Abstract:The literature contains many recommendations, both explicit and implicit, that suggest how an ethics program ought to be designed. While we recognize the contributions of these works, we also note that these recommendations are typically based on either social scientific theory or data and as a result they tend to discount the moral aspects of ethics programs. To contrast and complement these approaches, we refer to a theory of the right to identify the characteristics of an effective ethics program. We (...) draw from Kant’s ethical theory to identify three guiding principles of a moral ethics program and then apply those principles to the specific components of ethics programs as discussed in the Federal Sentencing Guidelines. Doing so provides insights as to how an ethics program ought to be designed from a moral point of view and sparks discussion of the moral aspects of ethics programs. (shrink)

Discrete choice experiments—selecting the best and/or worst from a set of options—are increasingly used to provide more efficient and valid measurement of attitudes or preferences than conventional methods such as Likert scales. Discrete choice data have traditionally been analyzed with random utility models that have good measurement properties but provide limited insight into cognitive processes. We extend a well-established cognitive model, which has successfully explained both choices and response times for simple decision tasks, to complex, multi-attribute discrete choice data. The (...) fits, and parameters, of the extended model for two sets of choice data (involving patient preferences for dermatology appointments, and consumer attitudes toward mobile phones) agree with those of standard choice models. The extended model also accounts for choice and response time data in a perceptual judgment task designed in a manner analogous to best–worst discrete choice experiments. We conclude that several research fields might benefit from discrete choice experiments, and that the particular accumulator-based models of decision making used in response time research can also provide process-level instantiations for random utility models. (shrink)

Lists of species underpin many fields of human endeavour, but there are currently no universally accepted principles for deciding which biological species should be accepted when there are alternative taxonomic treatments (and, by extension, which scientific names should be applied to those species). As improvements in information technology make it easier to communicate, access, and aggregate biodiversity information, there is a need for a framework that helps taxonomists and the users of taxonomy decide which taxa and names should be used (...) by society whilst continuing to encourage taxonomic research that leads to new species discoveries, new knowledge of species relationships, and the refinement of existing species concepts. Here, we present 10 principles that can underpin such a governance framework, namely (i) the species list must be based on science and free from nontaxonomic considerations and interference, (ii) governance of the species list must aim for community support and use, (iii) all decisions about list composition must be transparent, (iv) the governance of validated lists of species is separate from the governance of the names of taxa, (v) governance of lists of accepted species must not constrain academic freedom, (vi) the set of criteria considered sufficient to recognise species boundaries may appropriately vary between different taxonomic groups but should be consistent when possible, (vii) a global list must balance conflicting needs for currency and stability by having archived versions, (viii) contributors need appropriate recognition, (ix) list content should be traceable, and (x) a global listing process needs both to encompass global diversity and to accommodate local knowledge of that diversity. We conclude by outlining issues that must be resolved if such a system of taxonomic list governance and a unified list of accepted scientific names generated are to be universally adopted. (shrink)

Objective: To examine changes in patients’ desired control of the deep brain stimulator and perception of global life control throughout DBS.Methods: A consecutive cohort of 52 patients with Parkinson’s disease was recruited to participate in a prospective longitudinal study over three assessment points. Semi-structured interviews assessing participants’ desire for stimulation control and perception of global control were conducted at all three points. Qualitative data were coded using content analysis. Visual analog scales were embedded in the interviews to quantify participants’ perceptions (...) of control over time.Results: Participants reported significant increases in their perception of global control over time and significant declines in their desired control of the stimulation. These changes were unrelated to improvements in motor symptoms. Improvements in global control were negatively correlated with a decline in desired stimulation control. Qualitative data indicate that participants have changed, nuanced levels of desired control over their stimulators. Increased global life control following DBS may be attributed to increased control over PD symptoms, increased ability to engage in valued activities, and increased overall self-regulation, while other domains related to global control remained unaffected by DBS.Conclusions: There are few empirical data documenting patients’ desire for stimulation control throughout neuromodulation and how stimulation control is related to other aspects of control despite the growing application of neuromodulation devices to treat a variety of disorders. Our data highlight distinctions in different types of control and have implications for the development of patient-controlled neurostimulation devices. (shrink)

