Ethical guidelines for conducting clinical trials have historically been based on a perceived therapeutic obligation to treat and benefit the patient-participants. The origins of this ethical framework can be traced to the Hippocratic oath originally written to guide doctors in caring for their patients, where the overriding moral obligation of doctors is strictly to do what is best for the individual patient, irrespective of other social considerations. In contrast, although medicine focuses on the health of the person, public health is (...) concerned with the health of the entire population, and thus, public health ethics is founded on the societal responsibility to protect and promote the health of the population as a whole. From a public health perspective, research ethics should be guided by giving due consideration to the risks and benefits to society in addition to the individual research participants. On the basis of a duty to protect the population as a whole, a fiduciary obligation to realise the social value of the research and the moral responsibility to distribute the benefits and burdens of research fairly across society, how a public health perspective on research ethics results in fundamental re-assessments of the proper course of action for two salient topical issues in research ethics is shown: stopping trials early for reasons of efficacy and the conduct of research on less expensive yet less effective interventions. (shrink)

Firearm injury in the United States is a public health crisis in which physicians are uniquely situated to intervene. However, their ability to mitigate harm is limited by a complex array of laws and regulations that shape their role in firearm injury prevention. This piece uses four clinical scenarios to illustrate how these laws and regulations impact physician practice, including patient counseling, injury reporting, and the use of court orders and involuntary holds. Unintended consequences on clinical practice of laws intended (...) to reduce firearm injury are also discussed. Lessons drawn from these cases suggest that physicians require more nuanced education on this topic, and that policymakers should consult front-line healthcare providers when designing firearm policies. (shrink)

Initial responses to questionnaires used to assess participants' understanding of informed consent for malaria vaccine trials conducted in the United States and Mali were tallied. Total scores were analyzed by age, sex, literacy (if known), and location. Ninety-two percent (92%) of answers by United States participants and 85% of answers by Malian participants were correct. Questions more likely to be answered incorrectly in Mali related to risk, and to the type of vaccine. For adult participants, independent predictors of higher scores (...) were younger age and female sex in the United States, and male sex in Mali. Scores in the United States were higher than in Mali (P = 0.005). Despite this difference participants at both sites were well informed overall. Although interpretation must be qualified because questionnaires were not intended as research tools and were not standardized among sites, these results do not support concerns about systematic low understanding among research participants in developing versus developed countries. (shrink)

Transplantation of vital organs has been premised ethically and legally on "the dead donor rule" (DDR)—the requirement that donors are determined to be dead before these organs are procured. Nevertheless, scholars have argued cogently that donors of vital organs, including those diagnosed as "brain dead" and those declared dead according to cardiopulmonary criteria, are not in fact dead at the time that vital organs are being procured. In this article, we challenge the normative rationale for the DDR by rejecting the (...) underlying premise that it is necessarily wrong for physicians to cause the death of patients and the claim that abandoning this rule would exploit vulnerable patients. We contend that it is ethical to procure vital organs from living patients sustained on life support prior to treatment withdrawal, provided that there is valid consent for both withdrawing treatment and organ donation. However, the conservatism of medical ethics and practical concerns make it doubtful that the DDR will be abandoned in the near future. This leaves the current practice of organ transplantation based on the "moral fiction" that donors are dead when vital organs are procured. (shrink)

Although established in the law and current practice, the determination of death according to neurological criteria continues to be controversial. Some scholars have advocated return to the traditional circulatory and respiratory criteria for determining death because individuals diagnosed as ‘brain dead’ display an extensive range of integrated biological functioning with the aid of mechanical ventilation. Others have attempted to refute this stance by appealing to the analogy between decapitation and brain death. Since a decapitated animal is obviously dead, and ‘brain (...) death’ represents physiological decapitation, brain dead individuals must be dead. In this article we refute this ‘decapitation gambit.’ We argue that decapitated animals are not necessarily dead, and that, moreover, the analogy between decapitation and the clinical syndrome of brain death is flawed. (shrink)

Advances in life-saving technologies in the past few decades have challenged our traditional understandings of death. Traditionally, death was understood to occur when a person stops breathing, their heart stops beating and they are cold to the touch. Today, physicians determine death by relying on a diagnosis of ‘total brain failure’ or by waiting a short while after circulation stops. Evidence has emerged, however, that the conceptual bases for these approaches to determining death are fundamentally flawed and depart substantially from (...) the established biological conception of death. We argue that the current approach to determining death consists of two different types of unacknowledged legal fictions. These legal fictions were developed for practices that are largely ethically legitimate but need to be reconciled with the law. The considerable debate over the determination of death in the medical and scientific literature has not informed the public that vital organs are being procured from still-living donors and it seems unlikely that this information can remain hidden for long. Given the instability of the status quo and the difficulty of making the substantial legal changes required by complete transparency, we argue for a second-best policy solution: acknowledging the legal fictions involved in determining death to move in the direction of greater transparency. This may someday result in more substantial legal change to directly confront the challenges raised by life-sustaining and life-preserving technologies without the need for fictions. (shrink)

