional approaches in philosophy of science and to embrace scientific pluralism. This (...) article comes in three parts, each illustrating the shift from theory-focused to practice-centered epistemology. The first illustration shows how shifting philosophical attention to conceptual practice reveals how molecular biologists succeed in identifying coherent causal strands within systems of bewildering complexity. The second illustration suggests that analyzing how a multiplicity of alternative models function in practice provides an illuminating approach for understanding the nature of theoretical knowledge in evolutionary biology. The third illustration demonstrates how framing reductionism in terms of the reductive retooling of practice offers an informative perspective for understanding why putting DNA at the center of biological research has been incredibly productive throughout much of biology. Each illustration begins by describing how traditional theory-focused philosophical approaches are laden with fundamentalist assumptions and then proceeds to show that shifting attention to practice undermines these assumptions and motivates a philosophy of scientific pluralism. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

This chapter contains sections titled: Socrates and the Art of Love Socrates and Athenian Paiderastia Loving Socrates Love and the Ascent to the Beautiful The Art and Psychology of Love Explained Writing about Love.

It is necessary to take into account the data of science in the theoretical debates conducted by scientists contributing ontological theories in order to develop new approaches to theological issues in Islamic thought. Even, Kalam scholars with the duty of defending and basing the principles of Islam in the classical sense have established a theological understanding intertwined with science in understanding both existence philosophically and the Script theologically. With its discoveries and theories in the last century, it can be argued (...) that modern science has made a serious progress compared to the past. Maintaining its own methodology and paradigm, every scientific discipline has the opportunity to benefit from the methods and data of other disciplines. Consequently, it is possible to assert that Kalam can enjoy the same opportunity too, as long as staying in its own problem area. According to modern science, the motion system is the unity of structures that enable living things to move. Moreover, Bones and joints, which are the structures of the skeletal system, are passive elements of the movement system. Muscles, on the other hand, are the active elements of the movement system and provide the movement of the body by affecting the bones and joints. Muscle tissue shapes the body by adhering to the bones, besides enabling movement activity to occur. One of the most important systems that provide movement is the nervous system. Because for a person to have movement, the muscles must contract, and the muscles must be stimulated for the contraction of the muscles. The system that enables this contraction to occur is the nervous system. Energy is also required for contraction to occur in the human body. Muscles create energy for movement by first providing their energy from the ATP molecule present in the muscle cells. Considering the movement theories of classical theology scholars, it is seen that they shaped the occurrence of human actions through the concept of potency. While the scholars classify power as spiritual/mental and physical strength in terms of its structure, they have characterized it as accident in terms of its nature. In this context, we can say that the equivalent of the power, which is regarded as necessary for the formation of human acts by the theologians, is the movement system in today's science. The spirit/mental that scholars regard as a structure of power for the occurrence of human action can be regarded as the electrical activity that activates muscles when considered within the framework of the movement system of today's science. It is seen that Kalam scholars emphasize physical competence in their definitions of power as well. At this point, Ash'arians defined the power as the soundness of organs, Mu’tazila expressed it as the presence of organs and their being away from disasters, and the Mâturîdîs stated it as the organs being healthy. With these definitions, Kalam scholars mean that a person should also be physically competent to make a movement. The structures scientifically accepted as biological and physical competence in the movement system are the skeletal system, muscles and nervous system. Therefore, we can say that the strength of the physical fitness/well-being emphasized in the definition of power by theologians corresponds scientifically to the skeletal system, muscles and nervous system. One of the issues that Kalam scholars discuss about power is the issue of the accident of power. The reason why they describe power as an accident is to emphasize its impermanence and to show that it was created by Allah. So, in modern science, electrical activity must occur in the brain in order for human organs to move. The occurrence of this electrical activity is independent of the human being. The fact that electrical activity occurs independently from human beings shows that it conforms to Kalam scholars’ definition of the accident. As a result, we can say that the theory of power created by scholars for human movement has a counterpart in the movement system put forward by today's science. (shrink)

This chapter is written for an audience that is not intimately familiar with the philosophy of animal consumption. It provides an overview of the harms that animals, the environment, and humans endure as a result of industrial animal agriculture, and it concludes with a defense of ostroveganism and a tentative defense of cultured meat.