BackgroundKinarm Standard Tests is a suite of upper limb tasks to assess sensory, motor, and cognitive functions, which produces granular performance data that reflect spatial and temporal aspects of behavior. We have previously used principal component analysis to reduce the dimensionality of multivariate data using the Kinarm End-Point Lab. Here, we performed PCA using data from the Kinarm Exoskeleton Lab, and determined agreement of PCA results across EP and EXO platforms in healthy participants. We additionally examined whether further dimensionality reduction (...) was possible by using PCA across behavioral tasks.MethodsHealthy participants were assessed using the Kinarm EXO and EP. Four behavioral tasks were performed that quantified arm sensory and motor function, including position sense [Arm Position Matching ] and three motor tasks [Visually Guided Reaching, Object Hit, and Object Hit and Avoid ]. The number of components to include per task was determined from scree plots and parallel analysis, and rotation type was decided on a per-task basis. To assess agreement, we compared principal components across platforms using distance correlation. We additionally considered inter-task interactions in EXO data by performing PCA across all six behavioral assessments.ResultsBy applying PCA on a per task basis to data collected using the EXO, the number of behavioral parameters were substantially reduced by 58–75% while accounting for 76–87% of the variance. These results compared well to the EP analysis, and we found good-to-excellent agreement values between PCs from the EXO and those from the EP. Finally, we were able to reduce the dimensionality of the EXO data across tasks down to 16 components out of a total of 76 behavioral parameters, which represents a reduction of 79% while accounting for 73% of the total variance.ConclusionPCA of Kinarm robotic assessment appears to capture similar relationships between kinematic features in healthy individuals and is agnostic to the robotic platform used for collection. Further work is needed to investigate the use of PCA-based data reduction for the characterization of neurological deficits in clinical populations. (shrink)

Modernism is both a contested aesthetic category and a powerful political statement. Modernist music was condemned as degenerate by the Nazis and forcibly replaced by socialist realism under the Soviets. Sympathetic philosophers and critics have interpreted it as a vital intellectual defence against totalitarianism, yet some American critics consider it elitist, undemocratic, and even unnatural. Drawing extensively on the philosophy of Heidegger and Badiou, Quilting Points proposes a new dialectical theory of faithful, reactive, and obscure subjective responses to musical modernism, (...) which embraces all the music of Western modernity. (shrink)

Heterogeneity within MDD has hampered identification of biological markers (e.g., intermediate phenotypes, IPs) that might increase risk for the disorder or reflect closer links to the genes underlying the disease process. The newer characterizations of dimensions of MDD within Research Domain Criteria (RDoC) domains may align well with the goal of defining IPs. We compare a sample of 25 individuals with MDD compared to 29 age and education matched controls in multimodal assessment. The multimodal RDoC assessment included the primary IP (...) biomarker, positron emission tomography (PET) with a selective radiotracer for 5-HT1A ([11C]WAY-100635), as well as event-related functional MRI with a Go/No-go task targeting the Cognitive Control network, neuropsychological assessment of affective perception, negative memory bias and Cognitive Control domains. There was also an exploratory genetic analysis with the serotonin transporter (5-HTTLPR) and monamine oxidase A (MAO-A) genes. In regression analyses, lower 5-HT1A binding potential (BP) in the MDD group was related to diminished engagement of the Cognitive Control network, slowed resolution of interfering cognitive stimuli, one element of Cognitive Control. In contrast, higher/normative levels of 5-HT1A BP in MDD (only) was related to a substantial memory bias toward negative information, but intact resolution of interfering cognitive stimuli and greater engagement of Cognitive Control circuitry. The serotonin transporter risk allele was associated with lower 1a BP and the corresponding imaging and cognitive IPs in MDD. Lowered 5HT 1a BP was present in half of the MDD group relative to the control group. Lowered 5HT 1a BP may represent a subtype including decreased engagement of Cognitive Control network and impaired resolution of interfering cognitive stimuli. Future investigations might link lowered 1a BP to neurobiological pathways and markers, as well as probing subtype-specific treatment targets. (shrink)

