Affiliated Researcher at Department of Women's and Children's Health, Participatory eHealth and Health Data Research Group
- Visiting address:
- MTC-huset, Dag Hammarskjölds väg 14B, 1 tr
752 37 Uppsala
- Postal address:
- Akademiska sjukhuset
751 85 UPPSALA
Charlotte Blease is an interdisciplinary researcher in digital health with a background in philosophy. She is also a Research Affiliate at Digital Psychiatry, Department of Psychiatry, Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School. For 5 years, Charlotte was a researcher at Harvard, first as a Fulbright Scholar, and for 3 years as a Keane Scholar. She has held research positions in departments of philosophy, psychology, & medical humanities in the UK, Ireland, and Germany.
Keywords: bioethics digital health technology digital healthcare clinician-patient communication healthcare ethics placebo studies philosophy of medicine
Charlotte Blease is a philosopher and interdisciplinary healthcare researcher working on digital health innovations. From 2017-2018 she was a Fulbright Scholar at Harvard Medical School, and from 2017-2022 was a Researcher at Beth Israel Deaconess Medical Center, Harvard Medical School. Charlotte has a background in philosophy and health ethics, with training in survey research. As PI or co-Investigator on several university and nationally funded grants, she has a diverse publication portfolio of more than 100 peer-reviewed journal papers and book chapters ranging across digital health, medical and psychotherapy ethics, and philosophy of medicine. In her post as Keane Fellow at OpenNotes, Beth Israel Deaconess Medical Center (2019-2022) she initiated an ethical analysis of patient access to open notes with a particular focus on sharing notes among vulnerable populations.
During 2009-2013, Charlotte lectured in Philosophy at Queen's University, Belfast, Northern Ireland before undertaking full-time interdisciplinary healthcare research. In 2014, she co-founded the International Society for Interdisciplinary Placebo Studies (‘SIPS’) and is an internationally recognized expert in placebo studies and ethical issues relating to transparent communication. Charlotte has extensive experience in teaching ethics to a range of student and lay audiences. In Ireland, she co-founded a teaching network aimed at promoting ethics and philosophy education in Irish schools, that was recognized by the President of Ireland. In recognition of her philosophy outreach work in the UK among educators, she was appointed Patron of SAPERE, the country’s largest teacher training network which promotes philosophy for children. In 2012 she was a winner of the UK national Arts and Humanities Research Council / BBC New Generation Thinkers competition.
Patient online access to clinical records
Embracing greater moves toward shared decision-making and transparency in health care, in the last decade, access to online clinical records has grown worldwide. Using mixed methods survey research, together with colleagues in Europe and the US, I have investigated patient and clinician experiences of access. My research into online record access encompasses more than 30 publications including in medical ethics, medical epistemology, and legal considerations, many in top-tier journals such as the BMJ, JAMA, Lancet Psychiatry, Lancet Oncology, and BMJ Quality & Safety. In published work, I made a foundational case that patient access is a right, a perspective that had hitherto not been elaborated on in detail within healthcare ethics.
Digital interventions and the Professions
Attention in medicine and related fields has increasingly focused on the potential of big data, artificial intelligence (AI), and machine learning (ML) to change the delivery of healthcare. Much of this debate has focused on the promise of AI/ML to augment or even disintermediate the core clinical roles of clinicians. I have led mixed-methods research to explore the forecasts of a wide range of clinicians including psychiatrists, primary care physicians, and medical students, and of leading AI experts and informaticians, to explore their predictions about the short-term and long-term scope for the computerization of healthcare, and to investigate the adequacy of education and training on these topics. I am also under contract with Yale University Press for a monograph exploring the hope and hype around AI/ML in primary care. This volume specifically explores the purpose of technological innovations and whether and how these tools can improve human-mediated care.
Around a decade after physicians, including psychiatrists, endorsed the shift toward evidence-based medicine, in 2006, the world's largest association of psychologists, the American Psychological Association (APA), officially embraced the tenets of evidence-based practice. Building on these developments with colleagues in Switzerland (University of Basel), the US (Harvard Medical School), and the UK (University of Leeds). I have explored the ethical repercussions of evidence-based practice for psychological treatments. As the primary investigator of a number of publications, I have argued evidence carries ethical imperatives both in the decision about what is considered to be beneficial in psychotherapy, and the paucity of research regarding the potential negative effects of psychological treatments. My research emphasizes that evidence-based practice bears repercussions for clinicians' duty of professional competence – both with regard to the responsibility to acquire and apply accurate knowledge and the duty to respect patient autonomy—namely, the patient's right to make informed decisions concerning his or her treatment plans. This body of work encompasses ethical analyses, qualitative research into psychotherapy students’ opinions and attitudes about informed consent processes, and experimental work into disclosures and lay understanding about therapy.
For over a decade, I have been at the forefront of the emerging field of placebo studies working on questions related to informed consent procedures, and conceptual and methodological issues pertaining to placebo terminology in both research applications and in clinical translation. My studies identify conflicting definitions of placebo concepts, emphasizing why consistency is crucial to ensure an understanding of the size of placebo effects in clinical trials, and in experimental research aimed at exploring placebo effects. In my studies, I have applied bioethical frameworks to qualitative inquiries to explore the ethical use of placebos in clinical contexts. Finally, recognizing the need to forge an international network and bridge placebo studies with research, clinical practice, and ethics, I led and hosted an international, multidisciplinary workshop at the Brocher Fondation, Geneva, Switzerland. This workshop directly led to the emergence of the Society for Interdisciplinary Placebo Studies (SIPS) of which I am both a Founding and Steering Group Committee member. Currently, I am co-editing a book for Mayo Clinic Press entitled "The Nocebo Effect: When Words Make You Sick." I also mentor postgraduate and postdoctoral students and lead international collaborations in placebo studies.
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