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)

Byrne has demonstrated that although subjects can make deductively valid inferences of the modus ponens and modus tollens forms, these valid inferences can be suppressed by presenting an appropriate additional premise “If R then Q” with the original conditional “If P then Q”. This suppression effect challenges the assumption of all syntactic theories of conditional reasoning that formal rules of inference such as modus ponens is part of mental logic. This paper argues that both the syntactic and the mental model (...) accounts of the suppression effect are inadequate because they fail to give a principled account of the critical interpretive component involved in reasoning. In contrast, the relative salience model proposed in this study emphasized the centrality of the interpretative processes with the critical component being the relative salience of premises as judged by subjects on the basis of their prior knowledge activated in particular problem situations. Using 120 undergraduates and 120 policemen as subjects, predictions from the model were tested and confirmed in a suppression paradigm and evidence of convergent validity for the construct of salience were obtained. The results cannot be reconciled with either the syntactic view or the mental model view that have dominated theories of conditional reasoning. (shrink)

Could Christians and Muslims be referring to the same God? For an account of the reference of divine names, I follow Bogardus and Urban (2017) in advocating in favour of using Gareth Evans’s causal theory of reference, on which a name refers to the dominant source of information in the name’s “dossier”. However, I argue further that information about experiences, in which God is simply the object of acquaintance, can dominate the dossier. Thus, this demonstrative use of names offers a (...) promising alternative avenue by which users of the divine names can refer to the same referent despite having different conceptions of God. I also respond to Burling’s (2019) worship-worthiness view. (shrink)

This article examines the relevance and value of Confucian Ethics to contemporary Business Ethics by comparing their respective perspectives and approaches towards business activities within the modern capitalist framework, the principle of reciprocity and the concept of human virtues. Confucian Ethics provides interesting parallels with contemporary Western-oriented Business Ethics. At the same, it diverges from contemporary Business Ethics in some significant ways. Upon an examination of philosophical texts as well as empirical studies, it is argued that Confucian Ethics is able (...) to provide some unique philosophical and intellectual perspectives in order to forge a richer understanding and analysis of the field of contemporary Business Ethics. (shrink)

COVID-19 deeply affects many spheres of life. Lockdown measures implemented worldwide have accentuated mental wellbeing changes in the population from the perspectives of space and social relations. These changes leave lasting imprints on individuals and communities. This article draws upon solidarity and care ethics in exploring their role in rebuilding mental wellbeing in the light of constraints arising from lockdown. The diversity of responses to physical and social isolation during the pandemic illuminates the distinctly relational nature of human beings, offering (...) the opportunity for care and solidarity to respond to mental wellbeing challenges in an inclusive and context-sensitive way. (shrink)

This study empirically examines how Chinese executives perceive the role of guanxi and ethics played in their business operations. By factor-analyzing 850 valid replies collected from a comprehensive survey, the present study identifies three distinct ethics-related attitudes and two distinct guanxi-related attitudes for Chinese executives. The cluster analysis of the composite scores of these five attitudinal factors further indicates the existence of three distinct groups of Chinese executives that vary in their ethics and guanxi orientations. The three groups are unethical (...) profit seeker (UPS), anti-governance, guanxi-cultivator (AGGC), and apathetic executive (AE). The three groups are also found to be significantly different in such demographic characteristics as age and the ownership structure of the serving organization. Specifically, the inter-group comparison suggests that younger Chinese executives, and those working for privately-owned firms and joint ventures are more inclined to engage in unethical activities for profits. These findings provide useful insights for international investors to formulate their human resource and negotiation strategies in China. (shrink)

ABSTRACT This paper critically examines the liberal model of decision making for the terminally ill and contrasts it with the familial model that can be found in some Asian cultures. The contrast between the two models shows that the liberal model is excessively patient‐centred, and misconceives and marginalises the role of the family in the decision making process. The paper argues that the familial model is correct in conceiving the last journey of one's life as a sharing process rather than (...) a process of exercising one's prior or counterfactual choice, and concludes by suggesting a policy framework for the practice of familialism that can answer the liberal challenge that familialism cannot safeguard the patient from abuse and neglect. (shrink)

The question, ‘can Africa deal with a postcoloniality without reference to the colonising metropole?’ neglects that Africa must deal with many powers that were not colonisers. Dealing with China requires a relationship outside the period of formal colonial rule, and requires a new cosmopolitanism that can be difficult, yet vibrant.

A major obstacle to the political revival of Confucianism has been its tension with the rule of law. Systemic features of Confucianism such as social hierarchy (and the corresponding social inequal...

