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Charlotte Blease [32]Charlotte R. Blease [2]Charlotte Rosalind Blease [1]
  1. Epistemic injustice in healthcare encounters: evidence from chronic fatigue syndrome.Havi Carel, Charlotte Blease & Keith Geraghty - 2017 - Journal of Medical Ethics 43 (8):549-557.
    Chronic fatigue syndrome or myalgic encephalomyelitis remains a controversial illness category. This paper surveys the state of knowledge and attitudes about this illness and proposes that epistemic concerns about the testimonial credibility of patients can be articulated using Miranda Fricker’s concept of epistemic injustice. While there is consensus within mainstream medical guidelines that there is no known cause of CFS/ME, there is continued debate about how best to conceive of CFS/ME, including disagreement about how to interpret clinical studies of treatments. (...)
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  2.  29
    Patients, clinicians and open notes: information blocking as a case of epistemic injustice.Charlotte Blease, Liz Salmi, Hanife Rexhepi, Maria Hägglund & Catherine M. DesRoches - 2022 - Journal of Medical Ethics 48 (10):785-793.
    In many countries, including patients are legally entitled to request copies of their clinical notes. However, this process remains time-consuming and burdensome, and it remains unclear how much of the medical record must be made available. Online access to notes offers a way to overcome these challenges and in around 10 countries worldwide, via secure web-based portals, many patients are now able to read at least some of the narrative reports written by clinicians (‘open notes’). However, even in countries that (...)
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  3.  32
    Are open‐Label Placebos Ethical? Informed Consent and Ethical Equivocations.Charlotte Blease, Luana Colloca & Ted J. Kaptchuk - 2016 - Bioethics 30 (6):407-414.
    The doctor-patient relationship is built on an implicit covenant of trust, yet it was not until the post-World War Two era that respect for patient autonomy emerged as an article of mainstream medical ethics. Unlike their medical forebears, physicians today are expected to furnish patients with adequate information about diagnoses, prognoses and treatments. Against these dicta there has been ongoing debate over whether placebos pose a threat to patient autonomy. A key premise underlying medical ethics discussion is the notion that (...)
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  4.  21
    Sharing online clinical notes with patients: implications for nocebo effects and health equity.Charlotte Blease - 2023 - Journal of Medical Ethics 49 (1):14-21.
    Patients in around 20 countries worldwide are now offered online access to at least some of their medical records. Access includes test results, medication lists, referral information, and/or the very words written by clinicians (so-called ‘open notes’). In this paper, I discuss the possibility of one unintended negative consequence of patient access to their clinical notes—the potential to increase ‘nocebo effects’. A growing body of research shows that nocebo effects arise by engaging perceptual and cognitive processes that influence negative expectancies, (...)
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  5.  26
    Open AI meets open notes: surveillance capitalism, patient privacy and online record access.Charlotte Blease - 2024 - Journal of Medical Ethics 50 (2):84-89.
    Patient online record access (ORA) is spreading worldwide, and in some countries, including Sweden, and the USA, access is advanced with patients obtaining rapid access to their full records. In the UK context, from 31 October 2023 as part of the new NHS England general practitioner (GP) contract it will be mandatory for GPs to offer ORA to patients aged 16 and older. Patients report many benefits from reading their clinical records including feeling more empowered, better understanding and remembering their (...)
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  6.  25
    Open notes in patient care: confining deceptive placebos to the past?Charlotte Blease & Catherine M. DesRoches - 2022 - Journal of Medical Ethics 48 (8):572-574.
    Increasing numbers of health organisations are offering some or all of their patients access to the visit notes housed in their electronic health records. In some countries, including Sweden and the USA, this innovation is advanced with patients using online portals to access their clinical records including the visit summaries written by clinicians. In many countries, patients can legally request copies of their records; however, open notes are different because this innovation offers patients rapid, real-time access via electronic devices. In (...)
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  7.  29
    Evidence-Based Practice and Psychological Treatments: The Imperatives of Informed Consent.Charlotte R. Blease, Scott O. Lilienfeld & John M. Kelley - 2016 - Frontiers in Psychology 7.
  8.  48
    Overcoming disagreement: a roadmap for placebo studies.Charlotte Blease & Marco Annoni - 2019 - Biology and Philosophy 34 (2):18.
    In the field of placebo studies residual disagreement about the terminology ‘placebo’ and ‘placebo effect’ still persists. We differentiate between the conceptualization of placebos in clinical trials; and placebo effects understood as a psychobiological phenomenon. With respect to the latter, we argue that a scientific ‘placebo paradigm’ has emerged, indicating that—at least among placebo scientists—there exists relatively stable consensus about how to conceive of placebo effects. We claim that existence of a placebo paradigm does not protect concepts from revision; nonetheless, (...)
