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)

Pv~P: Cambridge Journal of Undergraduate Philosophy, Issue 1, 1982.

Festschrift honoring P.F. Strawson; includes contributed articles on his contributions in logic and on logic.

This is a transcript of a conversation between P F Strawson and Gareth Evans in 1973, filmed for The Open University. Under the title 'Truth', Strawson and Evans discuss the question as to whether the distinction between genuinely fact-stating uses of language and other uses can be grounded on a theory of truth, especially a 'thin' notion of truth in the tradition of F P Ramsey.

Frank Plumpton Ramsey (1903-1930), Cambridge mathematician and philosopher, was one of the most brilliant people of his generation. He lived in an extraordinarily stimulating milieu, surrounded by figures such as Russell, Whitehead, Keynes, Moore, and Wittgenstein. Ramsey's highly original papers on the foundations of mathematics, probability, economics, philosophy of science and the theory of knowledge were very influential in the 20th century and are still widely discussed in the 21st.