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)

This paper advances a theory of disease as domino dysfunction. It is often argued that diseases are biological dysfunctions. However, a theory of disease as biological dysfunction is complicated by some plausible cases of dysfunction, which seem clearly non-pathological. I argue that pathological conditions are not just dysfunctions but domino dysfunctions, and that domino dysfunctions can be distinguished on principled biological grounds from non-pathological dysfunctions. I then show how this theory can make sense of the problem cases; they are not (...) diseases because they are not domino dysfunctions. (shrink)

Considerations of dynamic inconsistency have figured prominently in debates over the rationality of preferences that violate the separability conditions characteristic of expected utility theory. These debates have mostly focused on risk- and ambiguity averse preferences, but analogous considerations apply to preferences for fairness. We revisit these debates in the context of a specific hypothesis regarding the violations of separability by such preferences, namely that they are potentially both explained and rationalised by attitudes to the chances of goods that motivate a (...) preference for equality in the distribution of chances across people and possible events. Our main aim is to argue that, first, when these violations of static separability are motivated by such attitudes to chances, then they need not result in dynamically inconsistent behaviour. Second, and more generally, considerations of dynamic consistency do not, we argue, undermine the rationality of such attitudes towards the distribution of chances, despite the fact that such attitudes give rise to violations of the static separability assumptions of expected utility theory. (shrink)

In this paper, I show that Aristophanes’s speech in Plato’s Symposium is tied into an interesting and hitherto unexplored web of ideas in Plato’s ethics and psychology. The poet’s analysis of erōs as ‘leading us to what “belongs” (the oikeion)’ (193d2) and as ‘restoring us in our “original nature” (archaia phusis)’ (193d4) is not a mere negative contribution that renders him a ‘target for Diotima’s fire’ (Dover). Rather, he unwittingly communicates central ethical and psychological ideas which we find developed in (...) key passages of Plato’s dialogues. What is interesting is that Diotima in a curious passage seems to dismiss his contribution of the oikeion as unrelated to our good (agathon) and irrelevant to the analysis of desire (205d10–206a1). I argue that this interpretation of Diotima’s response to Aristophanes, which would render her position an ethical anomaly in Plato’s dialogues, should be rejected. Instead, it is more plausible to read her response as proposing a revisionary conception of the oikeion, relying on the idea that our agathon is our true oikeion. In addition, I tentatively suggest that the theory of psychic pregnancy may be seen as presenting the agathon of wisdom of virtue produced in the ascent as an oikeion. Just as fascinating as Diotima’s stance on the oikeion is the question how her teachings relate to the concept of an archaia phusis of the soul. The idea that the soul’s self-perfection constitutes a return to a temporally prior condition of excellence, which in two places other than the Symposium (Republic X, Timaeus) is called the ‘archaia phusis’, is pervasive and centrally important to Plato’s psychology. I address the question whether Diotima’s ascent passage constitutes a psychological anomaly in portraying self-perfection as unrelated to the concept of the archaia phusis. I argue that an answer to this depends on the stance we take on the Symposium’s position regarding the immortality of the soul. While a reading that posits a rejection of immortality in the Symposium must indeed deny a role for the concept in Diotima’s speech, I show that a reading allowing for immortality as a theoretical commitment in the background has an interesting interpretative option: along with Timaeus 90d5, it may fruitfully interpret the ascent as an ordering of the soul ‘in accordance with its archaia phusis’. (shrink)

Ocean-based salmon farming, as presently practiced, is thought to pose an existential threat to what we today think of as wild salmon. This raises ethical questions about, first, the value of wild salmon, and, second, the value of wild salmon of the particular type that exists today. This essay uses the debate around ocean-based salmon farming as a case study of ‘irreversible damage’, a concept that figures heavily in environmental laws and regulations, in particular, in the so-called ‘precautionary principle’. It (...) is argued that although ocean-based salmon farming may, on the face of it, seem to be a prime example of a threat of irreversible damage, a wish to avoid irreversible damage does not support banning such farming. In contrast, it is argued that concern for irreplaceable value might support a ban. The findings suggest that it would often be appropriate for environmentalists and conservationists to focus more on irreplaceable value and less on irreversible damage. (shrink)

