Volume 19, Issue 10, October 2019, Page 99-101.

In their paper, “Helpful Lessons and Cautionary Tales: How Should COVID-19 Drug Development and Access Inform Approaches to Non-Pandemic Diseases?” Holly Fernandez Lynch and colleagues have present...

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)

Bu çalışmanın temel amacı, üniversite öğrencilerinin tevbe kavramına ilişkin sahip oldukları algıları metaforlar aracılığıyla ortaya çıkarmaktır. Araştırmada nitel araştırma desenlerinden olgubilim (fenomenoloji) modeli kullanılmıştır. Araştırmanın çalışma grubunu 2023-2024 eğitim-öğretim yılı güz döneminde Bursa Uludağ Üniversitesi ve Bursa Teknik Üniversitesi’nin çeşitli fakültelerinde öğrenim gören toplam 196 öğrenci oluşturmaktadır. Araştırmada veriler Google Form aracılığı ile toplanmıştır. Veri toplama aracı olarak çalışmada kişisel bilgi formu ve “Tevbe....(metafor)…benzer, çünkü....(metafor sebebi)” cümlelerinin kullanıldığı yarı yapılandırılmış bir anket formu kullanılmıştır. Verilerin analizi ve yorumlanmasında içerik analizi tekniğinden (...) yararlanılmıştır. Araştırma sonunda 196 üniversite öğrencisi tarafından 70 farklı metafor üretildiği bulgulanmıştır. Araştırmada tevbe kavramına ilişkin üretilen metaforlarla ilgili tevbenin dinî işlevi ve tevbenin psikolojik işlevi olmak üzere 2 tema oluşturulmuştur. Tevbenin dinî işlevi temasına (%60,2) ait 3 kod oluşturulmuştur: Manevî arınma yolu, kutsalla buluşma ve iyi davranışlarda kararlılık. Tevbenin psikolojik işlevi temasına (%39,8) ait olarak da 3 kod oluşturulmuştur. Bu kodlar; psikolojik rahatlama, yeni bir başlangıç ve kendisiyle yüzleşmedir. Araştırma sonuçlarına göre metaforların manevî arınma yolu, kendisiyle yüzleşme ve yeni bir başlangıç kodlarında yoğunlaştığı tespit edilmiştir. (shrink)

In the early part of the paper, I attempt to explain a dispute between two parties who endorse the compositionality of language but disagree about its implications: Paul Horwich, and Jerry Fodor and Ernest Lepore. In the remainder of the paper, I challenge the thesis on which they are agreed, that compositionality can be taken for granted. I suggest that it is not clear what compositionality involves nor whether it obtains. I consider some kinds of apparent counterexamples, and compositionalist responses (...) to them in terms of covert indexicality and unspecific meanings. I argue that the last option is the best for most of the cases I consider. I conclude by stressing, as against Horwich and Fodor and Lepore, that the appropriate question concerns the extent to which compositionality obtains in a natural language, rather than whether it obtains or not, so that the answer is essentially messy, requiring detailed consideration of a wide range of examples. (shrink)

Richard Martin's aim in this paper is to present a critical method of making ethical decisions in a medical context. He feels that such a reflective method provides the best means of making the appropriate decisions in given situations. It is based on Dr Martin's experience in applying ethical theory while collaborating with physicians in the daily course of clinical practice. Through his giving of a functional definition of medical ethics, his descriptions of an analytical model, the significance of values (...) for clinical decision-making and the advocacy role of medical ethicists and their relationships with clinicians, Richard Martin sets out his own value-intention as regards an ideal decision process. He stresses that his argument is of particular importance to his fellow ethicists who should continuously and vigorously examine the creative interaction of faith and fact in their own inquiry and action. Dr Martin concludes by stating that physicians and ethicists can work together to accomplish their common aim, which is, of course, the health and well-being of the patient. (shrink)

In concluding section 2, chapter VI of part II of [6], Duhem claimed:... the physicist can never subject an isolated hypothesis to experimental test, but only a whole group of hypotheses...... when the experiment is in disagreement with his predictions, what he learns is that at least one of the hypotheses constituting this group is unacceptable and ought to be modified; but the experiment does not designate which one should be changed'.

We argue that thoughts are structures of concepts, and that concepts should be individuated by their origins, rather than in terms of their semantic or epistemic properties. Many features of cognition turn on the vehicles of content, thoughts, rather than on the nature of the contents they express. Originalism makes concepts available to explain, with no threat of circularity, puzzling cases concerning thought. In this paper, we mention Hesperus/Phosphorus puzzles, the Evans-Perry example of the ship seen through different windows, and (...) Mates cases, and we believe that there are many additional applications. (shrink)

I had a strange dream, or half-waking vision, not long ago. I found myself at the top of a mountain in the mist, feeling very pleased with myself, not just for having climbed the mountain, but for having achieved my life's ambition, to find a way of answering moral questions rationally. But as I was preening myself on this achievement, the mist began to clear, and I saw that I was surrounded on the mountain top by the graves of all (...) those other philosophers, great and small, who had had the same ambition, and thought they had achieved it. And I have come to see, reflecting on my dream, that, ever since, the hard-working philosophical worms have been nibbling away at their systems and showing that the achievement was an illusion. True, their skeletons, indigestible to worms, remained, and were surprisingly similar to one another. But I was led to think again about what one can, and what one cannot, achieve in this direction. (shrink)

Are fictional characters such as Sherlock Holmes real? What can fiction tell us about the nature of truth and reality? In this excellent introduction to the problem of fictionalism R. M. Sainsbury covers the following key topics: what is fiction? realism about fictional objects, including the arguments that fictional objects are real but non-existent; real but non-factual; real but non-concrete the relationship between fictional characters and non-actual worlds fictional entities as abstract artefacts fiction and intentionality and the problem of irrealism (...) fictionalism about possible worlds moral fictionalism. R. M. Sainsbury makes extensive use of examples from fiction, such as Sherlock Holmes, Anna Karenina and Madame Bovary and examines the work of philosophers who have made significant contributions to the topic, including Meinong, David Lewis, and Bas Van Fraassen. Additional features include chapter summaries, annotated further reading and a glossary of technical terms, making _Fiction and Fictionalism_ ideal for those coming to the issue for the first time. (shrink)

This book is available either individually, or as part of the specially-priced Arguments of the Philosphers Collection.