This article challenges a reductive analysis of social practices by distinguishing five kinds of reason for following the rules of conventional practices. Depending on one’s preferred intellectual tradition, conventional practices enable coordination, facilitate cooperation, constitute activities, fulfil reciprocity, or specify abstract rights. Instead of being rival theories of social practices, these different models complement one another in a normative analysis of social practices. By distinguishing five kinds of reasons to follow conventional rules, this paper supports a more dynamic conventionalist analysis (...) of subjects like property, the law, professional obligation, civic responsibility, and culture. (shrink)

Монографія "Функціональність релігії: український контекст".

Discussions on the concept of Marifatullah as the foundation of belief hold a significant place in theology. There are different opinions among schools of theology regarding whether those who do not receive divine messages must know God. The majority of scholars belonging to the Mu'tazila and Māturīdī schools, including Imam Māturīdī, state that human beings must know God. Although al-Ashʿarī accepts that the most prominent obligatory duties are the methods of reasoning that lead to marifatullah, he states that responsibility in (...) this matter is formed by transmission. However, we can say that whether the human mind is sufficient to reach the knowledge of God, the method of reasoning has reached a different dimension today from the sciences of psychology, genetics, and neurobiology. This study explored whether individuals can achieve marifatullah from a holistic perspective. Whether human beings can be held responsible for this issue has been evaluated through the sciences of psychology, genetics, and neurobiology, and the opinions of schools of theology on this issue have been criticized. When we think in terms of Marifatullah, we can say that man’s psychological sense of obligation to adapt to society leaves him intellectually under the influence of society. In terms of genetic determinism, human personality, behavior, and intellectual adventure are completely determined by genes. Therefore, it is impossible for men to reach marifatullah in the context of their mental abilities. From an epigenetic perspective, we see that human thought structure, behavior, and personality are formed as a result of interactions with the environment. Serious hesitation arises in this idea in terms of intellect being a source of responsibility. Humans are genetically influenced by the environment and society, and they have a suitable nature for this, revealing that their genetic structure is open to environmental influences. In terms of brain plasticity, factors such as the society, environment, and family in which people live can change their brains and enable them to live accordingly. Although life adventures appear to be within the framework of social harmony, there must also be intellectual and religious harmony within social harmony. This reinforces the idea that individuals tend to align more with the thoughts and beliefs instilled by culture given the adaptable nature of the human brain influenced by cultural factors. When the views of the schools of theology are considered considering these evaluations, it becomes clear that the Mu'tazilites and Māturīdīs' belief that the source of the wujūb of marifatullah is intellect is at a point that needs to be reconsidered in terms of human biology and psychology. Although the Asharites emphasize human beings attaining knowledge of God through intellect, their focus on prophethood indicates that a revelation offer appears more accurate concerning human nature in the context of Marifatullah. (shrink)

This paper discusses the nature of liberty from the point of view of value. Liberty is the highest value for liberals. The root of this liberal view is their particular conception of self. Rawls says 'the self is prior to the ends which are affirmed by it.' This is also the Kantian view of the self: the self is prior to its socially given roles and relationships. Therefore, no end is exempt from possible revision by the self. There is nothing (...) wrong with this basic idea. In fact, all theories agree on free choice of life plan or self-determination. But they disagree about what package of rights and resources best enables people to pursue their own conceptions of the good. However, the liberal view of liberty is based on a metaphysically reasoned idealism. This results in a conception of liberty that is absolute, supreme, and has infinite value compared with other things. Communitarians have several arguments against the liberal view. I consider the following two points to be of utmost import: The liberal view of the self is empty; The liberal view ignores our embeddedness in communal practices. My reasoning is not exactly that of the communitarians. I view 'emptiness' as freedom associated with the substance of an action, which has a value that does not lie in itself. (shrink)

