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)

We review scholarship that examines relationships - and distinctions - between religion and delusion. We begin by outlining and endorsing the position that both involve belief. Next, we present the prevailing psychiatric view that religious beliefs are not delusional if they are culturally accepted. While this cultural exemption has controversial implications, we argue it is clinically valuable and consistent with a growing awareness of the social - as opposed to purely epistemic - function of belief formation. Finally, we review research (...) on continuities between religious and delusional cognition, which reveals that religious content is quite common in delusions and which provides tentative evidence for a positive relationship between religious belief and delusion-like belief in the general population. (shrink)

As previous pandemics, the coronavirus disease 2019 (COVID-19) has direct and indirect effects on mental health and well-being. The purpose of the current study was to examine whether meaning in life mediated the association between coronavirus suffering and satisfaction with life and whether stress-related growth moderated the mediating effect of meaning in life on the association between these variables. Stress-Related Growth Measure (SGM) was also conducted for the purpose of this study. The participants were 402 (66% women) young adults who (...) completed the Suffering Measure During COVID-19, Meaningful Living Measure, Satisfaction With Life Scale, and SGM. The results indicated that the SGM has adequate psychometric properties with unidimensional structure of stress-related growth in the face of adversity. Moderated mediation analysis revealed that coronavirus suffering directly influenced satisfaction with life as well as indirectly by its effect on meaning in life. Additionally, stress-related growth was found as a moderator in the relationship between coronavirus suffering–meaning in life and coronavirus suffering–satisfaction with life. These results suggest that meaning in life mitigates the effect of coronavirus suffering on satisfaction with life, and this mediating effect is moderated by stress-related growth in young adults. While meaning in life helps explain the relationship between coronavirus suffering and satisfaction with life, the stress-related growth functions as a protective factor against the adverse effect of coronavirus experiences. (shrink)

Dancy (philosophy, Florida State U.) presents two new interpretations of the evidence regarding the metaphysical ideas of two important figures in Plato's Academy, Eudoxus and Speusippus, and of Aristotle's reaction to those ideas.

Societies are composed of groups that interact. Symbiotic groups are those in which agents complement each other in resources that they have in excess. Symbiotic groups are useful especially when the resources in an environment are distributed unevenly, because they enable agents to trade resources easily. However, for trading to happen successfully, agents in symbiotic groups need to cooperate, i.e., they should be willing to donate resources when appropriate. Similarly, if some agents in a symbiotic group are defectors, they should (...) be identified by others and eliminated from the group for the well-being of the remaining agents. Accordingly, we first study Edmonds’ tag-based model of symbiotic groups to understand the lifespan of symbiotic groups (e.g., why some groups live shorter than others). Then, we enhance Edmonds’ model by adding the capability of reciprocal interactions to agents, thus achieving a hybrid model. We capture reciprocity in three different models and study their effects on the elimination of defectors in symbiotic groups. Our experimental results show that the groups that are built with the proposed hybrid model can eliminate more defectors and earlier than tag-based models. Further, the hybrid approach can generate symbiotic groups more effectively and efficiently. (shrink)

