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)

Journal of the History of Biology provides a fifty-year long record for examining the evolution of the history of biology as a scholarly discipline. In this paper, we present a new dataset and preliminary quantitative analysis of the thematic content of JHB from the perspectives of geography, organisms, and thematic fields. The geographic diversity of authors whose work appears in JHB has increased steadily since 1968, but the geographic coverage of the content of JHB articles remains strongly lopsided toward the (...) United States, United Kingdom, and western Europe and has diversified much less dramatically over time. The taxonomic diversity of organisms discussed in JHB increased steadily between 1968 and the late 1990s but declined in later years, mirroring broader patterns of diversification previously reported in the biomedical research literature. Finally, we used a combination of topic modeling and nonlinear dimensionality reduction techniques to develop a model of multi-article fields within JHB. We found evidence for directional changes in the representation of fields on multiple scales. The diversity of JHB with regard to the representation of thematic fields has increased overall, with most of that diversification occurring in recent years. Drawing on the dataset generated in the course of this analysis, as well as web services in the emerging digital history and philosophy of science ecosystem, we have developed an interactive web platform for exploring the content of JHB, and we provide a brief overview of the platform in this article. As a whole, the data and analyses presented here provide a starting-place for further critical reflection on the evolution of the history of biology over the past half-century. (shrink)

This paper traces the background to R. A. Fisher's multi-factorial theory of inheritance. It is argued that the traditional account is incomplete, and that Karl Pearson's well-known pre-Fisherian objections to the theory were in fact overcome by Pearson himself. It is further argued that Pearson's stated reasons for not accepting his own achievement has to be seen as a rationalization, standing in for deeper-seated metaphysical objections to the Mendelian paradigm of a type not readily discussed in a formal scientific paper. (...) The apparent, post-Fisherian, continued acceptance of Pearson's objections is presented as an interesting problem for the historian and sociologist. (shrink)

Volume 20, Issue 4, May 2020, Page 71-73.

Business theory and management practices are outgrowths of basic economic principles. To evaluate the proper place of ethics in business, the meaning of ethics as defined by economic theory must be assessed. This paper contends that classical economic thought advocates a nonethical decision-making context and is not functional for a modern complex, interdependent environment.

Char et al. describe an interesting and useful approach in their paper, “Identifying ethical considerations for machine learning healthcare applications.” Their proposed framework, which see...

B. Rundle; X—Transitivity and Indirect Speech, Proceedings of the Aristotelian Society, Volume 68, Issue 1, 1 June 1968, Pages 187–206, https://doi.org/10.1093/.

Denne artikkelen tar utgangspunkt i et skille mellom samfunnsstrukturer som avgrenser legers skjønnsmessige utfoldelse på den ene siden, og profesjonens tilrettelegging for kultiveringen av erkjennelsesmessige ferdigheter på den annen. Ved å videreføre H. Grimen og A. Molanders anvendelse av S.E. Toulmins modell for praktisk resonnering i en klinisk kontekst redegjør jeg for legeskjønnets multidimensjonale, epistemiske struktur. Gjennomgangen viser hvordan skjønnsanvendelse i legerollen kan analyseres i henhold til en fagteknisk, en distributiv og en relasjonell dimensjon. Mot denne bakgrunnen diskuterer jeg så (...) spenninger som oppstår i skjæringspunktet mellom strukturering og kultivering av skjønnets ulike dimensjoner. Diskusjonen tydeliggjør at den medisinske profesjonen ikke kan betraktes som en selvtilstrekkelig premissleverandør når det gjelder å sikre adekvat kultivering av medlemmenes skjønnsutøvelse i en klinisk kontekst. Ved å synliggjøre og vektlegge de relevante profesjonseksterne bidragene i profesjonens pågående selvregulering kan befolkningens berettigete tillit til profesjonen styrkes ytterligere.Nøkkelord: strukturelt skjønn, epistemisk skjønn, profesjon, selvregulering, tillitEnglish summary: In Between Structures of Society and Profession: On Delimitation, Cultivation and Premises for Adequately Exercising Judgment in the Role as PhysicianThe point of departure of this article is a distinction between societal structures that delimit the discretion of the physician on the one hand and the profession's arrangements for the cultivation of the physician's judgment on the other. By developing H. Grimen and A. Molander's application of S.E. Toulmin's model for practical reasoning in a clinical context, the multi-dimensional epistemic structure of the physician's judgment in terms of technical, distributive, and relational judgment is accounted for. Against this backdrop, tensions emerging in the intersection between delimitation and cultivation of professional judgment in its various dimensions are discussed. The discussion clarifies that the medical profession is not a self-sufficient provider when it comes to ensuring an adequate cultivation of its members' judgment in a clinical context. It is argued that by emphasising and implementing the relevant external contributions to the profession's ongoing self-regulation, the public's justified trust in the medical profession can be strengthened. (shrink)