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  9.  35
    The principle of parity: the 'placebo effect' and physician communication.Charlotte Blease - 2012 - Journal of Medical Ethics 38 (4):199-203.
    The use of ‘placebos’ in clinical practice is a source of continued controversy for physicians and medical ethicists. There is rarely any extensive discussion on what ‘placebos’ are and how they work. In this paper, drawing on Louhiala and Puustinen's work, the author proposes that the term ‘placebo effect’ be replaced in clinical contexts with the term ‘positive care effect’. Medical treatment always takes place in a ‘context of care’ that encompasses all the phenomena associated with medical intervention: it includes (...)
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  10.  22
    Psychotherapy is still failing patients: revisiting informed consent—a response to Garson Leder.Charlotte Blease - 2021 - Journal of Medical Ethics 47 (7):448-449.
    Compared with mainstream medicine and complementary and alternative therapies, the practice of psychotherapy has enjoyed a relative pass when it comes to ethical evaluation. Therefore, contributions to the, although slowly growing, body of literature on psychotherapy ethics are to be welcomed. In his paper ‘Psychotherapy, placebos, and informed consent’, Garson Leder takes issue with what he calls the ‘go open’ project in psychotherapy ethics—the idea that the so-called ‘common factors’ in therapy should be disclosed to prospective patients. Although Leder does (...)
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  11.  20
    When a Placebo Is Not a Placebo: Problems and Solutions to the Gold Standard in Psychotherapy Research.Cosima Locher, Jens Gaab & Charlotte Blease - 2018 - Frontiers in Psychology 9.
  12.  35
    Deception as treatment: the case of depression.Charlotte Blease - 2011 - Journal of Medical Ethics 37 (1):13-16.
    Is it ever right to prescribe placebos to patients in clinical practice? The General Medical Council is ambivalent about the issue; the American Medical Association asserts that placebos can be administered only if the patient is (somehow) ‘informed’. The potential problem with placebos is that they may involve deception: indeed, if this is the case, an ethical tension arises over the patient's autonomy and the physician's requirement to be open and honest, and the notion that medical care should be the (...)
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  13.  66
    Electroconvulsive therapy, the placebo effect and informed consent.Charlotte Rosalind Blease - 2013 - Journal of Medical Ethics 39 (3):166-170.
    Major depressive disorder is not only the most widespread mental disorder in the world, it is a disorder on the rise. In cases of particularly severe forms of depression, when all other treatment options have failed, the use of electroconvulsive therapy (ECT) is a recommended treatment option for patients. ECT has been in use in psychiatric practice for over 70 years and is now undergoing something of a restricted renaissance following a sharp decline in its use in the 1970s. Despite (...)
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  14.  15
    Response to commentaries on sharing online clinical notes with patients: implications for nocebo effects and health equity.Charlotte Blease - 2022 - Journal of Medical Ethics 49 (1):32-33.
    I am grateful for the variety of feedback. Three themes struck me: first, commentators recognised the value of open notes but underlined the importance of exploring unintended consequences of the innovation particularly for already disadvantaged populations; second, they suggested nocebo effects might arise via additional routes not identified in my paper; third, they signalled the need for further empirical and ethical exploration of nocebo effects. Exploring all three issues and offering a commentary that was equal parts intriguing and perturbing, Chang (...)
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  15.  44
    A Critical (and Cautiously Optimistic) Appraisal of Moerman's "Meaning Response".Marco Annoni & Charlotte Blease - 2018 - Perspectives in Biology and Medicine 61 (3):379-387.
    Shamans, healers, and doctors have always known that patients may improve even if no real therapy is administered. In the Charmides, Plato noted that to soothe a headache, one needed "a kind of leaf, which required to be accompanied by a charm, and if a person would repeat the charm at the same time he used the cure, he would be made whole; but that without the charm would be of no avail". Similarly, more than two millennia later, Thomas Jefferson (...)
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  16.  32
    Consensus in Placebo Studies: Lessons from The Philosophy of Science.Charlotte Blease - 2018 - Perspectives in Biology and Medicine 61 (3):412-429.
    A common observation in placebo studies is that definitional disagreement is rife. Philosopher and historian of science Robin Nunn recently argued that "Nobody who came and saw the placebo has conquered its definition". Nunn insists that "the placebo construct conceals more than it clarifies," and that we need to prepare for "a post-placebo paradigm". Pronouncements that disagreement is endemic are often the prologue for new definitions of placebo and "placebo effect": for example, in the opening of a recent philosophical paper (...)
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  17.  53
    Placebo effects and racial and ethnic health disparities: an unjust and underexplored connection.Phoebe Friesen & Charlotte Blease - 2018 - Journal of Medical Ethics Recent Issues 44 (11):774-781.
