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)

What do we really know? What are we in relation to the world around us? Here, the acclaimed playwright and novelist takes on the great questions of his career—and of our lives Humankind, scientists agree, is an insignificant speck in the impersonal vastness of the universe. But what would that universe be like if we were not here to say something about it? Would there be numbers if there were no one to count them? Would the universe even be vast, (...) without the fact of our smallness to give it scale? With wit, charm, and brilliance, this epic work of philosophy sets out to make sense of our place in the scheme of things. Our contact with the world around us, Michael Frayn shows, is always fleeting and indeterminate, yet we have nevertheless had to fashion a comprehensible universe in which action is possible. But how do we distinguish our subjective experience from what is objectively true and knowable? Surveying the spectrum of philosophical concerns from the existence of space and time to relativity and language, Frayn attempts to resolve what he calls “the oldest mystery”: the world is what we make of it. In which case, though, what are we? All of Frayn’s novels and plays have grappled with these essential questions; in this book he confronts them head-on. (shrink)

"Williams's masterful translation satisfies (at last!) a long-standing need. There are lots of good translations of Augustine's great work, but until now we have been forced to choose between those that strive to replicate in English something of the majesty and beauty of Augustine's Latin style and those that opt instead to convey the careful precision of his philosophical terminology and argumentation. Finally, Williams has succeeded in capturing both sides of Augustine's mind in a richly evocative, impeccably reliable, elegantly readable (...) presentation of one of the most impressive achievements in Western thought--Augustine's Confessions." --Scott MacDonald, Professor of Philosophy and Norma K. Regan Professor in Christian Studies, Cornell University. (shrink)

This article considers how seventeenth-century writer John Milton engages in modes of thinking that register the obstetric revolution occurring during the period. During a time when physicians were gaining entry to the birthing room, a medical rhetoric of childbirth was developing that cast childbirth in new pathological terms. Milton's A Masque Presented at Ludlow Castle demonstrates how childbirth was influenced by emerging obstetrical language and practice, as well as the ways in which a writer might question such influence. Finally, this (...) article also draws links between disrupted historical rituals of childbirth and modern anxieties about medically-centred birthing practices. (shrink)

This essay presents ecosemiotics as an approach to interpreting Heidegger in environmental philosophy. Comparisons between Heidegger’s philosophy and ecosemiotics have often focused on the 1929–1930 lecture course where Heidegger discusses Jakob von Uexküll’s notion of Umwelt. These and other ecological interpretations reach an impasse with the sharp ontological boundary Heidegger places between Dasein and more-than-human lifeforms. This essay revisits the theme by focusing on a central concept from Heidegger’s later work: enframing [Gestell]. Enframing, it is argued, can be understood as (...) a rupture between human (cultural) and natural signs, which is a consequence of technological modernity. Although this interpretation diverges from Heidegger’s philosophy, such critical readings may be necessary if Heidegger’s work is to speak to today’s technologies and ecological issues. (shrink)

The Moral Nexus develops and defends a new interpretation of morality—namely, as a set of requirements that connect agents normatively to other persons in a nexus of moral relations. According to this relational interpretation, moral demands are directed to other individuals, who have claims that the agent comply with these demands. Interpersonal morality, so conceived, is the domain of what we owe to each other, insofar as we are each persons with equal moral standing. The book offers an interpretative argument (...) for the relational approach. Specifically, it highlights neglected advantages of this way of understanding the moral domain; explores important theoretical and practical presuppositions of relational moral duties; and considers the normative implications of understanding morality in relational terms. The book features a novel defense of the relational approach to morality, which emphasizes the special significance that moral requirements have, both for agents who are deliberating about what to do and for those who stand to be affected by their actions. The book argues that relational moral requirements can be understood to link us to all individuals whose interests render them vulnerable to our agency, regardless of whether they stand in any prior relationship to us. It also offers fresh accounts of some of the moral phenomena that have seemed to resist treatment in relational terms, showing that the relational interpretation is a viable framework for understanding our specific moral obligations to other people. (shrink)

Often created by colonial societies characterized by violence and oppression, historical artefacts such as monuments are increasingly under criticism for perpetuating violent attitudes. While the links between artefacts and society are well understood, there has been little work that finds the opportunity for resistance to violence in these artefacts themselves. Developing a ‘spectrum of violence’ for artefacts, I argue that ambiguous artefacts move us towards non-violence by provoking critique, while absolute artefacts move us away from it by stilling critique. Applying (...) this spectrum to a discussion of a graffitied New York monument in 2020, I propose that the act of ‘refacement’ can turn absolute artefacts into ambiguous ones. In so doing, the artefacts that once upheld colonial values might be transformed to resist them. This paper offers a timely exploration of monuments and violence, and seeks to better understand how cultural artefacts can lay the foundations for a non-violent future. (shrink)

