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)

Bereits mit Anfang Zwanzig, wohl zwischen 1829 und 1831, verfasst John Stuart Mill fünf Essays, die seine ersten ökonomischen Schriften darstellen. Mit der Ausnahme des fünften Essays werden diese allerdings erstmals 1844 veröffentlicht, zwei Jahre nach dem Erfolg von A System of Logic. Diese frühen Texte zeugen von Mills Fähigkeiten als Synthetisierer unterschiedlicher theoretischer Ansätze, aber ebenso von seiner oft verkannten Innovationskraft auf dem Feld der Ökonomie. Zudem zeigen sie ihn als Autor des Übergangs vom klassischen zum neoklassischen Paradigma. Mill (...) ist offen gegenüber Ideen, die nicht ohne Weiteres mit der Klassischen Nationalökonomie zu vereinbaren sind. Entsprechend findet sogar Karl Marx, trotz aller berechtigten Kritik an den Essays, lobende Worte für das „Schriftlein, das in der Tat alle originellen Ideen des Herrn J[ohn] St[uart] Mill über political economy enthält“ (MEW 26.3, 190). Für John R. Hicks sind die Essays „perhaps the freshest of Mill’s economic writings“ (Hicks 1983, 60). (shrink)

At the very beginning of L’Homme-Machine, La Mettrie claims that Leibnizians with their monads have “rather spiritualized matter than materialized the soul”; a few years later Pierre-Louis Moreau de Maupertuis, President of the Berlin Academy of Sciences and natural philosopher with a strong interest in the modes of transmission of ‘genetic’ information, conceived of living minima which he termed molecules, “endowed with desire, memory and intelligence,” in his Système de la nature ou Essai sur les corps organisés. This text first (...) appeared in Latin in 1751 under the title Dissertatio inauguralis metaphysica de universali naturae systemate, with the pseudonym Dr Baumann; it was translated by Maupertuis in 1754 as Essai sur la formation des corps organisés and was later included in his 1756 Œuvres under the title Système de la nature. Now, it is clear that Maupertuis was a kind of Leibnizian; and that his molecule possessed higher-level, ‘mental’ properties. In that sense he falls under the first category described by La Mettrie. But he was also involved in a debate on this issue with Diderot, who put forth a sustained critique of Maupertuis’ theory of the molecule in the additions to his 1753 Pensées sur l’interprétation de la nature. Where Maupertuis attributes higher-level properties to his living minima, Diderot argues that these properties are ‘organizational’, i.e., they can only be properties of the whole. At issue here is the degree of commitment to a form of materialism. (shrink)

In his Philosophical Inquiry concerning Human Liberty (1717), the English deist Anthony Collins proposed a complete determinist account of the human mind and action, partly inspired by his mentor Locke, but also by elements from Bayle, Leibniz and other Continental sources. It is a determinism which does not neglect the question of the specific status of the mind but rather seeks to provide a causal account of mental activity and volition in particular; it is a ‘volitional determinism’. Some decades later, (...) Diderot articulates a very similar determinism, which seeks to recognize the existence of “causes proper to man” (as he says in the Réfutation d’Helvétius). The difference with Collins is that now biological factors are being taken into account. Obviously both the ‘volitional’ and the ‘biological’ forms of determinism are noteworthy inasmuch as they change our picture of the nature of determinism itself, but my interest here is to compare these two determinist arguments, both of which are broadly Spinozist in nature – and as such belong to what Jonathan Israel called in his recent book “the radical Enlightenment,” i.e. a kind of underground Enlightenment constituted by Spinozism – and to see how Collins’ specifically psychological vision and Diderot’s specifically biological vision correspond to their two separate national contexts: determinism in France in the mid-1750s was a much more medico-biological affair than English determinism, which appears to be on a ‘path’ leading to Mill and associationist psychology. (shrink)