    While a significant body of bioethical literature considers how the placebo effect might introduce a conflict between autonomy and beneficence, the link between justice and the placebo effect has been neglected. Here, we bring together disparate evidence from the field of placebo studies and research on health inequalities related to race and ethnicity, and argue that, collectively, this evidence may provide the basis for an unacknowledged route by which health disparities are exacerbated. This route is constituted by an uneven distribution (...)
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  18.  26
    The duty to be Well-informed: The case of depression.Charlotte Blease - 2014 - Journal of Medical Ethics 40 (4):225-229.
    It is now an ethical dictum that patients should be informed by physicians about their diagnosis, prognosis and treatment options. In this paper, I ask: ‘How informed are the ‘informers’ in clinical practice?’ Physicians have a duty to be ‘well-informed’: patient well-being depends not just in conveying adequate information to patients, it also depends on physicians keeping up-to-date about: popular misunderstandings of illnesses and treatments; and the importance of patient psychology in affecting prognosis. Taking the case of depression as an (...)
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  19.  16
    Hope in Medicine: Applying Multidisciplinary Insights.Tobias Kube, Charlotte Blease, Sarah K. Ballou & Ted J. Kaptchuk - 2019 - Perspectives in Biology and Medicine 62 (4):591-616.
    Providing a concise definition of hope is challenging. Psychologists alone have proposed 26 theories of hope and 54 definitions thereof. The difficulty of finding a universal definition of hope was summed up by the philosopher Joseph Godfrey who admitted, "I'd rather have hope than be able to define it". Part of the problem is that the concept is the object of scrutiny across many different scholarly disciplines, each of which have their own, sometimes divergent, methodologies and interests in the concept. (...)
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  20.  47
    In defence of utility: the medical humanities and medical education.Charlotte Blease - 2016 - Medical Humanities 42 (2):103-108.
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  21.  48
    Electroconvulsive therapy: the importance of informed consent and 'placebo literacy'.Charlotte Blease - 2013 - Journal of Medical Ethics 39 (3):173-174.
    I thank Julie Hersh for her thoughtful and valuable comments on the use of electroconvulsive therapy .1 Discussions with those who have experience of treatments is of the utmost importance when debating issues such as informed consent. I am therefore very pleased to be given this opportunity to respond. Hersh offers three main criticisms of my paper but I hope to show that the tenets of the paper are not undermined by her commentary.Hersh's first criticism stems from her personal experience: (...)
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  22.  21
    Putting the ‘Art’ Into the ‘Art of Medicine’: The Under-Explored Role of Artifacts in Placebo Studies.Michael H. Bernstein, Cosima Locher, Tobias Kube, Sarah Buergler, Sif Stewart-Ferrer & Charlotte Blease - 2020 - Frontiers in Psychology 11:501754.
    Physical environmental factors – or ‘artifacts’ – are linked to healthcare outcomes in the field of social psychology. However, the role of artifacts remains rarely examined in the burgeoning discipline of placebo studies. In this paper, we argue that a careful consideration of artifacts – such as provider clothing and office décor – may carry significant potential in eliciting placebo effects in clinical settings. We discuss three potential mechanisms by which artifacts may enhance or diminish placebo (or nocebo) effects: classical (...)
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  23.  33
    Authorized Concealment and Authorized Deception: Well-Intended Secrets Are Likely to Induce Nocebo Effects.Charlotte Blease - 2015 - American Journal of Bioethics 15 (10):23-25.
    Informed consent, as Alfano (2015) recognizes, has been routinely idealized within philosophical debate: Philosophers typically present a psychologically sanitized formulation of the temporal seque...
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  24.  20
    Return of Results in Digital Phenotyping: Ethical Considerations for Real-World Use Cases.John Torous & Charlotte Blease - 2024 - American Journal of Bioethics 24 (2):91-93.
    In their thoughtful paper, Shen et al. (2024) discuss optimal solutions to address the challenge of returning individual research results from digital phenotyping in psychiatry. Their conclusion to...
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  25.  37
    Are ME/CFS Patient Organizations “Militant”?Charlotte Blease & Keith J. Geraghty - 2018 - Journal of Bioethical Inquiry 15 (3):393-401.
    Myalgic encephalomyelitis or chronic fatigue syndrome is a contested illness category. This paper investigates the common claim that patients with ME/CFS—and by extension, ME/CFS patient organizations —exhibit “militant” social and political tendencies. The paper opens with a history of the protracted scientific disagreement over ME/CFS. We observe that ME/CFS POs, medical doctors, and medical researchers exhibit clear differences in opinion over how to conceptualize this illness. However, we identify a common trope in the discourse over ME/CFS: the claim of “militant” (...)
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  26.  18
    Does Disclosure About the Common Factors Affect Laypersons' Opinions About How Cognitive Behavioral Psychotherapy Works?Charlotte R. Blease & John M. Kelley - 2018 - Frontiers in Psychology 9.
