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 essay consists of two parts. In the first part, I focus my attention on the remarks that Frege makes on consistency when he sets about criticizing the method of creating new numbers through definition or abstraction. This gives me the opportunity to comment also a little on H. Hankel, J. Thomae—Frege’s main targets when he comes to criticize “formal theories of arithmetic” in Die Grundlagen der Arithmetik (1884) and the second volume of Grundgesetze der Arithmetik (1903)—G. Cantor, L. E. (...) J. Brouwer and D. Hilbert (1899). Part 2 is mainly devoted to Hilbert’s proof theory of the 1920s (1922–1931). I begin with an account of his early attempt to prove directly, and thus not by reduction or by constructing a model, the consistency of (a fragment of) arithmetic. In subsequent sections, I give a kind of overview of Hilbert’s metamathematics of the 1920s and try to shed light on a number of difficulties to which it gives rise. One serious difficulty that I discuss is the fact, widely ignored in the pertinent literature on Hilbert’s programme, that his language of finitist metamathematics fails to supply the conceptual resources for formulating a consistency statement qua unbounded quantification. Along the way, I shall comment on W. W. Tait’s objection to an interpretation of Hilbert’s finitism by Niebergall and Schirn, on G. Gentzen’s allegedly finitist consistency proof for Peano Arithmetic as well as his ideas on the provability and unprovability of initial cases of transfinite induction in pure number theory. Another topic I deal with is what has come to be known as partial realizations of Hilbert’s programme, chiefly advocated by S. G. Simpson. Towards the end of this essay, I take a critical look at Wittgenstein’s views about (in)consistency and consistency proofs in the period 1929–1933. I argue that both his insouciant attitude towards the emergence of a contradiction in a calculus and his outright repudiation of metamathematical consistency proofs are unwarranted. In particular, I argue that Wittgenstein falls short of making a convincing case against Hilbert’s programme. I conclude with some philosophical remarks on consistency proofs and soundness and raise a question concerning the consistency of analysis. (shrink)

There appear to be a number of general things which can be said about forgiveness. If these are left sufficiently vague they seem to be applicable to all the situations in which the term is used.First, there can be no question of forgiveness unless an injury has been inflicted on somebody by a moral agent. There must be something to forgive; and the injury that is to be forgiven must be one for which a moral agent can be held responsible. (...) One cannot forgive a rock for falling on one's foot or a cougar for attacking one's child—even though a child might kick the rock and a father might shoot the cougar. (shrink)

The present volume contains the lectures and papers given at the 1994 international conference on hermeneutics in Halle (Germany). The conference aimed at a state of the art in the light of recent developments in science and humanities. The place in which the conference was held is renowned for its centuries-old tradition in hermeneutics and among the lectures there are indeed some devoted to this history. For the most part, however, the papers concentrate on present-day problems in fields as different (...) as comparative literature, religious studies, bible exegesis, esthetics, social sciences, intercultural dialogue. The theme of the conference, "strangeness and familiarity", reflects the tension in which any interpretation process is situated and that any theory of interpretation has to account for. The contributions to the volume are in German and French. (shrink)

Quine seems to maintain that there is no sharp distinction between analytic and synthetic sentences, and also that 'analytic' and 'synthetic' have no meaning. the dependence of these concepts on 'meaning' is used to show the incompatibility of these two interpretations of quine's conception of the analytic and the synthetic, and to show that both have a paradoxical character of their own. that may threat reductionist semantics as a whole. still the need for a totally different (rationalistic, essentialistic) semantics may (...) be obviated by a reasonable explication of a vague distinction between the analytic and the synthetic. (shrink)