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)

During public health crises including the COVID-19 pandemic, resource scarcity and contagion risks may require health systems to shift—to some degree—from a usual clinical ethic, focused on the well-being of individual patients, to a public health ethic, focused on population health. Many triage policies exist that fall under the legal protections afforded by “crisis standards of care,” but they have key differences. We critically appraise one of the most fundamental differences among policies, namely the use of criteria to categorically exclude (...) certain patients from eligibility for otherwise standard medical services. We examine these categorical exclusion criteria from ethical, legal, disability, and implementation perspectives. Focusing our analysis on the most common type of exclusion criteria, which are disease-specific, we conclude that optimal policies for critical care resource allocation and the use of cardiopulmonary resuscitation (CPR) should not use categorical exclusions. We argue that the avoidance of categorical exclusions is often practically feasible, consistent with public health norms, and mitigates discrimination against persons with disabilities. (shrink)

In this essay Amy Shuffelton considers Jean-Jacques Rousseau's suspicion of imagination, which is, paradoxically, offered in the context of an imaginative construction of a child's upbringing. First, Shuffelton articulates Rousseau's reasons for opposing children's development of imagination and their engagement in the sort of imaginative play that is nowadays considered a hallmark of early and middle childhood. Second, she weighs the merits of Rousseau's opposition, which runs against the consensus of contemporary social science research on childhood imaginative play. Ultimately, Shuffelton (...) argues that Rousseau's work offers an important cautionary note to enthusiasts of children's imaginative play, due to the potentially disruptive influence of consumer capitalism, though she also notes that imagination may play a more redemptive role than Rousseau granted it. (shrink)

Contemporary educational reformers have claimed that research on social class differences in child raising justifies programs that aim to lift children out of poverty by means of cultural interventions. Focusing on the Knowledge Is Power Program (KIPP), Ruby Payne's “aha! Process,” and the Harlem Children's Zone as examples, Amy Shuffelton argues that such programs, besides overstepping the social science research, are ethically illegitimate insofar as they undermine the equitable development of civic agency. Shuffelton invokes Aristotelian civic friendship, particularly as interpreted (...) by Danielle Allen and Sibyl Schwarzenbach, as key to a politics that avoids relations of domination and subordination. She concludes that social justice requires that educators involved with culturally interventionist programs recognize the workings of power within schooling and society, that they accept the limits of their own perspectives, and that they remain open to what is of value in child-raising practices other than those associated with the contemporary middle class. (shrink)

When the debate over the value of ideal and nonideal theory crosses from political philosophy into philosophy of education, do the implications of the debate shift, and, if so, how? In this piece, Amy Shuffelton considers the premise that no normative political theory, ideal or nonideal, is of any use to human beings unless it can be affiliated with a credible educational theory that connects human beings as they are to human beings as that theory requires them to become. In (...) her response to the five articles in this symposium, Shuffelton addresses their overlapping yet varied treatments of human subjectivity as developed through education. If one accepts that ideal theory is the appropriate starting place for political philosophy because otherwise we would have no polestar by which to orient ourselves, Shuffelton concludes, a corresponding philosophy of education is required to survey the trajectory between here and wherever one aims to go. To do so, it needs to keep its feet on the ground, even as it looks to the stars. If, on the other hand, ideal theory fails to heed the Yankee truism that you can't get there from here, such that philosophers who attempt to do so inevitably get lost on back roads, philosophy of education is still necessary to chart paths to reachable destinations. (shrink)

“Chicago is the place to make you recognize at every turn the absolute opportunity which chaos affords—it is sheer Matter with no standards at all,” John Dewey wrote to his wife Alice on an early visit there.1 Such a city, which had become the geographical nexus of American industrial democracy, pushed Dewey to consider the problems industrial modes of organization pose for democratic theory. His reconceptualization of democracy, and the refinements and clarifications to it that he made over the years, (...) reflects an appreciation of the significance of work—of human transfiguration of chaotic matter into something useable, and of the corollary construction of human psychology as it meets with the world around it and .. (shrink)