The study of anarchism as a philosophical, political, and social movement has burgeoned both in the academy and in the global activist community in recent years. Taking advantage of this boom in anarchist scholarship, Nathan J. Jun and Shane Wahl have compiled twenty-six cutting-edge essays on this timely topic in New Perspectives on Anarchism.

The purpose of this paper is to provide further clarity to the technical and policy difficulties associated with mitigating greenhouse gas emissions from agriculture by identifying and distilling the core tensions which propagate and animate them. We argue that these complexities exist across four critical dimensions: the epistemological, the ethical, the political, and the practical. Adequately confronting the challenge of agricultural emissions will require improved transparency in emissions measurement, increased science communication, enhanced public participatory mechanisms, and the integration of ethical (...) deliberation in scientific and policy discussions. (shrink)

This paper analyzes the reasons behind what it calls the erosion of democracy under George W. Bush's presidency since September 11, 2001, and claims that they are twofold: first, the erosion in question can be attributed to a crisis of the state and the belief that security is its only genuine function. In other words, the erosion of democracy is an erosion of the very idea of the public sphere beyond security and war. Secondly, the erosion of the ethical sphere (...) goes hand in hand with an extraordinary resurgence of what, still following Hegel, I call "morality," and which privileges the subjective over the objective, or moral feeling over institutions and the law. (shrink)

This study examined the effect of various antecedent variables on marketers’ perceptions of the role of ethics and socialresponsibility in the overall success of the firm. Variables examined included Hofstede’s cultural dimensions (i.e., power distance, uncertainty avoidance, individualism, masculinity, and Confucian dynamism), as well as corporate ethical values and enforcement ofan ethics code. Additionally, individual variables such as ethical idealism and relativism were included. Results indicated that most ofthese variables impacted marketers’ perceptions of the importance of ethics and social responsibility, (...) although to varying degrees. (shrink)

The present study uses cross‐cultural samples of marketing practitioners from two European Union (EU) nations (the United Kingdom and Spain) and China to examine the relationships between moral intensity, personal moral philosophies and ethical decision making. Additionally, cross‐cultural comparisons were made regarding intentions, personal moral philosophies and moral intensity. Results indicate that both samples tend to use the perceived harm construct (e.g. magnitude of consequences, probability of effect, temporal immediacy and concentration of effect) to determine intentions in situations involving ethical (...) issues. However, social consensus tends to be situation‐specific for both groups and proximity seems not to be used at all when making decisions in situations involving ethics. As for personal moral philosophies, idealism is only used by the EU sample; however, for both samples, the use of relativism depends upon the specific situation. (shrink)

The present study uses cross‐cultural samples of marketing practitioners from two European Union (EU) nations (the United Kingdom and Spain) and China to examine the relationships between moral intensity, personal moral philosophies and ethical decision making. Additionally, cross‐cultural comparisons were made regarding intentions, personal moral philosophies and moral intensity. Results indicate that both samples tend to use the perceived harm construct (e.g. magnitude of consequences, probability of effect, temporal immediacy and concentration of effect) to determine intentions in situations involving ethical (...) issues. However, social consensus tends to be situation‐specific for both groups and proximity seems not to be used at all when making decisions in situations involving ethics. As for personal moral philosophies, idealism is only used by the EU sample; however, for both samples, the use of relativism depends upon the specific situation. (shrink)