J. Willard Gibbs derived the following equation to quantify the maximum work possible for a chemical reaction$${\text{Maximum work }} = \, - \Delta {\text{G}}_{{{\text{rxn}}}} = \, - \left( {\Delta {\text{H}}_{{{\text{rxn}}}} {-}{\text{ T}}\Delta {\text{S}}_{{{\text{rxn}}}} } \right) {\text{ constant T}},{\text{P}}$$ Maximum work = - Δ G rxn = - Δ H rxn - T Δ S rxn constant T, P ∆Hrxn is the enthalpy change of reaction as measured in a reaction calorimeter and ∆Grxn the change in Gibbs energy as measured, if (...) feasible, in an electrochemical cell by the voltage across the two half-cells. To Gibbs, reaction spontaneity corresponds to negative values of ∆Grxn. But what is T∆Srxn, absolute temperature times the change in entropy? Gibbs stated that this term quantifies the heating/cooling required to maintain constant temperature in an electrochemical cell. Seeking a deeper explanation than this, one involving the behaviors of atoms and molecules that cause these thermodynamic phenomena, I employed an “atoms first” approach to decipher the physical underpinning of T∆Srxn and, in so doing, developed the hypothesis that this term quantifies the change in “structural energy” of the system during a chemical reaction. This hypothesis now challenges me to similarly explain the physical underpinning of the Gibbs–Helmholtz equation$${\text{d}}\left( {\Delta {\text{G}}_{{{\text{rxn}}}} } \right)/{\text{dT}} = - \Delta {\text{S}}_{{{\text{rxn}}}} \left( {\text{constant P}} \right)$$ d Δ G rxn / dT = - Δ S rxn constant P While this equation illustrates a relationship between ∆Grxn and ∆Srxn, I don’t understand how this is so, especially since orbital electron energies that I hypothesize are responsible for ∆Grxn are not directly involved in the entropy determination of atoms and molecules that are responsible for ∆Srxn. I write this paper to both share my progress and also to seek help from any who can clarify this for me. (shrink)

The most pressing issues of the twenty-first century—climate change and persistent hunger in a world of food surpluses, to name only two—are not problems that can be solved from within individual disciplines, nation-states, or cultural perspectives. They are predicaments that can only be resolved by generating sustained and globally robust coordination across value systems. The scale of the problems and necessity for coordinated global solutions signal a world historical transit as momentous as the Industrial Revolution: a transition from the predominance (...) of technical knowledge to that of ethical deliberation. This volume brings together leading thinkers from around the world to deliberate on how best to correlate worth (value) with what is worthwhile (values), pairing human prosperity with personal, environmental, and spiritual flourishing in a world of differing visions of what constitutes a moral life. Especially in the aftermath of what is now being called the Great Recession, awareness has mounted of the imperative to question the modern divorce of economics from ethics. While the domains of economics and ethics were from antiquity through at least the eighteenth century understood in many cultures to be coterminous and mutually entailing, the modern assumption has been that the goal of maximizing human prosperity and the aim of justly enhancing our lives as persons and as communities were functionally and practically distinct. Working from a wide array of perspectives, the contributors to this volume offer a set of challenges to the assumed independence of the quantitative and qualitative dimensions of human and planetary well-being. Reflecting on the complex interrelationship among economics, justice, and equity, the book resists "one size fits all" approaches and struggles to revitalize the marriage of economics and ethics by activating cultural differences as the basis of mutual contribution to shared human flourishing. The publication of this important collection will stimulate or extend critical debates among scholars and students working in a number of disciplines in the social sciences and humanities, including philosophy, history, environmental studies, economics, and law. Contributors: Roger T. Ames, James Behuniak Jr., Steve Bein, Nalini Bhushan, Purushottama Bilimoria, Steven Burik, Amita Chatterjee, Baoyan Cheng, Gordon Davis, Jay L. Garfield, Steven F. Geisz, Peter D. Hershock, Larry A. Hickman, Kathleen M. Higgins, Heidi M. Hurd, Thomas P. Kasulis, Workineh Kelbessa, Lori Keleher, Oliver Leaman, James McRae, Jin Y. Park, James Peterman, Naoko Saito, May Sim, Robert Smid, Paul Standish, Kenneth W. Stikkers, Karsten J. Struhl, Meera Sushila Viswanathan, Wu Shiu- Ching, Xu Di, T. Yamauchi, Yang Liuxin. (shrink)

How do we judge whether an action is morally right or wrong? If an action is wrong, what reason does that give us not to do it? Why should we give such reasons priority over our other concerns and values? In this book, T. M. Scanlon offers new answers to these questions, as they apply to the central part of morality that concerns what we owe to each other. According to his contractualist view, thinking about right and wrong is thinking (...) about what we do in terms that could be justified to others and that they could not reasonably reject. He shows how the special authority of conclusions about right and wrong arises from the value of being related to others in this way, and he shows how familiar moral ideas such as fairness and responsibility can be understood through their role in this process of mutual justification and criticism. Scanlon bases his contractualism on a broader account of reasons, value, and individual well-being that challenges standard views about these crucial notions. He argues that desires do not provide us with reasons, that states of affairs are not the primary bearers of value, and that well-being is not as important for rational decision-making as it is commonly held to be. Scanlon is a pluralist about both moral and non-moral values. He argues that, taking this plurality of values into account, contractualism allows for most of the variability in moral requirements that relativists have claimed, while still accounting for the full force of our judgments of right and wrong. (shrink)