Organ donation has gained much attention as the need for transplant exceeds the supply of organs. Various proposals have been put forward to address the organ shortage challenge, ranging from offering incentives to donors, addressing family refusals to donations and instituting presumed consent laws. Presumed consent as the favoured approach has not been universally effective in increasing actual transplants despite its appeal. Few considerations have been given to the broader ethical climate influencing the organ donation debate. This paper examines the (...) ethical climate surrounding organ donation and identifies the challenges existing within such environments. It explores care ethics and its application to the donation system, demonstrating how it can influence the organ donation phases. The conclusion drawn from the analysis is that a caring ethical climate in the pre, during and post-transplant system respects donor autonomy, addresses family reluctance to agree to donation, facilitates the needs of the donee and creates an environment that promotes non-maleficence for all stakeholders. (shrink)

This paper argues that substantive ethical rules serve a critical ethical function, even in those cases where we should deviate from those rules. Assuming that the rules are valid provides decision-makers with the context essential to reaching a well-justified decision. Recognizing this helps to reconcile two attractive but incompatible positions regarding the evaluation of healthcare ethics consultants. The first position is that ethical rules can validly be used to evaluate the quality of consultants’ advice, ensuring conformity to standards promoted by (...) a significant portion of medical ethicists. The second position—the message of ethical particularism—is that we should not evaluate consultants according to strict rules, since good ethical advice may deviate from even the most carefully wrought moral rules. Steering a path between these extremes, I argue that we should evaluate the quality of consultations by examining whether consultants have communicated the relevant ethical rules to participants as ethical presumptions. In communicating presumptions, a consultant provides an indispensable ingredient to ethical decision-making, while leaving open the possibility that the ethical course of action involves violating the very ethical rules that one should presume. (shrink)

Inference has long been a concern in epistemology, as an essential means by which we extend our knowledge and test our beliefs. Inference is also a key notion in influential psychological or philosophical accounts of mental capacities, from perception via utterance comprehension to problem-solving. Consciousness, on the other hand, has arguably been the defining interest of philosophy of mind over recent decades. Comparatively little attention, however, has been devoted to the significance of consciousness for the proper understanding of the nature (...) and role of inference. It is commonly suggested that inference may be either conscious or unconscious. Yet how unified are these various supposed instances of inference? Does either enjoy explanatory priority in relation to the other? In what ways or senses, can an inference be conscious, or fail to be conscious, and how does this matter? This book brings together original essays from established scholars and emerging theorists that illustrate how several current debates in epistemology, philosophy of psychology, and philosophy of mind can benefit from reflections on these and related questions about the significance of consciousness for inference. Contributors include: Kirk Ludwig and Wade Munroe; Michael Rescorla; Federico Bongiorno and Lisa Bortolotti; Berit Brogaard; Nicholas Allott; Jake Quilty-Dunn and Eric Mandelbaum; Corine Besson; Anders Nes; David Henderson, Terry Horgan, and Matjaž Potrč; Elijah Chudnoff; and Ram Neta. (shrink)

My paper critiques the comparability requirement that practical reason is limited by the possibility of comparing alternatives. I describe methods of reasoning that are compatible with choice between incomparable options, and discuss a mistake about intention that supports the view that comparing alternatives is the only way to choose rationally. I then explain how a model of rational choice that prescribes the comparison of alternatives invents unacceptable concepts to make comparability possible. Finally, I criticize the assumption of the unity of (...) practical reason that requires that prudential and moral choices are both made by comparing alternatives. It turns out that moral conflicts that are intractable for those who reason with a method of comparison may be resolvable by using moral reasoning that does not involve the comparison of alternatives in terms of a comprehensive value. Making room for such forms of reasoning is preferable to denying incomparability. (shrink)

Post COVID-19 infections resulting in long COVID symptoms remain persistent yet neglected in healthcare priorities. Although long COVID symptoms are expected to decline after some time, many people continue to endure its debilitating effects affecting their daily lives. The diversity of characteristics amongst long COVID patients adds to the complexity of communicating personal health predicaments to healthcare providers. Recent research towards building an evidence base for long COVID with the aim of delivering responsive healthcare interventions for long COVID patients has (...) utilised datasets generated from wearable devices. This paper examines the prospects presented by wearable devices for long COVID patients and physicians. It highlights distinct ethical and legal challenges arising from their use in practice. Several recommendations aiming to support their usage amongst long COVID patients are outlined for future research using wearable devices for long COVID treatment. (shrink)

