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)

Although it seems that ethics and religion should be related, past research suggests mixed conclusions on the relationship. We argue that such mixed results are mostly due to methodological and conceptual limitations. We develop hypotheses linking Cornwall et al.’s (1986, Review of Religious Research, 27(3): 266–244) religious components to individuals’ willingness to justify ethically suspect behaviors. Using data on 63,087 individuals from 44 countries, we find support for three hypotheses: the cognitive, one affective, and the behavioral component of religion are (...) negatively related to ethics. Surprisingly, one aspect of the cognitive component (i.e., belief in religion) shows no relationship. Implications for research and practice are discussed. (shrink)

BackgroundIn response to COVID-19 pandemic, the Government of Uganda adopted public health measures to contain its spread in the country. Some of the initial measures included refusal to repatriate citizens studying in China, mandatory institutional quarantine, and social distancing. Despite being a public health emergency, the measures adopted deserve critical appraisal using an ethics and human rights approach. The goal of this paper is to formulate an ethics and human rights criteria for evaluating public health measures and use it to (...) reflect on the ethical propriety of those adopted by the government of Uganda to contain the spread of COVID-19.Main bodyWe begin by illustrating the value of ethics and human rights considerations for public health measures including during emergencies. We then summarize Uganda’s social and economic circumstances and some of the measures adopted to contain the spread of COVID-19. After reviewing some of the ethics and human rights considerations for public health, we reflect upon the ethical propriety of some of Uganda’s responses to COVID-19. We use content analysis to identify the measures adopted by the government of Uganda to contain the spread of COVID-19, the ethics and human rights considerations commonly recommended for public health responses and their importance. Our study found that some of the measures adopted violate ethics and human rights principles. We argue that even though some human rights can sometimes be legitimately derogated and limited to meet public health goals during public health emergencies, measures that infringe on human rights should satisfy certain ethics and human rights criteria. Some of these criteria include being effective, strictly necessary, proportionate to the magnitude of the threat, reasonable in the circumstances, equitable, and least restrictive. We reflect on Uganda’s initial measures to combat the spread of COVID-19 and argue that many of them fell short of these criteria, and potentially limit their effectiveness.ConclusionThe ethical legitimacy of public health measures is valuable in itself and for enhancing effectiveness of the measures. Such legitimacy depends on the extent to which they conform to ethics and human rights principles recommended for public health measures. (shrink)

For those to whom John Bowring's name means anything, the most likely association with it is the complex and question-begging term ‘Benthamite’. Contemporaries certainly used the term, particularly when they wanted to suggest that his actions were narrowly ideological or theoretical. But to some of Bowring's contemporaries another association served hostile intent almost as well: his Unitarianism.

In this article, the important but neglected link between workplace safety-enhancing behavior and ethics is explored. Using data from 237 employees from five manufacturing plants in the Midwest, we investigated how specific local ethical climate types are linked to incidences of injuries and two types of safety-enhancing behaviors: safety compliance and safety participation. It was hypothesized that egoist climates are positively related to injuries and negatively related to safety-enhancing behaviors. In contrast, it is proposed that both benevolent and principled climates (...) have negative relationships with injuries and positive relationships with safety-enhancing behaviors. Results provided support only for our principled climate types while benevolence has the desired negative relationship with injuries. Egoism and benevolence are not related to safety-enhancing behaviors. Theoretical and practical implications of findings are discussed. (shrink)

Yoga-Sutras of Patanjali is a foundational psychological text that organizes, codifies, and systematically presents in s_tra form the psychology as practised in India around second century BCE. Its theme is to help humans free themselves from their congenital bondage due to conditioned existence and consequent suffering. The goal is to restore the person to her inherent unconditioned blissful being. The quintessence of Yoga is meditation. Meditation consists of dharana and dhyana, a contemplative state of passive attention precipitated by a prolonged (...) practice of concentration. Dhy_na practice leads to sam_dhi, a stand-still altered state in which the mind is controlled and restrained from habitual cognitive processing. This paper provides a theoretical background of Patanjali Yoga and a select review of empirical research on the neurophysiological correlates of meditation, highlighting on the one hand some of its methodological shortcomings and conceptual problems and suggesting on the other hand the areas of promise for further research on meditation. (shrink)

What are the criteria for reasonable clinical judgements? The reasonableness of macro-level decision-making has been much discussed, but little attention has been paid to the reasonableness of applying guidelines generated at a macro-level to individual cases. This paper considers a framework for reasonable clinical decision-making that will capture cases where relevant guidelines cannot reasonably be followed. There are three main sections. (1) Individual claims on healthcare from the point of view of concerns about equity are analysed. (2) The demands of (...) responsibility and equity on professional clinical performance are discussed, and how the combination of these demands emerges into seven requirements that constitute the framework is explored. Since this framework is developed to assist in reasonable clinical decision-making, practical implications of all these requirements are also suggested. (3) Challenges concerning the framework are discussed. First, a crucial presumption that the framework relies upon is considered—namely, clinicians’ willingness to justify their decisions as requested. Then how public deliberation may influence clinical decision-making is discussed. Next is a consideration of how clinicians’ need to have confidence in their own judgements in order to perform in a manner worthy of trust would be compatible with adherence to the framework supported by public deliberation. It is concluded that fair distribution in the interplay between macro- and micro-level considerations can be secured by legitimising procedures on each level, by ensuring well-organised and continuing public debate and by basing individual clinical judgements upon well-justified and principled normative bases. (shrink)

