BackgroundIn the Canadian Alliance for Healthy Hearts and Minds cohort, participants underwent magnetic resonance imaging of the brain, heart, and abdomen, that generated incidental findings. 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 were recruited with (...) a follow-up questionnaire administered to 909 participants 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% of participants, with the highest proportions found in the brain and abdomen. The majority of participants 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 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)

Is God's foreknowledge compatible with human freedom? One of the most attractive attempts to reconcile the two is the Ockhamistic view, which subscribes not only to human freedom and divine omniscience, but retains our most fundamental intuitions concerning God and time: that the past is immutable, that God exists and acts in time, and that there is no backward causation. In order to achieve all that, Ockhamists distinguish ‘hard facts’ about the past which cannot possibly be altered from ‘soft facts’ (...) about the past which are alterable, and argue that God's prior beliefs about human actions are soft facts about the past. (shrink)

Y a-t-il une experience de la sante? La sante n'est-elle que l'absence de maladies? Etre en bonne sante, est-ce la meme chose qu'etre normal? Dois-je attendre de voir ce que l'avenir me reserve pour juger de l'etat de ma sante? La difference entre sante et maladie est-elle une difference comme les autres? Voila certaines des questions que pose le present ouvrage, grace a une methode qui croise la philosophie avec d'autres types de savoirs : la medecine, la biologie, mais aussi (...) la litterature et les sciences humaines. Cette etude conduit a confronter l'approche issue de Canguilhem avec d'autres conceptions philosophiques moins connues en France : celles de Boorse, Engelhardt et Nordenfelt. Il en ressort que les notions de sante et de maladie sont d'un maniement extremement delicat du fait de leur imprecision, sans doute irreductible, et du poids ideologique qui est le leur. Elles n'en sont pas moins centrales dans notre experience et dans les enjeux politiques d'aujourd'hui. (shrink)

Contrairement à la majorité des interprètes du Timée de Platon, nous ne croyons pas que la figure du démiurge représente réellement une cause productrice. Ce type de causalité, explicitement attribué au νοῦς dans le Phédon, ne peut, selon nous, être associé qu’à l’activité de l’âme du monde et des dieux de la tradition. Le démiurge joue un autre rôle. Représentant le meilleur des êtres intelligibles éternels (37a), un dieu éternel (34a), le démiurge ne peut, à ce titre, être un principe (...) de mouvement, puisque l’intelligible, selon Platon, n’exerce qu’une causalité paradigmatique. La figure du démiurge est, en fait, la représentation mythique de la causalité paradigmatique. Le démiurge représente, plus précisément, à titre de « fabricant » de l’espèce des dieux, la forme intelligible du dieu. Certaines caractéristiques du démiurge (sa corporéité, ses pensées et son activité productrice) sont indissociables de l’analogie employée pour représenter la dépendance des dieux à l’égard des formes intelligibles : le travail artisanal. Le démiurge, en tant que cause productrice, n’a pas de valeur ontologique réelle. Néanmoins, ce qu’il représente, la forme intelligible du dieu, constitue, selon Platon, la cause qui fonde l’immortalité de l’univers et des dieux de la tradition, une cause qui permet ainsi au νοῦς de ces divinités d’exercer leur causalité productrice. (shrink)

Wittgenstein’s concepts shed light on the phenomenon of schizophrenia in at least three different ways: with a view to empathy, scientific explanation, or philosophical clarification. I consider two different “positive” wittgensteinian accounts―Campbell’s idea that delusions involve a mechanism of which different framework propositions are parts, Sass’ proposal that the schizophrenic patient can be described as a solipsist, and a Rhodes’ and Gipp’s account, where epistemic aspects of schizophrenia are explained as failures in the ordinary background of certainties. I argue that (...) none of them amounts to empathic-phenomenological understanding, but they provide examples of how philosophical concepts can contribute to scientific explanation, and to philosophical clarification respectively. (shrink)

El propósito de este texto es ofrecer una visión general de la relación entre nación e historia en los debates que se generaron por parte de los historiadores y otros intelectuales de las ciencias sociales a finales del siglo XIX y durante gran parte del siglo XX. La reflexión central que se plantea consiste entonces en estudiar y mostrar cómo al mismo tiempo que las naciones modernas eran objeto de un proceso de redefinición política, en el escenario intelectual de las (...) ciencias sociales, y en particular de los historiadores, fueron apareciendo también un conjunto de debates y obras que intentaban problematizar y someter a consideración las relaciones que pretendían establecerse entre la nación y la historia como un elemento que las justificaba. (shrink)

É bem conhecida a oposição estabelecida por Kant entre experiência possível e dialética, na medida em que esta última é caracterizada como a “lógica da ilusão”. Ao mesmo tempo, o modo de pensar metafísico, que ocorre dialeticamente, em sentido kantiano, é uma tendência inevitável da razão, expressa na exigência formal de completude das categorias. Como o pensar, enquanto exercício livre da razão, é em si mesmo mais amplo do que a atividade de conhecer, própria do entendimento, o pensar contém o (...) conhecimento, embora este se qualifique pelas regras e pelos limites determinantes da objetividade. A pergunta que tentaremos formular é se essa relação continente-conteúdo não poderia configurar também uma dependência da experiência em relação ao raciocínio dialético, que estaria de algum modo indicada na função reguladora das idéias da razão. Nesse caso, a oposição formal entre conhecer e pensar seria inseparável da inclusão estrutural (dependência) da experiência no âmbito da razão. Na raiz do problema estaria talvez a tensão (dialética) entre a aspiração subjetiva de totalidade e as exigências objetivas de limitação e segmentação da experiência e a forma da experiência teria de ser finalmente concebida a partir de um fundo de inteligibilidade problemática. Dialectics and experienceThe separation of possible experience as objective knowledge and dialetics as a non-objective or non-theoretical knowledge is one of the most important aspects of kantian critical philosophy. But Kant also says that the activity of reason, as a pure thinking, has more amplitude than understanding knowledge. So we could say that theoric knowledge would depend on rational ( and non-theoretical) knowledge, as something contained in it. If we accept that, the consequence would be a relation of dependence between the form of objective knowledge and the background of a problematic – even doubtful – inteligible knowledge. (shrink)

An important contribution to the foundations of probability theory, statistics and statistical physics has been made by E. T. Jaynes. The recent publication of his collected works provides an appropriate opportunity to attempt an assessment of this contribution.