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)

Mérleg is an interesting quarterly selection of articles of general interest translated from the major Western languages into Hungarian. It is a Catholic publication for a general intellectual public and it contains besides the longer studies review articles, reviews, interviews and also short summaries. The most important articles of the two issues we are reviewing: A. Greeley, "The Sacred and the Psychedelic"; A. Plé, "The affective life of the consecrated celibate"; K. Franke, "Apology for the protection of the unborn life"; (...) "Basic issues of the Abortion Problem"; "Catechesis according to the Council"; R. Schnackenburg, "The birth of Christ without legends and Myths"; P. Caspers, "The role of the Church in Asia"; C. Aguiar, "Latin-American Catholicism"; "The Memory of Mauriac." The very difficulty of publishing in Hungarian a theologically orientated digest makes this selection dramatically sparing and it seems to give us a more coherent and more essential view of the "happenings" of the West than many of the reviews of America, France or Germany.--M. J. V. (shrink)

The maturing of metaethics has been accompanied by widespread, but relatively unarticulated, discontent that mainstream metaethics is fundamentally on the wrong track. The malcontents we have in mind do not simply champion a competitor to the likes of noncognitivism or realism; they disapprove of the supposed presuppositions of the existing debate. Their aim is not to generate a new theory within metaethics, but to go beyond metaethics and to transcend the distinctions it draws between metaethics and normative ethics and between (...) cognitivism and non-cognitivism. In our experience, the differences with traditional metaethics go deep enough that it can feel as if two different paradigms are talking past each other. We attempt to bring clarity and focus to this rather inchoate debate by simultaneously articulating the general issues involved and engaging in a detailed case study of one of the prominent representatives of this discontent, Christine Korsgaard. We argue that Korsgaard fails to go beyond metaethics–indeed, fails even to provide a theory within metaethics. Our strategy for showing this is to argue that her claims are compatible with both cognitivism and non-cognitivism. We have argued elsewhere that her distinctive claims are compatible with realism. Here we focus on the crucial role that claims about agency and the will seem to play her in work and, according to our interpretation, in her attempts to go beyond mainstream metaethics. We show in detail that these claims are actually compatible with non-cognitivism. Though our discussion often focuses on her work in particular, it has clear implications for other attempts to obviate the debates of traditional metaethics. (shrink)

The aim of this investigation is to discuss the merits of the three radically divergent views as to the nature and function of the categories held by Kant, Ward and Alexander.

This completes what I think one may state and defend on physical grounds concerning the foundations of Astrology and the coming year 1602. If those learned in matters of Physics think them worthy of consideration, and communicate to me their objections to them, for the sake of eliciting the truth, I shall, if God grants me the skill, reply to them in my prognostication for the following year. I urge all who make a serious study of philosophy to engage in (...) this contest. For it concerns our worship of God and the welfare of the human race. Meanwhile, I pray from the depths of my soul, through Christ our mediator, that for all and for each the coming year may be a very happy one. (shrink)

Providing adolescents with access to their electronic health information presents both opportunities and challenges for children and families. In an effort to protect the medical privacy of adolescents, some state policies provide adolescents with access to their electronic health information based solely on age, and exclude parents from seeing this information unless adolescents permit it, with both positive and negative consequences. This commentary reviews the genesis of these policies and discusses perceived benefits, struggles, and frustrations through the lens of twelve (...) narratives written by a diverse array of patients and parents. These stories demonstrate the widely variable impact of such policies depending on family dynamics, child development, and medical complexity, among many factors. By intimately illuminating the experience of adolescents and parents, these powerful narratives suggest that a more nuanced, ethically-sensitive, and principled approach to policies regulating pediatric access to electronic health information can help provide that information in a less distressing, and more meaningfully empowering manner for patients and families. (shrink)

The Declaration of Helsinki and the Council of the International Organization of Medical Sciences provide guidance on standards of care and prevention in clinical trials. In the current and increasingly challenging research environment, the ethical status of a trial design depends not only on protection of participants, but also on social value, feasibility, and scientific validity. Using the example of a study assessing efficacy of a vaccine to prevent human papilloma virus in HIV-1 infected adolescent girls in low resource countries (...) without access to the vaccine, we compare several trial designs which rank lower on some criteria and higher on others, giving rise to difficult trade-offs. This case demonstrates the need for developing more nuanced guidance documents to help researchers balance these often conflicting criteria. (shrink)

