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)

For more than fifty years, Sterling M. McMurrin served as one of the preeminent intellectual voices of the LDS community. From his beginnings as an Institute of Religion instructor to U.S. Commissioner of Education, and from a professor of philosophy to U.S. Envoy to Iran, he showed by example how personal and institutional morality can be defended.In a series of candid discussions with Jack Newell, McMurrin reveals his ability to reconcile freedom and conscience. In a spirit of repartee and friendship, (...) writes Boyer Jarvis in the foreword, Newell probes, challenges, and constantly draws McMurrin out as he... reflects upon his wide-ranging ideas and experiences. Rich in insight and humor, this remarkable dialogue captures the sweep and depth of McMurrin's thoughts as Newell engages him in discussing his approaches to philosophy, education, and religion.Among the qualities that characterized McMurrin's life and mind, explains Newell, perhaps the most notable is the freedom with which he has spoken his views on both the sacred and the profane. His intellectual integrity -- coupled as it almost always is with his humane instincts and innate fairness -- has simultaneously confounded and earned the respect of critics. (shrink)

This is the first of a series of commentaries on the works of the latest Heidegger; all of Heidegger's works published by Neske of Pfullingen since 1954 will be presented and interpreted in the series. The expository plan announced in the editor's preface calls for three-part commentaries, with the first part summarizing the work in question, the second presenting glosses of lines or paragraphs as required by their respective importance, and the third giving philological exegesis of texts also as required (...) in the judgment of the editors. The interpretative inspiration is generally traditional, with more emphasis given to themes with echoes in medieval and modern rationalism and in Italian and French ontologism. The editors adopt Heidegger's characteristic attitude in his latter period, his relinquishing of all objective or subjective idealistic presuppositions. Ontology thus becomes the unveiling of the conditions of possibility of Dasein's speech as truth-making. In Being and Time these conditions of possibility were given in the fundamental ontology and reached their existential expression in resolve. In Gelassenheit Dasein has become a mere instrumentality for the ultimate sense of Being to come to pass. The conditions of possibility of the new Dasein are well understood and highlighted by Landolt. Their existential expression is a new temporal tension within the Dasein, that of Warten or attending. If resolve was the modal intentionality of authentic Dasein, attending is the modal intentionality of poetic symbolic Dasein. Landolt does not seem to have been sufficiently critical of the reflective character of this new intentionality. Can it adequately ground essence, fact and freedom? The techniques of this commentary often depart from hermeneutical respect for the text.--A. M. (shrink)