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  27.  26
    Philosophy's Territorialism: Scientists Can Talk About Values Too.Charlotte Blease - 2017 - Philosophy, Psychiatry, and Psychology 24 (3):231-234.
    Tamara Browne proposes a provocative idea: She argues that philosophers, sociologists, and bioethicists should act as an independent editorial panel for future editions of the Diagnostic and Statistical Manual of Mental Disorders. Her paper depends on some well-versed claims in philosophy of psychiatry: She argues that psychiatric classifications are inherently value laden and philosophers, sociologists, and ethicists are best placed to discern the values are that embedded within scientific descriptions of mental disorders, and to speculate on the effects of any (...)
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  28.  20
    Scientific progress and the prospects for culture-bound syndromes.Charlotte Blease - 2010 - Studies in History and Philosophy of Science Part C: Studies in History and Philosophy of Biological and Biomedical Sciences 41 (4):333-339.
    This paper aims to show that the classification by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders of a distinct listing of disorders known as Culture-Bound Syndromes is misguided. I argue that the list of CBS comprises either genuine disorders that should be included within the main body of the DSM; or ersatz-disorders that serve a practical role for psychiatrists dealing with patients from certain cultures but will one day be eliminated or assimilated by bona (...)
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  29.  23
    Replication crisis and placebo studies: rebooting the bioethical debate.Charlotte Blease, Ben Colagiuri & Cosima Locher - 2023 - Journal of Medical Ethics 49 (10):663-669.
    A growing body of cross-cultural survey research shows high percentages of clinicians report using placebos in clinical settings. One motivation for clinicians using placebos is to help patients by capitalising on the placebo effect’s reported health benefits. This is not surprising, given that placebo studies are burgeoning, with increasing calls by researchers to ethically harness placebo effects among patients. These calls propose placebos/placebo effects offer clinically significant benefits to patients. In this paper, we argue many findings in this highly cited (...)
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  30.  21
    How do US orthopaedic surgeons view placebo-controlled surgical trials? A pilot online survey study.Michael H. Bernstein, Maayan N. Rosenfield, Charlotte Blease, Molly Magill, Richard M. Terek, Julian Savulescu, Francesca L. Beaudoin, Josiah D. Rich & Karolina Wartolowska - 2024 - Journal of Medical Ethics 50 (9):643-646.
    Randomised placebo-controlled trials (RPCTs) are the gold standard for evaluating novel treatments. However, this design is rarely used in the context of orthopaedic interventions where participants are assigned to a real or placebo surgery. The present study examines attitudes towards RPCTs for orthopaedic surgery among 687 orthopaedic surgeons across the USA. When presented with a vignette describing an RPCT for orthopaedic surgery, 52.3% of participants viewed it as ‘completely’ or ‘mostly’ unethical. Participants were also asked to rank-order the value of (...)
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  31.  22
    Editors' Introduction to Special Section on Meaning Response and the Placebo Effect.Charlotte Blease, Marco Annoni & Phil Hutchinson - 2018 - Perspectives in Biology and Medicine 61 (3):349-352.
    Over 200 years ago, doctors' most effective tools were typically not found in their medical bags. Indeed, most treatments in the history of medicine have, until relatively recently, caused more harm than good. Prior to the biomedical revolution in the late 19th century, doctors' most reliable and effective instruments of healing were their skills of communication with patients and an aptitude for a positive and supportive bedside manner. Bearing out this portrait of medicine, Thomas Jefferson, writing in 1807, noted that (...)
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  32. (1 other version)Eliminative materialism.Charlotte Blease - 2011 - In Michael Bruce & Steven Barbone (eds.), Just the Arguments: 100 of the Most Important Arguments in Western Philosophy. Malden, MA: Wiley-Blackwell.
     
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  33.  1
    Epistemic injustice, healthcare disparities and the missing pipeline: reflections on the exclusion of disabled scholars from health research.Joanne Hunt & Charlotte Blease - forthcoming - Journal of Medical Ethics.
    People with disabilities are subject to multiple forms of health-related and wider social disparities; carefully focused research is required to inform more inclusive, safe and effective healthcare practice and policy. Through lived experience, disabled people are well positioned to identify and persistently pursue problems and opportunities within existing health provisions that may be overlooked by a largely non-disabled research community. Thus, the academy can play an important role in shining a light on the perspectives and insights from within the disability (...)
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  34.  10
    Review of Nunn's 'After Placebo: in medical research and clinical practice'. [REVIEW]Cosima Locher, Jens Gaab, Michael Loughlin & Charlotte Blease - unknown
    Nunn's critique of the placebo concept is a radical and refreshing contribution to the debate. While there is much that can be contested in his analysis, his use of empirical and theoretical arguments to defend his conclusion - that the time has come to abandon the placebo construct altogether - presents an important challenge.
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