Formal training in clinical ethics must become a central part of residency curricula to prepare practitioners to manage the ethical dimensions of patient care. Residency educators must ground their teaching in an understanding of the conceptual, biomedical, and psychosocial aspects of the important ethical issues that arise in that field of practice. Four aspects of professional competence in clinical ethics provide a useful framework for curricular planning. The physician should learn to: (1) recognize ethical issues as they arise in clinical (...) care and identify hidden values and unacknowledged conflicts; (2) think clearly and critically about these issues in ways that lead to ethically justifiable courses of action; (3) apply those practical skills needed to implement an ethically justifiably course of action; and (4) judge when the management of a clinical situation requires consultation with individuals or institutional bodies with additional expertise or authority. We argue that these practical goals can be accomplished with a relatively modest emphasis on the theoretical aspects of medical ethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Plato and Aristotle in Agreement? Platonists on Aristotle from Antiochus to PorphyryR. M. DancyGeorge E. Karamanolis. Plato and Aristotle in Agreement? Platonists on Aristotle from Antiochus to Porphyry. Oxford: Clarendon Press, 2006. Pp. x + 419. Cloth, $125.00.Coleridge wrote: “Every man is born an Aristotelian or a Platonist. I do not think it possible that anyone born an Aristotelian can become a Platonist; and I am sure that (...) no born Platonist can ever change into an Aristotelian. They are two classes of man, beside which it is next to impossible to conceive a third.”Ancient Platonists could not be counted on to accept this kind of dichotomy, and that is what Karamanolis’s book is about. (It may be usefully compared with Lloyd P. Gerson’s 2005 book, Aristotle and Other Platonists.) It covers Antiochus (second century BC), Plutarch [End Page 634] of Chaeronea, Numenius, Atticus, Ammonius Saccas, Plotinus, and Porphyry (third century AD). And it does so with incredible thoroughness, making it a tough read. The book began as a dissertation; it still has something of the air of one.The longest chapter is devoted to Porphyry, whom Karamanolis claims to be the first Platonist to write commentaries on books of Aristotle, and the first to adopt the view that Aristotle simply was in agreement with Plato—the founder of a tradition in scholarship to the effect that “Plato is named as the authority in metaphysics, and Aristotle in logic” (330). His concluding paragraph is this:It is this understanding of philosophizing which lies behind the formation of the Pla-tonist syllabus I described in the beginning of this book. This remains the situation until the Renaissance. When Renaissance humanists revive ancient philosophy, especially Platonism, as happened in Renaissance Florence, they re-establish this very model. Few other shifts in the history of Western philosophy are of such significance as the one which we, quite rightly, attribute to Porphyry.(330)The “Platonist syllabus” to which Karamanolis here adverts is perhaps summed up when he says that “from the third to the sixth century AD... Aristotle was appropriated by Platonists because they found his philosophy, if properly studied, a prerequisite for, and conducive to, an understanding of Plato’s thought” (4). More precisely, Karamanolis’s book is about Porphyry’s view and the background of its formation.Answering Karamanolis’s title question is not what is at stake; rather, he is concerned with how the Platonists listed above answered it. So we are not getting a history of the reading of Plato and Aristotle as agreeing or disagreeing from the very beginning. The early Academy and the skeptical Academy before Antiochus, for example, do not figure, except incidentally, in Karamanolis’s story (although there is a useful appendix on the early peripatetics). There is enough here to keep us busy without this.Dealing with any of Karamanolis’s Platonists is made more difficult by the nature of the material that remains: except for Plutarch and Plotinus, it is almost entirely fragmentary. So it is a question of interpreting not just the target authors, whose works we do not possess, but the sources we have for them, who have their own hobby-horses to ride, and hence are not always reliable. Karamanolis pays suitable attention to such details. But the back-and-forth discussion required can make it difficult to keep the larger picture in view.Karamanolis’s Platonists do not uniformly go for the agreement of Plato and Aristotle. As Karamanolis has it, Porphyry is the only one to swallow it whole: “... nowhere does Porphyry criticize Aristotle,” he concludes (322). This requires him to explain away what he regards as misunderstandings of the evidence (243–45 records some disagreements, and the Porphyry chapter throughout is dedicated to rebuttal). Karamanolis is at least prima facie convincing. At the opposite end of the spectrum are Atticus and Numenius, whose antipathy toward Aristotle is universal.For the rest, whether we are to say that Plato and Aristotle were in agreement obviously depends on what the agreement is to be about. There is, among Karamanolis’s Platonists, a good deal of interesting variation over that. Most of those who... (shrink)

In A Priori Justification, Albert Casullo argues that extant attempts to explicate experiential justification—by stipulation, introspection, conceptual analysis, thought experimentation, and/or appeal to intuitions about hypothetical cases—are unsuccessful. He draws the following conclusion: “armchair methods” such as these are inadequate to the task. Instead, empirical methods should be used to investigate the distinction between experiential and non-experiential justification and to address questions concerning the nature, extent, and existence of the a priori. In this essay, I show that Casullo has not (...) refuted armchair explications of experiential justification, in particular those that appeal to introspectively accessible phenomenology. I do this by presenting a phenomenal theory of experiential justification that (a) has a significant degree of initial plausibility and (b) survives Casullo’s general attack on such theories. As a result, a premise in the central argument for Casullo’s signature proposal concerning the a priori is undermined. (shrink)

Welcome to the new series of "Thought and Practice: A Journal of the Philosophical Association of Kenya". Africa’s socio-political crisis is multi-faceted, and therefore requires a many-pronged approach. It is for this reason that Thought and Practice seeks to serve as a forum for scholars with broad interests in the humanities and social sciences, where they can exchange ideas on various facets of Africa’s current realities and challenges.