In this dissertation, I explain the psychological impact of narrative fiction films and some of their effects on social and moral life. This puts my project at one of the intersections between aesthetics and moral psychology. In the first half of the dissertation, which focuses on moral psychology, I develop an account of empathy that specifies its essential characteristics and distinguishes it from several closely related phenomena that are often confused with it. I define empathy as a complex psychological process (...) during which we imaginatively inhabit the perspective of another individual, while at the same time preserving a clearly differentiated sense of self. After defining empathy, I consider its role in social and moral life. The second half of the dissertation concerns the question of how we engage characters in narrative fiction films. I argue that we typically empathize with one or more characters, though this is only one dimension of our film viewing experience. To characterize this process and its effects on social and moral life, I utilize the account of empathy developed in the first half of the dissertation. My project is primarily descriptive and draws from several areas of philosophy, psychology, cognitive science, and cultural studies. (shrink)

. Philia and pedagogy ‘side by side’: the perils and promise of teacher–student friendships. Ethics and Education: Vol. 7, Creating spaces, pp. 211-223. doi: 10.1080/17449642.2013.766541.

(2008). Addressing measurement limitations in affective rating scales: Development of an empirical valence scale. Cognition & Emotion: Vol. 22, No. 1, pp. 180-192.

Wegner's The Illusion of Conscious Will (2002) ignores an important aspect of the history of the concept: the determinism of Jonathan Edwards (1754) and the later response to this determinism by William James and others. We argue that Edwards's formulation, and James's resolution of the resulting dilemma, are superior to Wegner's.

This study explored attention and interpretation biases in processing facial expressions as correlates of theoretically distinct self-reported anger experience, expression, and control. Non-selected undergraduate students completed cognitive tasks measuring attention bias, interpretation bias, and Spielberger’s State-Trait Anger Expression Inventory. Attention bias toward angry faces was associated with higher trait anger and anger expression and with lower anger control-in and anger control-out. The propensity to quickly interpret ambiguous faces as angry was associated with greater anger expression and its subcomponent of anger (...) expression-out and with lower anger control-out. Interactions between attention and interpretation biases did not contribute to the prediction of any anger component suggesting that attention and interpretation biases may function as distinct mechanisms. Theoretical and possible clinical implications are discussed. (shrink)

This book punctuates the moments of crisis in continental thought from the foundational crisis of reason in Husserl’s call for a rigorous science of phenomenology to the current crisis of postmodernism and its rejection of Husserl’s metanarrative of history and rationality. The mediating links between these moments is the centrality of the epochal history of Being, the power of cultural and disciplinary practices, and the dispersal of meaning in the post-Husserlian and post-subjective philosophies of Heidegger, Foucault, Derrida, and others. Included (...) here are the thoughts of leading scholars who critically discuss Husserl’s analysis of the crisis of Western thought and the importance of the concepts of “world” in Husserl’s early writings. The authors analyze the deprivileging of philosophy as social critique through the text of Husserl, Habermas, Foucault, and recent feminist theory. They examine the end of the epistemological and morally autonomous subject in continental thought. Together, these thoughts articulate multiple points or moments of crisis without cure or end. (shrink)

Ethics and Danger examines Heidegger’s association with German National Socialism and attempts to understand both the question of politics in Heidegger’s thought and the thought that gives rise to that question. It explores the contribution of Heidegger’s work to issues of ethics, technology, and social theory, as well as his relationship to other thinkers such as Parmenides, Aristotle, Hegel, Husserl, Benjamin, Levinas, Rorty, Foucault, and Derrida. Finally, it addresses the more general question of the future of ethical thought within continental (...) philosophy. In order to engage the ethical issues surrounding Heidegger’s life and thought, the authors speak of dangers such as facism and the facile, self-congratulatory moral stance that Heidegger exemplifies. The question of how to speak in the wake of Heidegger’s thought takes many forms, and the answers represent a diversity of viewpoints from both American and continental thinkers. (shrink)

Papers based on the work of Emmanuel Levinas' account of the face of the other.