Moral distress (MD) is well-documented within the nursing literature and occurs when constraints prevent a correct course of action from being implemented. The measured frequency of MD has increased among nurses over recent years, especially since the COVID-19 Pandemic. MD is less understood among nurse leaders than other populations of nurses. A qualitative systematic review was conducted with the aim to synthesize the experiences of MD among nurse leaders. This review involved a search of three databases (Medline, CINAHL, and APA (...) PsychINFO) which resulted in the retrieval of 303 articles. PRISMA review criteria guided authors during the article review and selection process. Following the review, six articles were identified meeting review criteria and quality was assessed using the Critical Appraisal Skills Programme (CASP) Checklist for qualitative studies. No ethical review was required for this systematic review. The six studies included in this review originated from the United States, Brazil, Turkey, and Iran. Leadership roles ranged from unit-based leadership to executive leadership. Assigned quality scores based upon CASP criteria ranged from 6 to 9 (moderate to high quality). Three analytical themes emerged from the synthesis: (1) moral distress is consuming; (2) constrained by the system; and (3) adapt to overcome. The unique contributors of MD among nurse leaders include the leadership role itself and challenges navigating moral situations as they arise. The nurse leader perspective should be considered in the development of future MD interventions. (shrink)

lecting statistics about missing bindings and macros, and other errors. This guides debugging and development efforts, leading to iterative improvements in both the tools and the quality of the converted corpus. The build system thus serves as both a production conversion engine and software test harness. We have now processed the complete arχiv collection through 2006 consisting of more than 400,000 documents (a complete run is a processor-yearsize undertaking), continuously improving our success rate. We are now able to convert more (...) than 90% of these documents to XHTML+MathML. We consider over 60% to be successes, converted with no or minor warnings. While the remaining 30% can also be converted, their quality is doubtful, due to unsupported macros or conversion errors. (shrink)

Although we find Gangestad & Simpson's argument intriguing, we question some of its underlying assumptions, including: (1) that fluctuating asymmetry (FA) is consistently heritable; (2) that symmetry is driving the effects; (3) that use of parametric tests with FA is appropriate; and (4) that a short-term mating strategy produces more offspring than a long-term strategy.

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 34.2 (2001) 179-181 [Access article in PDF] Book Review Rethinking the Rhetorical Tradition: From Plato to Postmodernism Rethinking the Rhetorical Tradition: From Plato to Postmodernism. James L. Kastely. New Haven, CT: Yale University Press, 1997. Pp. viii + 293. $30.00. In Rethinking the Rhetorical Tradition, James Kastely presents an alternative to the "standard" rhetorical tradition; he calls this alternative skeptical rhetoric, describes its characteristic activity as (...) refutation, and claims for it special relevance in negotiating postmodern challenges to rhetoric, specifically, that it can serve as a "refutation of postmodernism" (23). This alternative tradition inheres in a canon of works somewhat different from the standard canon, and an examination of key works organizes most of the chapters in this book. To establish and articulate this tradition in the classical era, Kastely examines Plato's Gorgias and Meno, Sophocles' Philoctetes, and Euripides' Hecuba; he then moves to the modern era, and to two works that address themes central to ancient rhetorical skepticism: Jane Austen's Persuasion (1818) and Jean-Paul Sartre's What Is Literature? (1949). Finally, Kastely turns to the two prongs of the postmodern reappropriation of traditional rhetoric, the tropological formalism of Paul de Man and the ideological approaches of Marxist critics such as Terry Eagleton, challenging both of them with the comic skepticism of Kenneth Burke.The skeptical tradition begins with Socrates, of course. It takes as its central problem, not the impossibility or contingency of knowledge, but the existence of injustice. In a political community, the unavoidability of doing inadvertent injury both requires rhetoric and at the same time makes it party to continued injustice: "[D]oing injury is an inescapable aspect of a being who is born into a world that is shaped by a language and by conventional practices that embody a particular set of values" (42). It is these prior commitments and conventional practices that, Kastely argues, lead us to cause injury. Thus, the positive task of rhetoric is not to persuade others away from injustice or to promote remedies; it is to keep us constantly open to refutation, to the possibility of seeing an alternative to the inadvertent wrong we commit. The inherency of injustice is what makes rhetoric a philosophical problem, but refutation is what rhetoric can offer to philosophy (a claim that might surprise philosophers). And in his reading of the Meno, Kastely argues explicitly for a rhetorical, rather than philosophical or logical, understanding of refutation.Overall, Kastely offers us a Plato who is not the enemy of rhetoric, but rather "the most sophisticated and profound rhetorical theorist" (30), who dramatizes in dialogue the philosophical dilemma of rhetoric. In [End Page 179] Sophocles and Euripides, he finds dramatists who illustrate practical forms the dilemma can take, specifically the problem of the unavailable audience. In the Philoctetes, the problem is how to regain the trust and confidence of the marginalized and disenfranchised, how to restore the status of rhetorical audience to one who no longer believes that justice is possible. In the Hecuba, the problem is how a disempowered rhetor can speak to the powerful. In both plays, but especially in Hecuba, the proximity of rhetoric to violence is a practical consequence of the unsolved philosophical problem.Kastely admits that the skeptical legacy from classical rhetoric has had little effect since antiquity. His argument that this alternate tradition deserves recognition is made primarily by his chapters on Austen and Sartre. He sees the works he examines here as raising a question central to rhetorical skepticism: "Can there be a way of speaking and writing that can effectively challenge the marginalization and dehumanization of people in a world in which traditional structures of authority that made discourse coherent have vanished or, at least, are seriously and irretrievably eroded?" (139-40). Both question Enlightenment assumptions about universality and at the same time confront the vacuum left by the erosion of local communal and authority structures. Austen's "active exploration" of a "crisis in discursive practice" (141) and Sartre's concern with the "social responsibility of the writer" and the loss of a public... (shrink)

