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)

The Irish poet W. B. Yeats once wrote, with great sapience and perception: Nor dread, nor hope attend A dying animal; A man awaits his end Dreading and hoping all. That death has ever been a problem to man is attested as far back as we can trace our species in the archaeological record—indeed, it seems to have been a problem even for that immediate precursor of homo sapiens, the so-called Neanderthal Man; for he buried his dead.

Published here is a critical edition of Augustine’s Sermons 293 and 299, the first edition since the Maurists. Sermon 293 was preached in Carthage on the 24th of June 413, feast of John the Baptist, at a time when infant baptism was a controversial question. Sermon 299 was delivered on the 29th of June, in honour of Peter and Paul : its manuscript transmission and thematic likeness with Sermon 293 suggest that it was preached, according to Pierre-Marie Hombert’s hypothesis, in (...) the same year in the same city, not five years later. Both texts, numbered among the longest of the De sanctis sermons, contradict Pelagian theses about the origin of death and the notion of human impeccability. (shrink)

Summary In establishing what he called the metaphysics of science , the French naturalist Buffon was confronted with the problem of situating the place occupied by man in the natural world, a problem which ultimately depended on discerning his true nature. The paradox of Descartes' dualism offered various solutions — the extremes being, either to condemn man's material nature as corrupted in order to exalt his spiritual nature as a moral being, as Pascal had done, or to reduce man's pretended (...) spiritual nature to nothing more than a manifestation of his material organization, the solution of La Mettrie. Buffon could accept neither, proves man's duality, and proceeds to establish his gnoseological principle on his critique of these two radical solutions. (shrink)

An amendment to this paper has been published and can be accessed via the original article.

This chapter first presents two arguments for the permissibility of physician-assisted suicide (PAS) and euthanasia (E) to eliminate physical suffering. I then present a third argument for PAS and E on grounds other than eliminating suffering. The chapter next considers several objections to these arguments that might be raised by Neil Gorsuch, now a US Supreme Court Justice. In the course of this I present a fourth argument for PAS and E. (I assume throughout that a patient’s free and informed (...) consent is required and present.). (shrink)

The question of Theodicy demands a reasonable justification of the nature, structures and goals of evil and suffering in the world. The paper attempts to explain the reasons for its presence in our lives and seeks to unveil its principles. If God is all knowing, almighty and also merciful, we must face the problem of the presence of evil and suffering in this world. The main goal of the paper is to show the way the New Testament deals with this (...) question, and further to show to what extent it has influenced the life of Christians from the point of view of teleology. (shrink)

First published in 1945. In this work the author seeks to correct the misinterpretation and incorrect labelling of Shelley's thought. While not neglecting Shelley as a poet, this book focuses on his contributions made to the general movement of political and philosophical thought of his era and by so doing his relevance to contemporary issues. This title will be of interest to students of literature.

The authority of humanism is emphatically not an authority based on intuition, spiritual awakening, personal revelation or epiphanies, scriptural witness of whatever faith, pseudo science, astrology, consensus, endorsements, testimony of enlightened gurus, swamis, pastors, priests, ayatollahs, Buddhist monks, or even justices of the Supreme Court of the United States. The central thesis of this essay is to identify the specific authority underlying the humanist claim which states that “Humanism is a progressive philosophy of life that, without supernaturalism, affirms our ability (...) and responsibility to lead ethical lives of personal fulfillment that aspire to the greater good of humanity.” (Humanist Manifesto III, Washington, DC: American Humanist Association, 2003, italics added.) This essay addresses the question: By what authority do humanists make this claim? The answer is based on consideration of the impossibility of a-priori premises and assumptions except for mathematics and logic. Rather than a priori assumptions and premises, the authority underlying humanism is based on the legitimacy of the a-posteriori, in short, empirical and scientific processes and methodologies. (shrink)

An adamant fan of Darwin, F.W. Headley attempts to argue the difficulties of believing in Socialism and Darwinism simultaneously and highlights issues which could prevent Socialism from being put into practice. Originally published in 1909, this study uses examples of communities in countries such as England and India to illustrate Headley’s key belief that societies only function well if they do not interfere with the fight for existence and natural selection. This title will be of interest to students of Philosophy, (...) Sociology and Anthropology. (shrink)