This essay presents ecosemiotics as an approach to interpreting Heidegger in environmental philosophy. Comparisons between Heidegger’s philosophy and ecosemiotics have often focused on the 1929–1930 lecture course where Heidegger discusses Jakob von Uexküll’s notion of Umwelt. These and other ecological interpretations reach an impasse with the sharp ontological boundary Heidegger places between Dasein and more-than-human lifeforms. This essay revisits the theme by focusing on a central concept from Heidegger’s later work: enframing [Gestell]. Enframing, it is argued, can be understood as (...) a rupture between human and natural signs, which is a consequence of technological modernity. Although this interpretation diverges from Heidegger’s philosophy, such critical readings may be necessary if Heidegger’s work is to speak to today’s technologies and ecological issues. (shrink)

Anything comic has got to be basically serious – that’s what makes it funny. If there wasn’t anything at issue in comedy there wouldn’t be anything to laugh at. Similarly, if you’re writing about multiple universe theory, or whatever it happens to be, you can’t help seeing the funny side of it, because there are many, many funny aspects to a lot of philosophical and scientific ideas and it’s absolutely impossible to write them all with a completely straight face.

The advent of simple in vitro fertilisation techniques has provided the reproductive biologist with an invaluable system for assaying sperm fertilising ability. In particular, they provide a useful way of identifying and characterising gamete‐specific proteins that play a role in sperm‐egg interactions, and in recent years, a growing number of sperm surface proteins have been identified that appear to be involved in these processes. Fertilin β was one of the first sperm membrane proteins to be implicated in egg interactions and (...) it has been proposed that this is mediated by means of binding of its disintegrin‐like domain to cognate integrin receptors on the egg plasma membrane. A recent paper in Science by Cho and colleagues [Cho et al. 1998. Fertilisation defects in sperm from mice lacking fertilin β. Science 281:1857–1859 (Ref. 1)] provides preliminary data on a fertilin β knockout mouse. Whilst fertilin βnull males had greatly reduced fertility, somewhat surprisingly, this could be largely attributed to causes other than impaired binding to the egg plasma membrane. BioEssays 21:183–187, 1999. © 1999 John Wiley & Sons, Inc. (shrink)

Abstinence from meat has been a subject of much controversy and friction from the dawn of Christian history. Relatively widespread in the early Church, it was praised when it formed part of a temporary ascetic fasting regimen, but condemned if it amounted to a permanent rejection of animal flesh, as it would be associated with heretical ideas found in various dissident groups, gnostic sects, and pagan philosophical schools. Nevertheless, several patristic authors put forth a number of compelling arguments in defense (...) of a meatless diet, all of which would be revisited by future generations of Christian thinkers. Laying the emphasis upon the ethical incentives for abstaining from animal flesh, as well as upon enduring ambivalent attitudes toward vegetarian dietary practices, this article offers a brief overview of abstinence from meat throughout Christian history. (shrink)

This article uncovers the historical connection between anarchism and vegetarianism in France. In doing so, it restores the significance of a little-known branch of the libertarian movement, namely individualist anarchism. Individualist anarchists sought to transform themselves by applying anarchist principles in their daily lives instead of waiting for a future revolution. Retracing the thoughts and deeds of these forgotten pioneers of the ecological and animal liberation movements, I show that vegetarianism is a striking illustration of anarcho-individualist prefigurative politics and that (...) their aspiration to find their place within nature is as topical as ever. (shrink)

This article examines the monastic diet during the high and late medieval periods. The evolution of this central aspect of daily life gives us greater insight into contemplative monks’ increasing worldliness. Monks not only fell short of their forefathers’ ideals, but also of their own codes of behavior. Their diet gradually became more akin to that of noblemen than to that of their ancient brothers and sisters. Frugality and temperance all too often gave way to indulgence and debauchery. Days on (...) which one should have expected to endure the austerity of fasting were sometimes more reminiscent of the lavishness of feasts. In addition to mead, merriment, and music, meat invaded the cloister. (shrink)