As organizations place greater emphasis on environmental objectives, business educators must produce the next set of leaders who can champion corporate environmental sustainability initiatives. However, environmental sustainability represents a polarizing topic with some students dismissing its importance and legitimacy. Limited research exists to understand student behavioral influences on sustainability education, especially as it translates to environmental sustainability behavior in the workplace. This gap challenges our ability as educators to understand how to best teach environmental sustainability in order to reach diverse (...) student mindsets. We apply the theory of planned behavior (TPB) to address this gap, investigating the influence of student attitudes, subjective norm, and perceived behavioral control on environmental sustainability intention and behavior. A structural model tested with student survey data finds that student attitude represents the strongest influence on environmental sustainability intention. The model also validates that subjective norm affects sustainability intention with students considering professors along with business leaders and politicians as valid references for sustainability knowledge. To tie the results to effective educational interventions, we use the TPB to organize an extensive review of the sustainability pedagogy literature and identify specific teaching recommendations for increasing the effectiveness of environmental sustainability education. (shrink)

Previous research suggests a higher perceived risk associated with a risky behavior predicts a lower likelihood of involvement in that behavior; however, this relationship can vary based on personality characteristics such as impulsivity and behavioral activation. During the COVID-19 pandemic, individuals began to re-evaluate the level of risk associated with everyday behaviors. But what about risks associated with “typical” risk-taking behaviors? In the present study, 248 undergraduate student participants completed measures of impulsivity, behavioral activation and inhibition, propensity to take risks, (...) numeracy, and perceptions of and involvement in both risk-taking behavior and health promoting behavior. Our study revealed that higher behavioral inhibition and greater propensity to take risks predicted greater likelihood of involvement in COVID-19-related risk behaviors, even after accounting for perceived risks and benefits of the behavior. Greater likelihood of involvement in social risk behaviors was predicted by greater numeracy and risk-taking propensity. Identifying as male, a greater propensity to take risks, and greater impulsivity predicted increased health/safety risk behaviors. Younger age, lower risk-taking propensity, and lower impulsivity were associated with a greater likelihood of donating blood. For the likelihood of registering to become an organ donor, increasing risk perception, both before and during the pandemic, was associated with greater likelihood of registering, but greater risk-taking propensity was associated with a decreased likelihood of organ donation registration. For flu vaccination, a greater propensity to take risks was associated with a greater likelihood of flu vaccination during the 2020–2021 flu season. Both cognitive and personality factors can predict involvement in risk-taking and health-promotion behaviors, warranting their continued examination. (shrink)

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons. We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.

In America today, the problem of achieving racial justice--whether through "color-blind" policies or through affirmative action--provokes more noisy name-calling than fruitful deliberation. In Color Conscious, K. Anthony Appiah and Amy Gutmann, two eminent moral and political philosophers, seek to clear the ground for a discussion of the place of race in politics and in our moral lives. Provocative and insightful, their essays tackle different aspects of the question of racial justice; together they provide a compelling response to our nation's most (...) vexing problem.Appiah begins by establishing the problematic nature of the idea of race. He draws on the scholarly consensus that "race" has no legitimate biological basis, exploring the history of its invention as a social category and showing how the concept has been used to explain differences among groups of people by mistakenly attributing various "essences" to them. Appiah argues that, while people of color may still need to gather together, in the face of racism, under the banner of race, they need also to balance carefully the calls of race against the many other dimensions of individual identity; and he suggests, finally, what this might mean for our political life.Gutmann examines alternative political responses to racial injustice. She argues that American politics cannot be fair to all citizens by being color blind because American society is not color blind. Fairness, not color blindness, is a fundamental principle of justice. Whether policies should be color-conscious, class conscious, or both in particular situations, depends on an open-minded assessment of their fairness. Exploring timely issues of university admissions, corporate hiring, and political representation, Gutmann develops a moral perspective that supports a commitment to constitutional democracy.Appiah and Gutmann write candidly and carefully, presenting many-faceted interpretations of a host of controversial issues. Rather than supplying simple answers to complex questions, they offer to citizens of every color principled starting points for the ongoing national discussions about race. (shrink)