Addictive behaviour has qualities that make it ideal for study using implicit techniques. Addictive behaviours are mediated in part by automatic responses to drug cues, and there is sometimes social pressure to distort self-reports. However, relationships between implicit attitudes and addictive behaviours have been inconsistent. Using a new implicit measure, the affect misattribution procedure (AMP), we found consistent evidence that drinking-related behaviours are systematically related to implicit attitudes. The procedure predicted a behavioural choice to drink beer and self-reported typical drinking (...) tendencies, including hazardous drinking and alcohol-related problems. The AMP showed larger relationships with drinking behaviour than other implicit measures, and explained unique variance in drinking beyond those measures and beyond explicit measures. Though self-presentation distorted self-reports, it did not affect AMP scores. These studies highlight the importance of automatic affective responses in addictive behaviour and suggest a useful means for measuring those responses. (shrink)

Ten new graduate speech pathologists recounted their experiences in managing workplace ethical dilemmas in semi-structured interviews. Their stories were analysed for elements that described the nature and management of the ethical dilemmas. Ethical reasoning themes were generated to reflect the participants’ approaches to managing these dilemmas. Finally, a conceptual model, the Dynamic Model of Ethical Reasoning, was developed. This model incorporates the elements of awareness, independent problem solving, supported problem solving, and decision and outcome evaluation. Features of the model demonstrate (...) the complexity of ethical reasoning and the challenges that new graduates encounter when managing ethical dilemmas. The results have implications for preparing new graduates to manage ethical dilemmas in the workplace. (shrink)

In a spirit of critical appreciation, this essay challenges several core aspects of the critique of secular morality and the defense of Orthodox Christianity offered by H. Tristram Engelhardt in After God. First, I argue that his procedurally driven approach to a binding morality based solely on a principle of permission leaves morality without any substantive definition in general terms, in ways that are both conceptually problematic and also at odds with Engelhardt’s long-standing distinction between non-malevolence and beneficence. Second, I (...) question the accuracy or adequacy of Engelhardt’s critique of the Enlightenment project for his unwarranted privileging of a particular version of Enlightenment thinking at the expense of other Enlightenment perspectives less amenable to Engelhardt’s working generalizations. Third, I challenge the theoretical cogency of Engelhardt’s insistence on the ubiquity and intractability of moral controversies and his depiction of moral strangers and moral friends as, in effect, mutually exclusive terms. Finally, I question Engelhardt’s embrace of a divine command model of ethics as the appropriate resolution of Euthyphro’s dilemma and suggest that there may be intermediate approaches to the usual starkly drawn contrasts between divine command and naturalist accounts. (shrink)

Modern science developed in the interflow of culture between west and east. Combing of pratice technology with philosophic thoughts formed experimental method. Holistic views contacting atomism produced system theory. System thoughts are applicated in the science and engineering of biosystems, and the cencepts of system biomedicine (Kamada T.1992), systems biology (Zieglgansberger W, Tolle TR.1993), system bioengineering and system genetics (Zeng BJ. 1994) were established. From positive to synthetic thoughts, philosophy have been developed ontology, cosmology, organism theories. Structurity is structure logic (...) system founded on entity, develop, exist axioms, tolerance, adaptation, fluctuate, interweave, transform theorems and integrate, adaptation, construct laws. Structurity be discussed on the cosmos, life, culture system, creation, hologram theories of structure ontology, construct mutation, simi-structure organism and entity emergence, symbol implication. From the relation of structure, function and development, the structurity put forward the cycle, spiral, triangle structure stability patterns of self-organization in structure complement each other and stratification, functional couple and interflow bounds growth, coordinativetransformation and holographic symmetry. (shrink)

Professor Kemp Smith in providing a new edition of Hume’s Dialogues Concerning Natural Religion , embodying all the author’s additions and corrections, has given expression to the perennial interest and fascination which this work has possessed for many minds during the odd one hundred and fifty years since it was first published by Hume’s nephew. The editor himself has performed a great service by contributing an Introduction and a clear and concise summary of the Dialogues , in both of which (...) he expounds his own view as to how Hume’s discussion is to be interpreted. Hume employs three characters—Demea, Philo, and Cleanthes; and. (shrink)