This long and complicated sentence has not been correctly translated nor clearly explained by any of the editors of the Phaedo that I have been able to consult. Bekker, Stallbaum, Wohlrab, Geddes, Wagner, Archer-Hind, Williamson, Burnet, in their notes on the passage say much that is true, but all seem to fall into certain errors. None of them has given an accurate and coherent picture of the passage as a whole. In attempting to supply such a picture I have pointed (...) out what I believe to be the mistakes of these editors, and on certain points of grammar, textual criticism, and interpretation I have some new suggestions to offer. So much emphasis on one sentence is not misplaced, for this is an important sentence, the culminating point of the first section of the dialogue, and containing in brief the essence of the ethics which Plato expounds through the mouth of Socrates. It is the peroration of Socrates' Apologia pro Vita sua, introduced by the impressive words: ⋯ μακ⋯ριε ειμμ^iota;α, a form of address often used by Socrates in passages of ‘pith and moment’. (shrink)

The pregnant phrase fatale monstrum comes at a crucial point in the third and longest of the three sentences of the ‘Cleopatra Ode’. Before it Cleopatra is being hissed from the stage of history with cries of disapproval; after it she is recalled to receive plaudit after plaudit for her courage and resolution. The phrase is emphasized by its position at the start of a stanza followed by a marked pause. Prima facie it is the climax of the vituperation, and (...) has often so been taken. T. E. Page, for example, comments: ‘Horace speaks of Cleopatra as not human, but a hideous and portentous creature sent by destiny to cause horror and alarm.’. (shrink)

This dissertation seeks to contribute to research in the philosophy of social science. The study focuses upon select epistemological and ontological aspects of Hannah Arendt’s work from which methodological implications are drawn pertaining to sociology. Arendt, although critical of the sociology of her time, has become increasingly cited and influential for emerging sociological research and this study seeks to contribute to this by focusing upon the problem of novelty. The aim is to explore the philosophical and methodological implications of novelty (...) for social science by working through three case studies that are theoretically pivotal for social science—action, the ‘social’, and the self—in terms of novelty as expressed in Arendt’s writing. Arendt is critical of methodology and epistemology, aiming to draw her readers to ontological concerns outlined from her preoccupation with the 'world' and social reality. In this aim, Arendt seeks to distance herself from social sciences that she claims ignore human novelty in favour of reading social regularities, tendencies and similarities. Despite her disdain for method, Arendt suggests a anti-methodological 'method' (outlined in an overlooked footnote) for keeping trained upon and for dealing with novel, anomalous events. In the seed of this method lies a unique opportunity for social science to reassess and extend its methods, addressing this oversight and in so doing bring to light the novel social object as a legitimate subject of social research. (shrink)

In Cratylus 385 b-c Plato argues that if statements () can be true or false, names (),2 as parts () of statements, are also capable of being true or false. From Aristotle onwards this view has often been challenged,3 and R. Robinson put the case against it trenchantly when he wrote:4This argument is bad; for names have no truth-value, and the reason given for saying that they do is a fallacy of division. No one in the dialogue points out that (...) it is bad. … Nevertheless it is fairly probable that Plato saw or at least felt that it is a bad argument, quite different in quality from those he later produces against the nature-theory. (shrink)

The current rise in malpractice litigation has led to concern in the research community as to the prospect of litigation against researchers. Clearly as the responsibility for the day-to-day conduct of the research falls upon the researchers they will be potentially liable should there be negligence in the conduct of the research project itself. But to what extent can the research ethics committee and its members be held liable should harm result to the research subject? How far does the prospect (...) of the threat of litigation equate with the reality of the prospect of liability? Although the NHS research governance framework suggests that primary responsibility for the conduct of the trial is with the researcher this does not mean that REC members will be immune from actions in tort where research subjects suffer harm in the conduct of a research project approved by their NHS REC. This paper focuses upon the prospect for liability in the law of tort of NHS RECs and their members. While in practice the vast majority of such claims are unlikely to be successful members of RECs may incur resultant legal costs as a consequence of involvement in proposed litigation. It is submitted that the scope of indemnity provision provided to RECs and their members should be precisely determined, otherwise there is a real prospect that the risk of malpractice litigation may deter individuals from serving on such committees. (shrink)