Ce livre étudie, à travers une série d'épisodes allant de la philosophie des Lumières à notre époque, le problème du matérialisme dans l'histoire de la philosophie et l’histoire des sciences. Comment comprendre les spécificités de l’histoire du matérialisme, des Lumières à nos jours, au sein de la grande histoire de la philosophie et de l’histoire des sciences ? Quelle est l’actualité de l’opposition classique entre le corps et l’esprit ? Qu’est-ce que le rire ou le rêve peuvent nous apprendre du (...) matérialisme ? En traversant l’histoire de ce concept jusqu’à l’émergence d’un « nouveau matérialisme » contemporain, l’ouvrage vise à revitaliser le matérialisme et sa lecture. -/- . (shrink)

Synthetic biologists aim to generate biological organisms according to rational design principles. Their work may have many beneficial applications, but it also raises potentially serious ethical concerns. In this article, we consider what attention the discipline demands from bioethicists. We argue that the most important issue for ethicists to examine is the risk that knowledge from synthetic biology will be misused, for example, in biological terrorism or warfare. To adequately address this concern, bioethics will need to broaden its scope, contemplating (...) not just the means by which scientific knowledge is produced, but also what kinds of knowledge should be sought and disseminated. (shrink)

The purpose of this article is to translate teaching experiences through an interpretation of the world of signs. In between confinements, teachers exercise on stagings that are not just replicating transformations of themselves; but, unique recreations in their worldliness, and in potent sensibilities; possibly different in their own repetition. As a way of resistance in the subjectification experience, we reinvent ourselves with worlds already created, rethinking the school as an environment, institution, space, time, world, and form. With Cortázar, we place (...) ourselves in the unstable opposition, where there is an amorous combat between signs and their interpretation. And this requires a permanent process of reconstruction and recreation of the research perspective, sustained, especially, in Deleuze. Being able to translate in a different way what we are doing, caused concerns in ourselves and even in others. (shrink)

The integration of normative analysis with empirical data often remains unclear despite the availability of many empirical bioethics methodologies. This paper sought bioethics scholars’ experiences and reflections of doing empirical bioethics research to feed these practical insights into the debate on methods. We interviewed twenty-six participants who revealed their process of integrating the normative and the empirical. From the analysis of the data, we first used the themes to identify the methodological content. That is, we show participants’ use of familiar (...) methods explained as “back-and-forth” methods (reflective equilibrium), followed by dialogical methods where collaboration was seen as a better way of doing integration. Thereafter, we highlight methods that were deemed as inherent integration approaches, where the normative and the empirical were intertwined from the start of the research project. Second, we used the themes to express not only how we interpreted what was said but also how things were said. In this, we describe an air of uncertainty and overall vagueness that surrounded the above methods. We conclude that the indeterminacy of integration methods is a double-edged sword. It allows for flexibility but also risks obscuring a lack of understanding of the theoretical-methodological underpinnings of empirical bioethics research methods. (shrink)

Abstract I argue that the two primary motivations in the literature for positing seemings as sui generis mental states are insufficient to motivate this view. Because of this, epistemological views which attempt to put seemings to work don’t go far enough. It would be better to do the same work by appealing to what makes seeming talk true rather than simply appealing to seeming talk. Content Type Journal Article Pages 1-12 DOI 10.1007/s11406-012-9363-8 Authors T. Ryan Byerly, Department of Philosophy, Baylor (...) University, Waco, TX, USA Journal Philosophia Online ISSN 1574-9274 Print ISSN 0048-3893. (shrink)

Some philosophers have thought that life could only be meaningful if there is no God. For Sartre and Nagel, for example, a God of the traditional classical theistic sort would constrain our powers of self-creative autonomy in ways that would severely detract from the meaning of our lives, possibly even evacuate our lives of all meaning. Some philosophers, by contrast, have thought that life could only be meaningful if there is a God. God and the Meanings of Life is interested (...) in exploring the truth in both these schools of thought, seeking to discover what God could and couldn't do to make life meaningful (as well as what he would and wouldn't do). Mawson espouses a version of the 'amalgam' or 'pluralism' thesis about the issue of life's meaning – in essence, that there are a number of different legitimate meanings of 'meaning' (and indeed 'life') in the question of life's meaning. According to Mawson, God, were he to exist, would help make life meaningful in some of these senses and hinder in some others. He argues that whilst there could be meaning in a Godless universe, there could be other sorts of meaning in a Godly one and that these would be deeper. (shrink)

This is the text of The Lindley Lecture for 1996, given by T.M. Scanlon, an American philosopher.