The eleventh-century Byzantine compiler Cedrenus includes a unique story in the midst of his otherwise traditional and hagiographic material on the emperor Constantine. Mentioning the outbreak of war between the Roman and Persian empires, he describes the cause of the breakdown of peace somewhat as follows. A certain Metrodorus, who was of Persian origin, went to visit the Brahmins in India to study philosophy and won the reputation of being a holy man through his asceticism. He also built water mills (...) and baths, unknown to the Indians till that time. Having acquired this reputation, he entered the temples and took away many precious stones and pearls. He also received gifts from the king of the Indians. On his return to Byzantium he gave them to the emperor Constantine as being gifts of his own. When Constantine expressed his astonishment, Metrodorus said he had sent other gifts by the land route but that they had been detained by the Persians. Constantine then wrote a strong protest to Sapor demanding the gifts but received no reply; thus the peace was broken. This remarkable conte, more appropriate to the Arabian Nights than to sober history, is generally supposed to be referred to in a passage in Ammianus. Towards the end of a long section commenting on the personality and achievements of Julian, Ammianus turns briefly to the question of the ultimate responsibility for the Persian War which ended so disastrously for Julian and the Roman Empire: et quoniam eum obtrectatoribus novos bellorum tumultus ad perniciem rei communis insimulant concitasse, sciant docente veritate perspicue, non Iulianum sed Constantinum ardores Parthicos succendisse, cum Metrodori mendaciis avidius acquiescit, ut dudum rettulimus plane. (shrink)

This paper considers two of the most prominent kinds of evidence that have been used to argue that certain embedded questions receive weakly exhaustive interpretations. The first kind is exemplified by judgments of consistency for declarative sentences that attribute knowledge of a wh-question and ignorance of the negation of that question to the same person, and the second concerns asymmetries between the role of positive and negative information in validating question-embedding surprise ascriptions, and similar judgments for other attitudes. I argue (...) that neither type suffices to show weak exhaustivity. The first can be analyzed in terms of strong exhaustivity in combination with domain restriction effects, while the second can be analyzed in terms of a mention-some interpretation. These kinds of evidence have served as the empirical basis for many claims about weakly exhaustive readings, so the observation that they are unreliable calls into questions a large body of established work on the semantics of question embedding. (shrink)

In the paper “Translational Neuroethics: A Vision for a More Integrated, Inclusive, and Impactful Field,” Wexler and Sullivan provide an insightful analysis of challenges within the field and how t...

There are numerous challenges posed to Roman Catholic health care institutions by recent developments in health care delivery. Some are practical, involving the acceptable limits of accommodation to and collaboration with secular networks of health care delivery. Others, quite often implicated in the first set, are explicitly theological. What does it mean to be a distinctively Roman Catholic health care institution? What are the nature and the scope of Roman Catholic institutional identity? More broadly, what is the moral relevance of (...) themes in Roman Catholic social teaching to the provision of health care? This issue of Christian Bioethics addresses these questions with a spirited exchange among its authors. They offer noticeably different perspectives on the general cogency of Roman Catholic social teaching and different strategic recommendations for Roman Catholic institutions to maintain, or recover, their distinctive presence in health care delivery. (shrink)

Reading Kevin Hart’s creative hermeneutic of the ‘basileic’ reduction in his latest book, Kingdoms of God, naturally leads me to consider another eminent linguistic phenomenologist who continually occupies my thoughts. Although I have been reading Hart now for about 25 years, I have been reading Paul Ricoeur for a decade longer than that, and it is his theory of poetic discourse that my mind keeps tenaciously associating with Hart’s perspectives on parable. Granted, Hart never mentions Ricoeur in Kingdoms of God—unless (...) my careful reading is not so careful and I missed it! In Trespass of the Sign, however, he does note Ricoeur’s significance as a hermeneutical philosopher, specifically his emphasis on the distinction between the hermeneutics of faith and the hermeneutics of suspicion. Also, in an article on John Caputo’s postsecular philosophy of ‘religion without religion,’ Hart makes a brief comment on Ricoeur’s apparent Hegelianism with reference to a general theory of revelation as nonreligious and nontheistic. Still, nowhere that I know of does he extensively address Ricoeur’s fascinating discourse theory regarding metaphor, mimesis, narrative, and parable. If great minds think alike, then Hart and Ricoeur are, indeed, great minds, for, truly, Ricoeur’s reflections on parables and the Kingdom offer an intriguing gloss on Hart’s parabolic ‘basileiology.’ Translating Hart into Ricoeur, therefore, is, in my mind, an easy and profitable exercise that may well enhance the provocative character of Hart’s basileic reduction. Such a translation is the central purpose of this essay. (shrink)