This book provides a collection of sources, many of them fragmentary and previously scattered and hard to access, for the development of Peripatetic philosophy in the later Hellenistic period and the early Roman Empire. It also supplies the background against which the first commentator on Aristotle from whom extensive material survives, Alexander of Aphrodisias (fl. c. AD 200), developed his interpretations which continue to be influential even today. Many of the passages are here translated into English for the first time, (...) including the whole of the summary of Peripatetic ethics attributed to 'Arius Didymus'. (shrink)

R.I.G. Hughes presents a series of eight philosophical essays on the theoretical practices of physics. The first two essays examine these practices as they appear in physicists' treatises (e.g. Newton's Principia and Opticks ) and journal articles (by Einstein, Bohm and Pines, Aharonov and Bohm). By treating these publications as texts, Hughes casts the philosopher of science in the role of critic. This premise guides the following 6 essays which deal with various concerns of philosophy of physics such as laws, (...) disunities, models and representation, computer simulation, explanation, and the discourse of physics. (shrink)

We should approach this topic with great fear and respect. It is not a merely “academic” issue. Human rights are trampled upon in the East as in the West, in the North as in the South of our planet. Granting the part of human greed and sheer evil in this universal transgression, could it not also be that Human Rights are not observed because in their present form they do not represent a universal symbol powerful enough to elicit understanding and (...) agreement? (shrink)

Chemical structures are among the trademarks of our profession, as surely chemical as flasks, beakers and distillation columns. When someone sees one of us busily scribbling formulas or structures, he or she has no trouble identifying a chemist. Yet these familiar objects, which accompany our work from start to end, from the initial doodlings (Fig. I) to the final polished artwork in a publication (Fig. II), are deceptively simple. They raise interesting and difficult questions about representation. It is the intent (...) of this article to reflect upon molecular graphics. (shrink)

Ethics and Decision Making in Counseling and Psychotherapy has a distinct and timely focus on counseling as a profession. Chapters address the mental health professions, values in counseling, decision making, ethical principles, ethical standards, technology, ethical climate, and office/administrative practices. The early chapters present a foundation for ethical practice of the profession and provides solid building blocks to the more advanced perspectives in later chapters. Chapters on specialty practice are lively and contemporary overviews of these practice areas in counseling that (...) reflect more recent trends to increased differentiation of these areas of practice. Each specialty has its own chapter to allow for an extended discussion of the unique aspects of the field that provide clarity to understanding the particular ethical issues and standards that apply in each specialty. The specialty areas recognized by CACREP are included: mental health counseling; school counseling; couple, marital, and family counseling; rehabilitation counseling; addictions counseling; career counseling; and group counseling. This book is broad in its coverage of the most practiced specialties in mental health practice, and provides an efficient and effective overview of the broad scope of particular areas addressed in counseling. (shrink)

How do we explain violence? What is so significant of modern forms of violence that it has produced such large-scale destruction in its wake? This volume builds on the political philosophy of Wittgenstein, his notions of peace and violence, to explore how violence in any form is contained within culturally or ideologically formed institutions. Drawing on Wittgenstein's work on language, it explores the link between language and violence, everydayness, culture. It examines everyday instances of micro-violence which we sometimes forget to (...) recall. This book puts forth the claim that any theory of violence will have to touch upon the many myriad - both micro and macro -- political, social and cultural interactions that make up the human condition. The author further comments on the unseen ways in which violence has been instrumentalized in modern history's many stages to create a spectacle of power so as to reinforce authority. The volume will be of great interest to students and scholars of peace and conflict studies, political philosophy, linguistics and modern history. (shrink)

I investigate the consequences of Nietzsche's perspectivism for notions of truth and objectivity, and show how the metaphor of visual perspective motivates an epistemology that avoids self-referential difficulties. Perspectivism's claim that every view is only one view, applied to itself, is often supposed to preclude the perspectivist's ability to offer reasons for her epistemology. Nietzsche's arguments for perspectivism depend on “internal reasons”, which have force not only in their own perspective, but also within the standards of alternative perspectives. Internal reasons (...) allow a perspectivist argument against dogmatism without presupposing aperspectival criteria for theory choice. Nietzsche also offers “internal” conceptions of truth and objectivity which reduce them to a matter of meeting our epistemic standards. This view has pluralistic implications, which conflict with common sense, but it is nevertheless consistent and plausible. Nietzsche's position is similar to Putnam's recent internalism, and this is due to their common Kantian heritage. (shrink)