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid wheat genome. Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection. Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of (...) ESTs into contigs. These contigs plus singletons were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5′ and 3′ sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics. (shrink)

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

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)

DBS Think Tank IX was held on August 25–27, 2021 in Orlando FL with US based participants largely in person and overseas participants joining by video conferencing technology. The DBS Think Tank was founded in 2012 and provides an open platform where clinicians, engineers and researchers can freely discuss current and emerging deep brain stimulation technologies as well as the logistical and ethical issues facing the field. The consensus among the DBS Think Tank IX speakers was that DBS expanded in (...) its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. After collectively sharing our experiences, it was estimated that globally more than 230,000 DBS devices have been implanted for neurological and neuropsychiatric disorders. As such, this year’s meeting was focused on advances in the following areas: neuromodulation in Europe, Asia and Australia; cutting-edge technologies, neuroethics, interventional psychiatry, adaptive DBS, neuromodulation for pain, network neuromodulation for epilepsy and neuromodulation for traumatic brain injury. (shrink)

Les professeurs Macey et Miller analysent la relation entre l’assurance des dépôts et l’ inadé quation dans la structure des échéances des actifs et passifs des banques commerciales. Après avoir critiqué l’hypothèse traditionnelle concernant la réglementation, d’après laquelle les banques sont incitées à financer les actifs à long terme par des passifs à court terme parce que l’assurance des dépôts garantie par l’Etat stimule le crédit des banques et subventionne les passifs à court terme, ils utilisent l’analyse économique des décisions (...) publiques pour soutenir qu’une version modifiée de l’hypothèse de la réglementation est la meilleure explication de la déstructuration des échéances des actifs et passifs bancaires.Finalement, ils considèrent que soutenir l’hypothèse de la réglementation n’entraîne pas l’ acceptation du modèle d’assurance des dépôts garantie par l’Etat tel qu’il existe aux Etats-Unis aujourd’hui.Professors Macey and Miller explore the relationship between deposit insurance and the mismatch in the term structure of commercial banks’ assets and liabilities. After criticizing the traditional regulatory hypothesis, which posits that banks have incentives to fund long-term assets with short-term liabilities because government-sponsored deposit insurance enhances bank credit and subsidizes short-term liabilities, they use public choice theory to argue that a modified version of the regulatory hypothesis is the best explanation for the mismatch in the term structure of banks’ assets and liabilities. Finally, they argue that embracing the regulatory hypothesis does not imply acceptance of the government-sponsored deposit insurance scheme as it exists in the U.S. today. (shrink)