The dominant approach to environmental policy endorsed by conservative and libertarian policy thinkers, so-called “free market environmentalism”, is grounded in the recognition and protection of property rights in environmental resources. Despite this normative commitment to property rights, most self-described FME advocates adopt a utilitarian, welfare-maximization approach to climate change policy, arguing that the costs of mitigation measures could outweigh the costs of climate change itself. Yet even if anthropogenic climate change is decidedly less than catastrophic, human-induced climate change is likely (...) to contribute to environmental changes that violate traditional conceptions of property rights. Viewed globally, the actions of some countries—primarily industrialized nations—are likely to increase environmental harms suffered by other countries—less developed nations that have not made any significant contribution to climate change. It may well be that aggregate human welfare would be maximized in a warmer, wealthier world, or that the gains from climate change will offset environmental losses. Yet such claims, even if demonstrated, would not address the normative concern that the consequences of anthropogenic global warming would infringe upon the rights of people in less-developed nations. As a consequence, this paper calls for a rethinking of FME approaches to climate change policy. (shrink)

Description: Ancient Indian logic by itself is a very vast subject. The ancient Sanskrit term nyaya which was first used in a different or in a much more general sense, was later specifically applied to the Nyaya school. The physics and physiology and psychology of the Nyaya doctrine are not specifically its own, being from the first indistinguishable from those of its sister Sastra, the Vaisesika. What characterizes it specifically is the development of the nyaya or five-membered method of demonstration (...) and its insistence on the four sources of knowledge, corresponding to the first four members of its demonstrative formula, or 'Syllogism.' The importance of Nyaya is in its doctrine of the pramanas, or sources of proof, and in its formulation of the nyaya, or method of demonstration. Indian Logic in its Early Schools by H.N. Randle is an interpretation of Indian logical theory in its historical development based on the study of original texts wherever reference to Nyaya as a method of logic has been made, and thus, covers a very wide field of Indian philosophy. An indispensable work for students of Indian philosophy, it is especially important for those who are interested in Nyayadarsana in its relation to the early logic of other schools. (shrink)

Protection of study participants is an integral function of the Institutional Review Board. Recently, great efforts were dedicated to enhance investigators’ awareness of ethical principles in conducting human research and to implement reviewing committees’ standards in Jordan to ensure the transparency, versatility, and responsibility in handling human subjects research in the country. The aim of the current study is to evaluate the awareness and attitudes of healthcare investigators in Jordan towards the structure and importance of IRBs. A questionnaire was distributed (...) to 200 investigators and graduate students from the Jordan University of Science and Technology. The majority of the responses indicated positive knowledge towards core ethics guidelines and the importance of IRBs. This includes beneficence, confidentiality, informed consent, and treating participants with respect. In addition, the majority of participants agreed on the importance of the IRB for ensuring the rights, safety, and well-being of the research subjects. Moreover, the majority of participants agreed that the IRB members should be trained on ethics regulations in conducting research and declare any conflict of interest with the investigators. On the other hand, about 30% of participants believed that being reviewed by the IRB would delay research and make it more difficult for the researcher. Jordanian investigators have good awareness of and knowledge about research ethics and the importance of IRBs, though more education is needed. (shrink)

This paper studies general numerical networks with support and attack. Our starting point is argumentation networks with the Caminada labelling of three values 1=in, 0=out and ½=undecided. This is generalised to arbitrary values in [01], which enables us to compare with other numerical networks such as predator?prey ecological networks, flow networks, logical modal networks and more. This new point of view allows us to see the place of argumentation networks in the overall landscape of networks and import and export ideas (...) to and from argumentation networks. We make a special effort to make clear how general concepts in general networks relate to the special case of argumentation networks. We pay special attention to the handling of loops and to the special features of numerical support. We find surprising connections with the Dempster?Shafer rule and with the cross-ratio in projective geometry. This paper is an expansion of our 2005 paper and so we also consider higher level features such as numerical attacks on attacks, and propagation of numerical values.We conclude with a brief view of temporal numerical argumentation and with a detailed comparison with related papers published since 2005. (shrink)

We start this issue of Journal of Military Ethics with a recent address on military ethics given by one of the US ARMY's leading officers.Brigadier General H. R. McMaster graduated from the United...