Purpose: This paper is a brief introduction to enactive cognitive science: a description of some of the main research concerns; some examples of how such concerns have been realized in actual research; some of its research methods and proposed explanatory mechanisms and models; some of the potential as both a theoretical and applied science; and several of the major open research questions. Findings: Enactive cognitive science is an approach to the study of mind that seeks to explain how the structures (...) and mechanisms of autonomous cognitive systems can arise and participate in the generation and maintenance of viable perceiver-dependent worlds -- rather than more conventional cognitivist efforts, such as the attempt to explain cognition in terms of the ``recovery'' of (pre-given, timeless) features of The (objectively-existing and accessible) World. As such, enactive cognitive science is resonant with radical constructivism. Research implications: As with other scientific efforts conducted within a constructivist orientation, enactive cognitive science is broadly ``conventional'' in its scientific methodology. That is, there is a strong emphasis on testable hypotheses, empirical observation, supportable mechanisms and models, rigorous experimental methods, acceptable criteria of validation, and the like. Nonetheless, this approach to cognitive science does also raise a number of specific questions about the scope of amenable phenomena (e.g., meaning, consciousness, etc.) -- and it also raises questions of whether such a perspective requires an expansion of what is typically considered within the purview of scientific method (e.g., the role of the observer/scientist). (shrink)

A review of empirical and theoretical work on reasoning and linguistic inference, which will be a useful introduction to the subject for students of language and thought. The book focuses on the relationship between what people do and what people are supposed to do when making inferences.

In Nicolaus Cusanus on Faith and the Intellect: A Case Study in 15th-Century Fides-Ratio Controversy, K.M. Ziebart presents an account of the Cusan epistemology as a fascinating late-medieval attempt to definitively harmonize faith and reason.

Recent research in the cognitive science of religion suggests that humans intuitively believe that others survive death. In response to this finding, three cognitive theories have been offered to explain this: the simulation constraint theory (Bering, Citation2002); the imaginative obstacle theory (Nichols, Citation2007); and terror management theory (Pyszczynski, Rothschild, & Abdollahi, 2008). First, I provide a critical analysis of each of these theories. Second, I argue that these theories, while perhaps explaining why one would believe in his own personal immortality, (...) leave an explanatory gap in that they do not explain why one would intuitively attribute survival of death to others. To fill in the gap, I offer a cognitive theory based on offline social reasoning and social embodiment which provides for the belief in an eternal social realm in which the deceased survive—the afterlife. (shrink)

In the context of the blurring of boundaries between club and theatre, game and theatre, and party and theatre, experiential spectatorship is spilling into the mainstream. This article starts from the recognition of the rapid rise of the experience economy as a turning point in consumer culture towards a specific appeal to the sensory body. The definition of experience in this analysis is key and a distinction is made between experience as it passes moment by moment, erlebnis, and experience as (...) something that is cumulatively built up over time, erfahrung. This paper asks, in a society defined by the crisis of experience, does this rise of the experiential in theatre simply reflect the reduction of experience to a series of consumable sensory moments or is there a mode of experience modelled through performance interaction which moves both beyond this established mode of experience and also beyond the notion of experience as cumulatively formed wisdom? Drawing a parallel between established popular cultural practices of the body and those of the spectator in spectacular promenade performance, Fuerzabruta is used as an illustrative example of popular experiential performance and Hwang’s The Road as an example of experiential performance in which a transformative aesthetic is made possible. (shrink)

Why do we persist in the relentless pursuit of artificial nourishment and other treatments to maintain a permanently unconscious existence? In facing the future, if not the present world-wide reality of a huge number of persistent vegetative state (PVS) patients, will they be treated because of our ethical commitment to their humanity, or because of an ethical paralysis in the face of biotechnical progress? The PVS patient is cut off from the normal patterns of human connection and communication, with a (...) life unlike other forms of human existence. Why the struggle to justify ending a life which, it is said, has suffered an irreversible loss of the content of consciousness? Elsewhere, the authors have addressed the ethical controversies and confusion engendered by ambiguous terminology, misuse of medical facts and the differing interpretations of what constitutes 'effective' treatment: in particular, the issue of whether in fact artificial nutrition and hydration is a medical treatment, or simply part of the obligatory care owed to all patients, permanently unconscious or not. In this paper, we intend to argue that recent analyses of medical futility, its meaning and ethical implications, despite an absence of public consensus, permit some tentative re-evaluation of our ethical obligations to the PVS patient. (shrink)

Clinician gate-keeping is the process whereby healthcare providers prevent access to eligible patients for research recruitment. This paper contends that clinician gate-keeping violates three principles that underpin international ethical guidelines: respect for persons or autonomy; beneficence or a favourable balance of risks and potential benefits; and justice or a fair distribution of the benefits and burdens of research. In order to stimulate further research and debate, three possible strategies are also presented to eliminate gate-keeping: partnership with professional researchers; collaborative research (...) design and clinician education. (shrink)

Study of the Advaita and the philosophy of Immanuel Kant, 1724-1804, German philosopher.