There are an infinite variety of attitudes to euthanasia, each individual response to the concept being influenced by many factors. Consequently there is a literature on the subject ranging from the popular article to papers in specialized journals. This study, however, has taken a well defined sample of people, inviting them to answer a questionnaire which was designed to elicit their attitudes to euthanasia in a way which could be analysed statistically. Nor surprisingly attitudes appeared to 'harden' as those answering (...) the questionnaire grew more experienced in dealing with patients and also more professionally established. Thus it was found that of the seven groups questioned practising physicians showed more positive attitudes to euthanasia and their responses did not differ significantly from those of senior medical students. It is these groups which actually or potentially have to resolve the clinical dilemma posed by the dying patient. (shrink)

1. Concerning the meaning of reality, Mr. Demos asserts that, according to me, "what we call real is wholly relative to our purposes" and then points out that this is not what "real" means when we ask about a story whether what it relates really happened.

This is the third, penultimate volume in the Toward a Theoretical Biology series. The contributors agree that there is a major problem in finding methods of dealing with the great complexity of biological systems. Molecular biology has given us considerable insight into the nature of the elementary units and processes of life, but to understand how these are put together to form systems that are usually too complicated to be analyzed completely, but exhibit global properties of simplicity, presents biologists with (...) an intellectual challenge that physical sciences and chemistry must also face. The problem is approached from several different angles: quantum physics, topology, and statistical mechanics. A stimulating discussion is recorded: that the behavior of randomly constructed networks exhibits simplicity. Thoughtful analyses of complexities in such basic biological processes as the genetic control of differentiation, evolution, and ecology is also included. Some of the questions dealt with are: What kinds of theories should we wish to have in connection with developmental biology? And have we got them? The subject matter of Organization Stability and Process is defined as the basic concept of biology. None of the contributors herein contained is a molecular biologist in the modern sense, but molecular biology casts a shadow over this work, at least in so far as they challenge its interpretative aggressiveness and its enthusiastic but unendearing self-confidence and self-sufficiency. This volume inaugurates a new and authentic style of scientific literature. The contributions are thoughtful, imaginative, illuminating, and exceptionally well written. (shrink)

With the increasing prices of newly approved anti-cancer treatments contributing to rising healthcare costs, healthcare systems are facing complex economic and ethical dilemmas. Especially in countries with universal access and mandatory health insurance, including many European countries, the organizing of funding or reimbursement of expensive new treatments can be challenging. When expensive anti-cancer treatments are deemed safe and effective, but are not (yet) reimbursed, ethical dilemmas arise. In countries with universal healthcare systems, such as the Netherlands, this gives rise to (...) a rather new ethical dilemma: should patients be allowed to pay out of pocket, using private funds, for medical treatments? On the one hand, to allow patients to pay for treatments out of pocket would be in line with the medical-ethical principles of beneficence and autonomy. On the other hand, allowing patients to pay out of pocket for anti-cancer treatments may lead to unequal access to medical treatments and could be considered unfair to patients who are less well-off. Thus, it could undermine the values of equality and solidarity, on which the Dutch healthcare system is built. Furthermore, out-of-pocket payments could potentially lead to financial hardship and distress for patients, which would conflict with the principle of non-maleficence. Does this mean that patients can rightfully be denied access to approved but not (yet) reimbursed anti-cancer treatments? In this article, we will use the Dutch healthcare system, which is based on equal access and solidarity, as a case study to draw attention to this—currently relatively unknown and unresolved—dilemma and to clarify the values at stake. This article contributes to current discussions about the societal problem of rising healthcare costs by informing policymakers, healthcare professionals, and ethicists about the ethical dilemma of out-of-pocket payments in universal healthcare systems, and aims to support health authorities, policymakers and health professionals in developing policy for whether to allow out-of-pocket payment-based access to newly approved but (too) expensive anti-cancer treatments. (shrink)