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)

Neuroscientists are searching for the engram within the conceptual framework established by John Locke's theory of mind. This framework was elaborated before the development of information theory, before the development of information processing machines and the science of computation, before the discovery that molecules carry hereditary information, before the discovery of the codon code and the molecular machinery for editing the messages written in this code and translating it into transcription factors that mark abstract features of organic structure such as (...) anterior and distal. The search for the engram needs to abandon Locke's conceptual framework and work within a framework informed by these developments. The engram is the medium by which information extracted from past experience is transmitted to the computations that inform future behavior. The information-conveying symbols in the engram are rapidly generated in the course of computations, which implies that they are molecules. (shrink)

Professor Austin explores four main areas in this paper. First of all he outlines the physical development of sex differentiation in the embryo. He develops this by describing the clinical manifestations of abnormality which can appear at that stage. Professor Austin points out that there are relatively few people with abnormalities and that those who do show homosexual tendencies are not noticeably different from the norm in terms of their sexual equipment and hormone levels. It is much more likely that (...) their psychological and social development has a greater influence in differentiating them sexually. The last section of the paper is a synopsis of society's reactions to homosexuality or bisexuality which term in Professor Austin's opinion is more accurate and descriptive of the condition. (shrink)

Recent reports published by the United Nations and the World Health Organization suggest that the brain drain of healthcare professionals from the developing to the developed world is decimating the provision of healthcare in poor countries. The migration of these key workers is driven by a combination of economic inequalities and the recruitment policies of governments in the rich world. This article assesses the impact of the healthcare brain drain and argues that wealthy countries have a moral obligation to reduce (...) the flow of healthcare workers from the developing to the developed world. (shrink)

This paper, which gives continuity to another article, analyzes the content of I Dialogus V, 14-22 and, in an appendix, presents our Portuguese translation of this excerpt. In these chapters, the Inceptor Venerabilis discusses whether St. Peter and the Roman Church possess primacy over all other apostles and churches; andwhether this primacy is granted by God himself. Ockham first presents, not ad litteram, the opinion of those who refute the thesis that Christ did not give primacy to Peter and the (...) Roman Church. Then, because this thesis fully deflates papal power, he proposes a contrary thesis based on five proofs. We conclude that Ockham’s unnamed opponent is Marsilius of Padua, whose opinions are in his Defensor Pacis. (shrink)

Recent research on the relations of personality to well-being shows that the people who are most healthy, happy and fulfilled are those who are high in all three of the character traits of self-directedness, cooperativeness, and self-transcendence as measured by the Temperament and Character Inventory. In the past, the healthy personality has often been considered to require only high self-directedness and high cooperativeness. However, now the self-centred behaviour of people who are low in self-transcendence is degrading the conditions needed for (...) sustainable life by all human beings. Consequently, human beings need to and can develop their capacity for self-transcendence in order to maintain their individual and collective well-being. (shrink)

The title may be understood in three ways. Firstly, the truth under study is the truth about freedom. We speak of the truth of something, in as much as we presume that there are many misconceptions about that something, and it stands in need of clarification. Thus, the many misconceptions about freedom will have to be divested, if freedom is to be rightly grasped. Secondly, in the sense that there is a truth in the core of freedom, indeed, truth is (...) the essence of freedom. If truth is to be rightly grasped, its core has to be penetrated. Thirdly, there is a deeper relation between truth and freedom. Freedom cannot be understood, much less rightly practised, if we do not comprehend the necessary relation that freedom bears to truth. This essay purports to study all three senses, not quite generally, but with special reference to Ratzinger, the German theologian-cum-phenomenologist of religion, who also happens to be the current pope Benedict XVI of the Catholic Christianity. The study proceeds in three stages. First of all, I will give the statement of the problem. Secondly, I will briefly dwell on the modern Western history of freedom. Thirdly, I will study the interface between freedom and truth, highlighting the nature of human freedom, the relation between freedom and responsibility, and the relation between freedom and the truth of human existence itself. The essay is more interpretive than evaluative, with an eye to be as close to the insightful thoughts of Ratzinger as possible. (shrink)