Despite the widespread agreement that the ontology of the marketing discipline is exchange, marketing ethics researchers have largely adopted a monadic viewpoint of ethical decision making. In this research, an interactionist approach is adopted in order to introduce a dyadic perspective of un/ethical decision making. The dyadic model includes each channel member's individual, situational and decision process factors linked by relationalism, an emerging paradigm in marketing channels. Relationalism is represented as a discriminating variable between perceived ethical dilemma and decision behaviour. (...) Finally, a number of theoretical propositions are presented and future research directions are discussed. (shrink)

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by (...) a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. (shrink)

The present paper analyzes the regularities referred to via the concept 'self.' This is important, for cognitive science traditionally models the self as a cognitive mediator between perceptual inputs and behavioral outputs. This leads to the assertion that the self causes action. Recent findings in social psychology indicate this is not the case and, as a consequence, certain cognitive scientists model the self as being epiphenomenal. In contrast, the present paper proposes an alternative approach (i.e., the event-control approach) that is (...) based on recently discovered regularities between perception and action. Specifically, these regularities indicate that perception and action planning utilize common neural resources. This leads to a coupling of perception, planning, and action in which the first two constitute aspects of a single system (i.e., the distal-event system) that is able to pre-specify and detect distal events. This distal-event system is then coupled with action (i.e., effector-control systems) in a constraining, as opposed to 'causal' manner. This model has implications for how we conceptualize the manner in which one infers the intentions of another, anticipates the intentions of another, and possibly even experiences another. In conclusion, it is argued that it may be possible to map the concept 'self' onto the regularities referred to in the event-control model, not in order to reify 'the self' as a causal mechanism, but to demonstrate its status as a useful concept that refers to regularities that are part of the natural order. (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)

To better illuminate aspects of stress that are relevant to the moral domain, we present a definition and theoretical model of “moral stress.” Our definition posits that moral stress is a psychological state born of an individual’s uncertainty about his or her ability to fulfill relevant moral obligations. This definition assumes a self-and-others relational basis for moral stress. Accordingly, our model draws from a theory of the self (identity theory) and a theory of others (stakeholder theory) to suggest that this (...) uncertainty arises as a manager faces competing claims for limited resources from multiple stakeholders and/or across multiple role identities. We further propose that the extent to which the manager is attentive to the moral aspects of the claims (i.e., moral attentiveness) moderates these effects. We identify several consequences of managerial moral stress and discuss theoretical, empirical, and practical implications of our approach. Most importantly, we argue that this work paves an important path for considering stress through the lens of morality. (shrink)

We conducted a survey of residents of Kingston, Ontario, Canada, (n = 107) to understand their attitudes to and experiences of waste management and governance. Currently, the municipality is emphasising waste diversion and exploring new waste processing systems (WPS; e.g., incineration) to reduce costs. Using Foucault's governmentality theory, our data suggest Kingston's reliance on an attitude-behaviour-context model of behaviour change successfully fosters an environmental citizenship identity based on waste diversion (e.g., recycling). However, we argue that the neoliberal governmentality upon which (...) the attitude-behaviour-context model is predicated elides the need for, and inhibits consideration of, broader societal change concerning urgent environmental issues involving consumption and waste. (shrink)

The contributors to this volume address global, regional, and local landscapes, cosmopolitan and indigenous cultures, and human and more-than-human ecology as they work to reveal place-specific tensional dynamics. This unusual book, which covers a wide-ranging array of topics, coheres into a work that will be a valuable reference for scholars of geography and the philosophy of place.

Do the rich descriptions and narrative shapings of literature provide a valuable resource for readers, writers, philosophers, and everyday people to imagine and confront the ultimate questions of life? Do the human activities of storytelling and complex moral decision-making have a deep connection? What are the moral responsibilities of the artist, critic, and reader? What can religious perspectives—from Catholic to Protestant to Mormon—contribute to literary criticism? Thirty well known contributors reflect on these questions, including iterary theorists Marshall Gregory, James Phelan, (...) and Wayne Booth; philosophers Martha Nussbaum, Richard Hart, and Nina Rosenstand; and authors John Updike, Charles Johnson, Flannery O'Connor, and Bernard Malamud. Divided into four sections, with introductory matter and questions for discussion, this accessible anthology represents the most crucial work today exploring the interdisciplinary connections between literature, religion and philosophy. (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.