In this thesis I shall summarize and critically examine the central features of the theories of values of four contemporary moral philosophers: A.J. Ayer, C.L. Stevenson, R.M. Hare, and P.H. Nowell - Smith. I shall first look back, however, to the theory of moral philosophy of the most influential 'forefather' of this group, David Hume. Hume's theory stands as a challenge to moral philosophers who would assume that moral judgments are primarily, in some sense, acts of 'reason'. Although our four (...) contemporaries follow Hume in this, his challenge, in the form I shall indicate shortly, will provide the main theme for this thesis. (shrink)

Bernard Williams charges that the moral psychology built into R. M. Hare’s utilitarianism is incoherent in virtue of demanding a bifurcated kind of moral thinking that is possible only for agents who fail to reflect properly on their own practical decision making. I mount a qualified defence of Hare’s view by drawing on the account of the ‘reactive attitudes’ found in P. F. Strawson’s ‘Freedom and Resentment’. Against Williams, I argue that the ‘resilience’ of the reactive attitudes ensures that our (...) taking an instrumental view of our dispositions to experience guilt and compunction, as Hare calls for us to do while engaged in ‘critical’ moral thinking, will not prevent us from experiencing these feelings as people ordinarily do while we are thinking ‘intuitively’. I also consider the implications of my argument for consequentialism more generally and (briefly) Kantianism. (shrink)

We show that if add(null) = c, then the globally Baire and universally measurable chromatic numbers of the graph of any Borel function on a Polish space are equal and at most three. In particular, this holds for the graph of the unilateral shift on [N]N, although its Borel chromatic number is N₀. We also show that if add(null) = c, then the universally measurable chromatic number of every treeing of a measure amenable equivalence relation is at most three. In (...) particular, this holds for "the" minimum analytic graph G₀ with uncountable Borel (and Baire measurable) chromatic number. In contrast, we show that for all κ ∈ {2, 3...., N₀. c}, there is a treeing of E₀ with Borel and Baire measurable chromatic number κ. Finally, we use a Glimm—Effros style dichotomy theorem to show that every basis for a non-empty initial segment of the class of graphs of Borel functions of Borel chromatic number at least three contains a copy of (R<N, ⊇). (shrink)

Combinatorial operations on sets are almost never well defined on Turing degrees, a fact so obvious that counterexamples are worth exhibiting. The case we focus on is the symmetric-difference operator; there are pairs of degrees for which the symmetric-difference operation is well defined. Some examples can be extracted from the literature, e.g. from the existence of nonzero degrees with strong minimal covers. We focus on the case of incomparable r.e. degrees for which the symmetric-difference operation is well defined.

© Ginn et al. 2016.The indexing methods currently used for serial femtosecond crystallography were originally developed for experiments in which crystals are rotated in the X-ray beam, providing significant three-dimensional information. On the other hand, shots from both X-ray free-electron lasers and serial synchrotron crystallography experiments are still images, in which the few three-dimensional data available arise only from the curvature of the Ewald sphere. Traditional synchrotron crystallography methods are thus less well suited to still image data processing. Here, a (...) new indexing method is presented with the aim of maximizing information use from a still image given the known unit-cell dimensions and space group. Efficacy for cubic, hexagonal and orthorhombic space groups is shown, and for those showing some evidence of diffraction the indexing rate ranged from 90% to 151%. Here, the indexing rate refers to the number of lattices indexed per image. (shrink)

Miller first examines the New Critics’ theory of metaphor, then presents his own views. There is one chapter on Hulme and Richards, one on Empson, Tate, Ransom and Brooks, and a third on Wimsatt, Wheelwright, and Krieger. Chapter Four contains Miller’s position and applies it to some metaphors from the metaphysical poets, and Chapter Five examines the problem of the objective status of a work of verbal art. Miller uses Richards’ distinction between the tenor and vehicle of a metaphor; in (...) "My love is a red, red rose," "love" is the tenor and "rose" the vehicle, and a metaphor occurs only in the tense convergence of tenor and vehicle. With this formal scheme he defines surface and submerged metaphors—the former having both elements stated, the latter having the tenor unstated but implied; Miller distinguishes these from moribund metaphors, like the "foot" of a mountain, in which the appropriate tenors are forgotten, not submerged. He distinguishes positive and negative metaphor, depending upon the emphasis the metaphor places on either the fusion or the resistance between tenor and vehicle, for both forces must operate within a lively metaphor. He distinguishes simple, complex and compound metaphors, to the extent that tenor and vehicle are either simple terms or else contain, each or both of them, metaphors inside themselves. In the case of compound metaphors, sometimes the vehicle can be submerged, and if the critic can find what the vehicle is, the poetic passage acquires a more condensed and unified logical form. Miller’s application of these schemes to concrete instances of metaphor are carried out to good effect. His treatment of the epistemology and ontology of a work of verbal art is less successful; he wishes to accommodate both subjective and objective aspects, but tends to consider a manifestation of a poem as the poem itself. He considers the written documentation of a poem to be marks on a surface which serve as stimuli to the reader’s awareness; but units of documentation are written words, not marks, and the process of reading is not, as he claims, a process of decoding. He distinguishes between oral documentation and performance, but seems to think records, tapes and films are instances of the former; would not memory, or perhaps even recitation by rote, be better examples of oral documentation? He considers Saussurian langue as an example of a "cultural object" which finds manifestation in parole; but if this is so, how can there ever be intermediate cultural objects like poems or stories? Langue would be the only verbal cultural object there is. It would be better to consider poems and stories as cultural objects, and language as a potential matrix for them, much as matter is a matrix for substances. Miller objects to the metaphor of "organism" for a poem, because, he says, when we take a poem apart in critical analysis, we do not kill it; therefore the metaphor of "machine" is better—something that can be taken apart and put together again. But surely the correction here is not to replace organism by machine, but to change one’s understanding of what it is to take apart. The critic takes apart in thought, the way a mathematician does, and not like a butcher. Miller’s book is extremely interesting, asks many good questions, and should be read with profit and delight by philosophers interested in language.—R. S. (shrink)

