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)

Ruhollah Khomeini views on clergy and professional ethics.

It is notorious that great philosophers are apt to be misunderstood. Controversy rages about their work, and sometimes they are credited with completely contradictory views. Consider the sharply contrasted opinions of Plato's political thought by Sir Karl Popper, on the one hand, and G. C. Field and H. B. Acton on the other.

Professor H. James Birx shows how the never-ending controversy of human evolution came to be. He details the events that caused thinkers like Charles Darwin to develop his theory of evolution, and what ideas caused some people to reconcile a somewhat mystical theology with a concrete model of the universe. He tells you how Darwin's work infuriated everybody from "God-fearing" Christians to the church heirarchies. Birx explains how scientific advances and philosophical arguments have made beliefs about divine intervention as the (...) origin of man a moot point. He shows how creationism ignores proven scientific facts, and how human evolution remains a much sounder truth. You'll read how some western religions are starting to accept evolution as the process which creates life on earth. You'll also learn why scientific evolution and creationism have not been accepted together and how bold attempts to merge the two ideas have failed miserably. (shrink)

This paper attempts some integration of two perspectives on questions about rationality and irrationality: the classical conception of irrationality as sophism and themes from the romantic revolt against Enlightenment reason. However, since talk of "reason" and "the irrational" often invites rigid dualities of reason and its opposites (such as feeling, intuition, faith, or tradition), the paper turns to "intelligence" in place of "reason," thinking of human intelligence as something less abstract, less purely theoretical, and more firmly rooted in practice, including (...) communicative practice. "Intelligence" is "reason" naturalized. -/- . (shrink)

This paper proceeds from an analysis (Callaway 1992, pp. 239-240) of a role of conflict in the origin of value commitments, a pervasive sociological pattern in the development of unifying group values which transforms personal conflicts, or differences, into large-scale collective conflicts. I have urged that these forces are capable of distorting even the cognitive processes of science and that they are a chief reason why value claims are regarded as incapable of objective evaluation. The thesis of the present paper (...) is that romantic collectivism (uncritical attachment to an identification group) renders members passive with respect to the ideals or content embodied in collective identity and that this is often exploited to convert groups into instruments of personal power. The issue is examined by reference to Reinhold Niebuhr's 1932 thesis of the inevitability of group egoism and inter-group conflicts and an opposing pragmatist conception of moral development, self-identity, and the individual's relationship to reference communities. (shrink)

Cultural boundaries in Islam based on Hadith (Islamic traditions).