Wilkinson and Savulescu did not agree with the court's decision to continue M's treatment and suggested in their recent commentary that the magnitude of benefits of being alive for M is small compared with the potential use of health resources for other patients. We argue that the benefits of being sensate to the surroundings for an otherwise unconscious person are not necessarily small. One cannot assess on behalf of another person the magnitude of benefits of being alive according to the (...) intensity or the duration of negative experiences. Denying life-sustaining treatment to patients in a minimally conscious state solely on the grounds that they are less capable of enjoying the benefits represents grave discrimination against disabled persons. For patients in a minimally conscious state who have not delegated a surrogate or made any advance decision about their medical treatment, the duty of doctors is to preserve their right to self-determination and maximise their capacity to enjoy their life. M should live on, and life-sustaining treatment should not be withdrawn. (shrink)

The Japanese martial arts are suggested to the West, and to the Japanese themselves as `old'. They are less old than the suggestion and are, indeed, part of an attempt to make the Japanese suitably `samurai', in the first instance, so that an export of an image can take place in the second instance. Under outer shells and forms, however, something spiritual is indeed old, but people - Japanese and non-Japanese alike - have tended within modernity to reify the shells (...) and forms. (shrink)

T'ang Chün-i's early work Ai-ching chih fu-yin (Gospel of love) has been much neglected by T'ang scholars. This essay argues that this text is not a caprice, and that it marks an important stage in T'ang's life and studies. Furthermore, in the history of Chinese philosophy, it is probably the first book ever written on the philosophy of love.

When two people need a kidney transplant, but only one kidney is available, we need to decide who gets it. If one of the potential recipients needs the kidney because of their own voluntary behavior, but the other is not at all responsible for needing a kidney, then we need to decide whether this fault should be a consideration in favor of the other patient getting the kidney. While there has been considerable philosophical debate on this issue, there is far (...) less research into the views of the public. To explore opinions on these issues, we first asked survey participants to ascribe or deny responsibility for the risky behavior for kidney disease, and for being deprived of a kidney in cases of drinking alcohol, drug abuse, smoking and unhealthy eating when the patient did or did not stop the risky behavior after being diagnosed with kidney disease. Next, we asked participants who should get the kidney when the patient who engaged in risky behavior did or did not know, or have easy access to, the information that the behavior was risky. We found that participants generally ascribed responsibility on the basis of knowledge but allocated the kidney on the basis of access to information. These findings have important implications for moral theories as well as medical policies. (shrink)

LANGUAGE NOTE | Document text in Chinese; abstract also in English. 現代科技日新月異，令我們生活更為方便，但亦帶來不少的道德問題。本文的主旨，正是從應用倫理學的角度來討論如何處理在2019冠狀病毒病持續全球大流行下，由此而來的私隱倫理問題。本文會特別聚焦在高等教育與社 會預防及控制疾病政策這兩組例子當中涉及的私隱問題。根據後果評價的道德框架，本文會討論私隱與私隱權利的概念，還有不完整排序下最大化與最優化的分別。之後本文會討論控制論述與讀取論述對失去私隱的意義，然後會 探討親密關係與私隱價值的互動，以此説明若要解決一些私隱的道德議題，討論親密關係的重要性是不可避免的。最後本文會詳細討論如何運用以上的分析，來處理兩組例子所涉及的私隱倫理問題。 Alongside greater convenience, the rapid development of technology in the modern world has also brought about many ethical problems. This article examines privacy issues that emerged during the COVID-19 pandemic from the perspective of applied ethics. It focuses on two specific examples of privacy issues that emerged in higher education and social policy amid attempts to prevent and control the disease. Based on the moral framework of consequential evaluation, (...) this article discusses the concepts of privacy and privacy rights and the difference between maximization and optimization in the context of an incomplete ranking of options. This article also discusses two ways that the loss of privacy has been understood: the control account and the access account. Another important discussion in the article is the place of privacy in the context of intimate relationships, and why the resolution of some issues concerning privacy requires a discussion of the concept of intimacy. Based on the above analysis, this article concludes with a discussion of how to evaluate the privacy issues in the two examples. (shrink)

In this paper, I discuss an example from Buchanan of active voluntary euthanasia (AVE). I first refute objections to the intuitive permissibility of the killing described in the example. After explaining why the killing is intentional, I evaluate Buchanan's solution to the ‘problem of intending death’. According to Buchanan, what justifies a physician in intentionally bringing about a patient's death by AVE is a principle that embodies the values of patient self-determination and well-being. I argue that these two considerations are (...) not sufficient for justifying AVE. The motive of the physician matters, but it is his desire rather than his intention that is relevant. An ethical physician may bring about intentionally the death of his patient if in forming his intention, he began with an appropriate desire to keep the patient alive as well as a legitimate desire to prevent prolonged suffering, with the latter outweighing the former. The ethical physician also desires to respect the choice of his patient wherever possible. On my account, the physician should be guided by the virtues and goals of his profession rather than by strict ‘all-or-nothing’ principles. I defend my account by describing the advantages of my account, and dismissing possible objections. (shrink)