Coral bleaching has impacted reefs worldwide and the predictions of near‐annual bleaching from over two decades ago have now been realized. While technology currently provides the means to predict large‐scale bleaching, predicting reef‐scale and within‐reef patterns in real‐time for all reef users is limited. In 2020, heat stress across the Great Barrier Reef underpinned the region's third bleaching event in 5 years. Here we review the heterogeneous emergence of bleaching across Heron Island reef habitats and discuss the oceanographic drivers that (...) underpinned variable bleaching emergence. We do so as a case study to highlight how reef end‐user groups who engage with coral reefs in different ways require targeted guidance for how, and when, to alter their use of coral reefs in response to bleaching events. Our case study of coral bleaching emergence demonstrates how within‐reef scale nowcasting of coral bleaching could aid the development of accessible and equitable bleaching response strategies on coral reefs. Also see the video abstract here: https://youtu.be/N9Tgb8N-vN0. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.4 (2003) 369-372 [Access article in PDF] Unity of Agency and Volition:Some Personal Reflections Stephen Weiner The issues of unity of agency, self-as-narrative, and more generally, volition are highly personal to me. Indeed, I would say I have frequently been obsessed with them. I am 52 years old, and date the onset of my psychiatric symptoms—my long-term misery—very specifically: 11:00 pm Pacific Standard Time, August (...) 28, 1965. At almost precisely that time, I started obsessing that I was homosexual and, in fact, turning into a girl. Within days, derealization followed: for instance, the houses in my neighborhood seemed one-dimensional—they seemed as though they were painted, as though I could stick my hand or an object through them. Colors seemed less bright as well—but I hardly had words for all this at the time: it was an overwhelmingly preverbal feeling, but I found some words for it.I was also depressed, and knew I was depressed—that is, I was worried, had trouble sleeping, and had suicidal thoughts and feelings. Within weeks, I asked my parents if I could see a psychiatrist, and I did. I remember asking my psychiatrist if he ever thought about the possibility that everything might be an illusion, and he quoted the refrain from "Row, Row, Row Your Boat": "merrily, merrily, merrily, merrily, life is but a dream." But just asking him produced a chilling feeling that he did not exist and, largely for this reason, I did not mention unreality feelings again to therapists for another 20 years.So, like Dr. Wells' patient Edward, described by James Phillips (2003), I was in trouble; like Edward, I was starting to construct a narrative. I started feeling that I had "to tell my story" at about this time—before then, I had not felt a need to do that. That may be partly because young children take life for granted (at least, I did), and it may be partly because suffering, by its very nature, demands explanation; both reasons were probably operating—certainly, both my parents told me years later that I had seemed emotionally distressed as a child, and my mother told they would have given me Ritalin if it had been available. So, to other people (my parents and my teachers) I was mentally ill in some sense, and I have some pretty clear memories of what I now recognize as depression, especially in the second and third grades; but I did not think of myself as sick and I did not think of myself as suffering—and I did not experience the duality (at least) of selves that I started to experience almost immediately in August 1965.Phillips further points out that the "future Edward" could look back in his narrative, at a later age, and reconstruct his history either as someone with a continuing mental illness, or as someone who had attained a secure, healthy adulthood and saw his experience as adolescent pain in the service of ultimate adult health and integration. I see my story, I am sorry to report, as [End Page 369] one of unremitting basic pain but with the positive dimension that I was able to go on, obtain a good education, work a good deal in my adult life, and father a child. But my narrative—and am I not, as a highly verbal person, almost constrained to think of my life as a narrative?—has been one, as Phillips (following Kleinman) realizes, of suffering. It is, above all else, an illness narrative. I find the approach of J. Melvin Woody (2003)—of privileging performing and performing arts and spatial metaphors over story—less relevant and true to myself, although I see no reason to argue with Mary's preference for such forms. It may be that the temporal discontinuities she has experienced predispose her to see herself in such terms—may, in fact, necessitate doing so. I am not exactly sure why, but it probably has to do with acting, with trying on and performing one role... (shrink)