We study the sets that are computable from both halves of some (Martin–Löf) random sequence, which we call 1/2-bases. We show that the collection of such sets forms an ideal in the Turing degrees that is generated by its c.e. elements. It is a proper subideal of the K-trivial sets. We characterize 1/2-bases as the sets computable from both halves of Chaitin’s Ω, and as the sets that obey the cost function c(x,s)=Ωs−Ωx−−−−−−−√. Generalizing these results yields a dense hierarchy of (...) subideals in the K-trivial degrees: For k<n, let Bk/n be the collection of sets that are below any k out of n columns of some random sequence. As before, this is an ideal generated by its c.e. elements and the random sequence in the definition can always be taken to be Ω. Furthermore, the corresponding cost function characterization reveals that Bk/n is independent of the particular representation of the rational k/n, and that Bp is properly contained in Bq for rational numbers p<q. These results are proved using a generalization of the Loomis–Whitney inequality, which bounds the measure of an open set in terms of the measures of its projections. The generality allows us to analyze arbitrary families of orthogonal projections. As it turns out, these do not give us new subideals of the K-trivial sets; we can calculate from the family which Bp it characterizes. We finish by studying the union of Bp for p<1; we prove that this ideal consists of the sets that are robustly computable from some random sequence. This class was previously studied by Hirschfeldt [D. R. Hirschfeldt, C. G. Jockusch, R. Kuyper and P. E. Schupp, Coarse reducibility and algorithmic randomness, J. Symbolic Logic81(3) (2016) 1028–1046], who showed that it is a proper subclass of the K-trivial sets. We prove that all such sets are robustly computable from Ω, and that they form a proper subideal of the sets computable from every (weakly) LR-hard random sequence. We also show that the ideal cannot be characterized by a cost function, giving the first such example of a Σ03 subideal of the K-trivial sets. (shrink)

The radical psychiatrist R. D. Laing's first book, The Divided Self (1960), is informed by the work of Christian thinkers on scriptural interpretation — an intellectual genealogy apparent in Laing's comparison of Karl Jaspers's symptomatology with the theological tradition of `form criticism'. Rudolf Bultmann's theology, which was being enthusiastically promoted in 1950s Scotland, is particularly influential upon Laing. It furnishes him with the notion that schizophrenic speech expresses existential truths as if they were statements about the physical and organic world. (...) It also provides him with a model of the schizoid position as a form of modern-day Stoicism. Such theological recontextualization of The Divided Self illuminates continuities in Laing's own work, and also indicates his relationship to a wider British context, such as the work of the `clinical theologian' Frank Lake. (shrink)

This article aims to place the work of R.D. Laing into the context of Scottish history of ideas. It is possible to clarify and strengthen Laing’s arguments by situating them alongside the work of Scottish philosophers such as David Hume, J. B. Baillie and John Macmurray. In particular, it can be shown that Laing is not philosophically naïve. Philosophy – and this is readily apparent in Hume’s account of human nature – tends to say that we are indeed divided selves. (...) The work of Baillie and Macmurray helps to defend Laing from the charge that the "divided self" is, in truth, the logically inevitable account of human being. The study of Laing’s Scottish precursors also has a further consequence. The side of Laing that values social relations emerges in greater clarity, and in greater consonance with his sympathy for the marginalised and the alienated. (shrink)