The question of whether the Einstein shift in clock rates has a bearing on the validity of the fourth Heisenberg uncertainty relation is discussed. It is shown that, even if one would accept all the relevant assumptions and conclusions of Bohr and Rosenfeld, this uncertainty relation could not be saved by an Einstein shift in the case of an electrostatic weighing. This means that the Einstein shift does not play any role in determining the validity of the fourth Heisenberg relation.

The object of this article is to examine, with the work of Jeremy Bentham as the principal example, one strand in the complex pattern of European social theory during the second half of the eighteenth century. This was of course the period not only of the American and French revolutions, but of the culmination of the movements of thought constituting what we know as the Enlightenment. Like all great historical episodes, the Enlightenment was both the fulfilment of long-established processes and (...) the inauguration of new processes of which the fulfilment lay in the future. Thus the seminal ideas of seventeenth-century rationalism realized and perhaps exhausted their potentialities in the eighteenth-century Enlightenment. The ideas with which this article is concerned, however—conveniently grouped and labelled as the ideas of utilitarianism—only began to achieve systematic development in these later decades of the eighteenth century. Within that period—during the first half and more of Bentham's long life—attempts to apply those ideas to the solution of social problems met largely with failure and frustration. Yet unrealized potentialities remained, the realization of which was reserved for a time when the world of the philosophes no longer existed. The movements for social and political reform which have played so large a part in modern history since the French Revolution may be judged in widely differing ways; but whatever the verdict, these movements surely cannot be understood without due consideration of that part of their origins which lies in eighteenth-century utilitarianism. (shrink)

By the death, last summer, of Jack Robson, the world of utilitarian studies and a wider world of scholarship on both sides of the Atlantic lost one of their most distinguished figures. It would not be appropriate here, even if it were possible now, to attempt a full and measured assessment of his work. Writing only a few months after the news of his death, while the sense of loss is still so sharp for all his many friends, two things (...) are possible. Something can and should be said to acknowledge and celebrate Robson's achievement as a scholar; and to this can be added some personal recollections of one whose human qualities were as outstanding as his scholarship. (shrink)

This essay provides evidence to support a promising conceptual and potentially practical set of ideas at once both principled and effective found in the work of Max Weber and Alfred Schutz addressed to the issue of ‘adequacy’ as a goal in social research. Efforts to achieve adequacy beyond the epistemological conditions required by Weber’s demand that evidence meet both causal adequacy and adequacy on the level of meaning were significantly refocused by Schutz’s later concern, responding specifically to Weber, that the (...) social sciences also address themselves to his postulate of adequacy. It states that “Each term used in a scientific system referring to human action must be so constructed that a human act performed within the life-world by an individual actor in the way indicated by the typical construction would be reasonable and understandable for the actor himself, as well as for his fellow men”. A serious attempt to implement a more expansive notion of adequacy by practically activating this postulate in the ways suggested can be beneficial not only for the social research situation but in everyday life as well. (shrink)

In studying the thinkers discussed, we have generally used (translations of) their writings. The very breadth of this study makes one dependent upon ...

I start with two contradictory statements: Jaeger, Aristotle, p. 330: ‘Thus all indications point to a late date for the origin of the philosopher's zoological works.’ D'Arcy Thompson, Historia Animalium, Prefatory Note: ‘It can be shown that Aristotle's natural history studies were carried on, or mainly carried on, in his middle age, between his two periods of residence at Athens.‘.

Pioneering sociologist William Graham Sumner (1840Ð1910) was a prolific and astute historian of the early American republic. His work is informed by both his classical liberalism and his understanding of economics. He authored eight major works including major biographies and thematic studies concentrating on the vital subjects of currency, banking, business cycles, foreign trade, protectionism, and democratic politics.

At the beginning of the twentieth century, poliomyelitis presented a scientific and medical challenge of a complexity similar to that of AIDS now. Research on polio, mainly in the US, gradually became focussed to solving basic questions, but was held up by the lack of suitable laboratory techniques. The financing of the research and the wide range of basic topics funded were the model for later medical science. The problem of polio, at least in the wealthier temperate countries, has been (...) solved by the use of vaccines. Many fundamental questions about the mechanism of the disease remained unsolved and this lack of knowledge has contributed to many unfortunate accidents. The history of polio has many lessons for AIDS researchers. (shrink)