There is quite a bit of disagreement in cognitive science regarding the role that consciousness and control play in explanations of how people do what they do. The purpose of the present paper is to do the following: (1) examine the theoretical choice points that have lead theorists to conflicting positions, (2) examine the philosophical and empirical problems different theories encounter as they address the issue of conscious agency, and (3) provide an integrative framework (Wild Systems Theory) that addresses these (...) problems and potentially naturalizes conscious agency. It does so by grounding conscious and control in the notion of self-sustaining energy-transformation systems (i.e., living systems), versus computational or self- organizing systems, as is the case in information processing theory and dynamical systems theory, respectively. Given its assertion that content (and consciousness) emerges in self-sustaining systems, Wild Systems Theory may also provide a sound theoretical basis for a science of consciousness in general. (shrink)

The relationship between ethics and job satisfaction for MIS professionals is examined empirically. Five dimensions of job satisfaction are examined: (1) satisfaction with pay, (2) satisfaction with promotions, (3) satisfaction with co-workers, (4) satisfaction with supervisors and (5) satisfaction with the work itself. These dimensions of satisfaction are compared to top management's ethical stance, one's overall sense of social responsibility and an ethical optimism scale (i.e., the degree of optimism that one has concerning the positive relationship between ethics and success (...) in his/her company).Results indicate that MIS professionals are more satisfied with the various dimensions of their jobs when top management stresses ethical behavior and when they are optimistic about the relationship between ethics and success within their firms. The one exception to this is pay satisfaction which is unrelated to these constructs. One's sense of social responsibility is also relatively unrelated to job satisfaction. (shrink)

Epistemic justifications for democracy have been offered in terms of two different aspects of decision-making: voting and deliberation, or ‘votes’ and ‘talk.’ The Condorcet Jury Theorem is appealed to as a justification in terms votes, and the Hong-Page “Diversity Trumps Ability” result is appealed to as a justification in terms of deliberation. Both of these, however, are most plausibly construed as models of direct democracy, with full and direct participation across the population. In this paper, we explore how these results (...) hold up if we vary the model so as to reflect the more familiar democratic structure of a representative hierarchy. We first recount extant analytic work that shows that representation inevitably weakens the voting results of the Condorcet Jury Theorem, but we question the ability of that result to shine light on real representative systems. We then show that, when we move from votes to talk, as modeled in Hong-Page, representation holds its own and even has a slight edge. (shrink)

Borrett, Kelly, and Kwan follow the lead of Merleau-Ponty and develop a theory of neural-network modeling that emerges out of what they find wrong with current approaches to thought and action. Specifically, they take issue with "cognitivism" and its tendency to model cognitive agents as controlling, representational systems. While attempting to make the point that pre-predicative experience/action/place (i.e. grasping) involves neither representation nor control, the authors imply that control-theoretic concepts and representationalism necessarily go hand-in-hand. The purpose of the present paper (...) is to demonstrate that this is not the case. Rather, it will be argued that such necessity is only assumed because the authors attempt to apply the control theory of servo-mechanisms to the behavior of organisms. By adopting this engineering control-theoretic perspective, the authors are led, as are most of the cognitivists with whom they disagree, to overlook critical aspects of how it is that biological systems do what they do. It is the ignoring of these critical aspects of biological control, due to the acceptance of an engineering approach to control, that makes it appear as though control theory and representationalism necessarily go hand-in-hand. (shrink)

Hommel et al. propose that action planning and perception utilize common resources. This implies perception should have intention-relative content. Data supporting this implication are presented. These findings challenge the notion of perception as “seeing.” An alternative is suggested (i.e., perception as distal control) that may provide a means of integrating representational and ecological approaches to the study of organism-environment coordination.

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)