> Wealthy nations must do much more, much faster. The United Nations General Assembly in September 2021 will bring countries together at a critical time for marshalling collective action to tackle the global environmental crisis. They will meet again at the biodiversity summit in Kunming, China, and the climate conference 26) in Glasgow, UK. Ahead of these pivotal meetings, we—the editors of health journals worldwide—call for urgent action to keep average global temperature increases below 1.5°C, halt the destruction of nature (...) and protect health. Health is already being harmed by global temperature increases and the destruction of the natural world, a state of affairs health professionals have been bringing attention to for decades.1 The science is unequivocal; a global increase of 1.5°C above the preindustrial average and the continued loss of biodiversity risk catastrophic harm to health that will be impossible to reverse.2 3 Despite the world’s necessary preoccupation with COVID-19, we cannot wait for the pandemic to pass to rapidly reduce emissions. Reflecting the severity of the moment, this editorial appears in health journals across the world. We are united in recognising that only fundamental and equitable changes to societies will reverse our current trajectory. The risks to health of increases above 1.5°C are now well established.2 Indeed, no temperature rise is ‘safe’. In the past 20 years, heat-related mortality among people aged over 65 has increased by more than 50%.4 Higher temperatures have brought increased dehydration and renal function loss, dermatological malignancies, tropical infections, adverse mental health outcomes, pregnancy complications, allergies, and cardiovascular and pulmonary morbidity and mortality.5 6 Harms disproportionately affect the most vulnerable, including children, older populations, ethnic minorities, poorer communities and those with underlying health problems.2 4 Global heating is also contributing to the decline in …. (shrink)

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 study described the relationships between academic class and student moral sensitivity and reasoning and between curriculum design components for ethics education and student moral sensitivity and reasoning. The data were collected from freshman (n = 506) and senior students (n = 440) in eight baccalaureate nursing programs in South Korea by survey; the survey consisted of the Korean Moral Sensitivity Questionnaire and the Korean Defining Issues Test. The results showed that moral sensitivity scores in patient-oriented care and conflict were (...) higher in senior students than in freshman students. Furthermore, more hours of ethics content were associated with higher principled thinking scores of senior students. Nursing education in South Korea may have an impact on developing student moral sensitivity. Planned ethics content in nursing curricula is necessary to improve moral sensitivity and moral reasoning of students. (shrink)

The need of reason is not inspired by the quest for truth but by the quest for meaning. And truth and meaning are not the same. The basic fallacy, taking precedence over all specific metaphysical fallacies, is to interpret meaning on the model of truth. (Hanna Arendt, The Life of the Mind: Thinking)2 The problem of agency in liberal political thought begins when dictates of reason grounded in philosophical truth become separated from motivations premised on desires and appetites articulated in (...) moral psychology. In the writings of Thomas Hobbes, John Locke, and John Stuart Mill, political agency requires both reason and motive, and motive, in turn, requires narratives of meaning that enable and motivate us to act. These narratives incorporate elements of the sacred and these religious elements, in turn, become parts of their moral psychologies. Part I is a summary of the role of sacred narrative for human agency in Thomas Hobbes, John Locke, and John Stuart Mill. In America, a sacred/national narrative became an essential part of Progressive political thought at the turn of the last century. Part II explores the construction of national narratives in Progressive political thought that were intended to discredit prevailing forms of constitutionalist and other static and abstract forms of rights talk. The decline of this narrative framework and the rise of fixed principles of moral neutrality in liberal public philosophy in America during the second half of the twentieth century had two effects: it downplayed the role of civic virtue and it submerged national narratives of substantive public purpose. This narrative absence runs parallel with the demise of progressive liberalism as a formative political force in America. Recently, American public intellectuals have sought to restore narrative and patriotism to principles of liberal-progressive reform. Part III concludes by returning to the moral psychology of liberalism, this time by contrasting John Rawls and Charles Taylor on human agency. (shrink)

For the second edition this popular collection on contemporary ethical issues has been expanded to nine sections. Abortion and euthanasia are now given expanded coverage, and there are new sections as well on assisted reproduction and commodification, and on ethics and the use of violence. The book is primarily composed of pieces by philosophers, chosen both for their intrinsic value and for their accessibility to students. But where relevant the collection also includes legal documents and non-philosophical writings that help to (...) set issues in context for Canadian students. In all, Ethical Issues now includes sixty-six selections, thirty-nine of which are new to this edition. The editor has also provided extensive introductory material and questions for discussion. (shrink)

What are the differences between hypocrisy, change of mind, and weakness of will? Each typically involves a gap between word and deed, yet they do not seem morally equivalent. Moreover, they are intuitively different concepts, even though the conceptual boundaries between them are fuzzy. This paper explores diverse examples, attempting to identify elements which may be distinctive of each concept, with special attention to hypocrisy. It also provides a discussion of the appropriateness of such use of examples in moral philosophy.

Habermas passa a atribuir, a partir de 1990, um papel central ao mundo da vida que, como fonte da racionalidade comunicativa, é capaz de se opor ao processo de dominação sistêmica e manter a autonomia dos indivíduos. O texto explicita os argumentos que levam Habermas a considerar a espontaneidade do mundo da vida como fonte que assegura a validade cognitiva e normativa das ações dos indivíduos em interação e avalia o potencial crítico desse posicionamento na educação. A ideia orientadora é (...) que o entendimento da vida escolar só pode ser atingido se levar em conta a forma de produção do mundo da vida dos atores que a compõem. (shrink)

Berkeley introduces his water experiment in order to demonstrate that in perception the perceiver does not reach the world itself but is confined to a realm of representations or sense data. We will attempt to demonstrate that Berkeley's description of our experience at the end of the water experiment is inauthentic, that it is not so much a description of an experience as a reconstruction of what we would experience if the receptor organs were objects existing in a space partes (...) extra partes. Our argument is that there is nothing in our experience of the illusion to suggest that under normal conditions perception does not reach the world itself. (shrink)