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)

An outline of the life of Heraclides and his fragmentary writings (on the theory of matter, astronomy, ethical and religious topics) is followed by an attempt to reconstruct his thought. He emerges as not so much a profound thinker as a many-sided writer of considerable literary gifts and occasional flashes of brilliance.

This work has been selected by scholars as being culturally important and is part of the knowledge base of civilization as we know it. This work is in the public domain in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. Scholars believe, and we concur, that this work is important enough to be (...) preserved, reproduced, and made generally available to the public. To ensure a quality reading experience, this work has been proofread and republished using a format that seamlessly blends the original graphical elements with text in an easy-to-read typeface. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

It is easy to understand why Hegel's philosophy should be little studied by English-speaking philosophers today. Those who at the beginning of the twentieth century initiated the movement we are now caught up in presented their earliest philosophical arguments as criticisms of the prevailing Anglo-Hegelian views. It may now be thought illiberal to take much interest in this perhaps excusably slaughtered royal family, and positively reactionary to hanker after the foreign dynasty from which it sometimes claimed descent. Hegel was a (...) systematic philosopher with a scope hardly to be found today, and men who, as we say, wish to keep up with their subject may well be daunted at the idea of having to understand a way of looking at philosophy which they suspect would not repay them for their trouble anyway. Furthermore, since Hegel wrote, formal logic has advanced in ways he could not have foreseen, and has, it seems to many, destroyed the whole basis of his dialectical method. At the same time, the creation of a science of sociology, it is supposed, has rendered obsolete the philosophy of history for which Hegel was at one time admired. In countries where there are Marxist intellectuals, Hegel does get discussed as the inadvertent forerunner of historical and dialectical materialism. But in England, where there is no such need or presence, there do not seem to be any very strong ideological reasons for discussing him. In what follows I shall be asking you to direct your thoughts to certain forgotten far-off things which I hope you will find historically interesting even if you do not agree with me that they give important clues for an understanding of human nature and human society. (shrink)

It is easy to understand why Hegel's philosophy should be little studied by English-speaking philosophers today. Those who at the beginning of the twentieth century initiated the movement we are now caught up in presented their earliest philosophical arguments as criticisms of the prevailing Anglo-Hegelian views. It may now be thought illiberal to take much interest in this perhaps excusably slaughtered royal family, and positively reactionary to hanker after the foreign dynasty from which it sometimes claimed descent. Hegel was a (...) systematic philosopher with a scope hardly to be found today, and men who, as we say, wish to keep up with their subject may well be daunted at the idea of having to understand a way of looking at philosophy which they suspect would not repay them for their trouble anyway. Furthermore, since Hegel wrote, formal logic has advanced in ways he could not have foreseen, and has, it seems to many, destroyed the whole basis of his dialectical method. At the same time, the creation of a science of sociology, it is supposed, has rendered obsolete the philosophy of history for which Hegel was at one time admired. In countries where there are Marxist intellectuals, Hegel does get discussed as the inadvertent forerunner of historical and dialectical materialism. But in England, where there is no such need or presence, there do not seem to be any very strong ideological reasons for discussing him. In what follows I shall be asking you to direct your thoughts to certain forgotten far-off things which I hope you will find historically interesting even if you do not agree with me that they give important clues for an understanding of human nature and human society. (shrink)