Charlotte Blease
Researcher at Department of Women's and Children's Health; Participatory eHealth and Health Data Research Group
- E-mail:
- charlotte.blease@uu.se
- Visiting address:
- MTC-huset, Dag Hammarskjölds väg 14B, 1 tr
752 37 Uppsala - Postal address:
- Akademiska sjukhuset
751 85 UPPSALA
More information is available to staff who log in.
Short presentation
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
- clinician-patient communication
- digital health technology
- digital healthcare
- healthcare ethics
- philosophy of medicine
- placebo studies
Biography
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.
Research
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.
Psychotherapy Ethics
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.
Placebo Studies
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.
Media
https://scholar.google.co.uk/citations?user=KL5fMn0AAAAJ&hl=en&oi=ao
Scholar Google publications
List of publications
https://scholar.google.co.uk/citations?user=KL5fMn0AAAAJ&hl=en&oi=ao
Personal website
Information about me, including access to publications
https://www.charlotteblease.com/
Publications
Recent publications
- Open AI meets open notes (2024)
- Experiences and opinions of general practitioners with patient online record access (2024)
- Generative artificial intelligence in primary care (2024)
- Generative Language Models and Open Notes (2024)
- Psychiatrists' experiences and opinions of generative artificial intelligence in mental healthcare (2024)
All publications
Articles
- Open AI meets open notes (2024)
- Experiences and opinions of general practitioners with patient online record access (2024)
- Generative artificial intelligence in primary care (2024)
- Generative Language Models and Open Notes (2024)
- Psychiatrists' experiences and opinions of generative artificial intelligence in mental healthcare (2024)
- Experiences from patients in mental healthcare accessing their electronic health records (2024)
- Lay Perspectives on Empathy in Patient-Physician Communication (2024)
- Adolescents' and Young Adults' Experiences of Offense from Reading Their Health Records Online (2024)
- Adolescents' reasons for accessing their health records online, perceived usefulness and experienced provider encouragement (2024)
- Security and Privacy of Online Record Access (2024)
- Epistemic injustice, healthcare disparities and the missing pipeline (2024)
- Affordance trajectories and the usefulness of online records access among older adults in Sweden (2024)
- A Nordic Perspective on Patient Online Record Access and the European Health Data Space (2024)
- Reply to Ballou and Kube (2024)
- Mapping Patients' Online Record Access Worldwide (2024)
- Open notes in psychotherapy (2024)
- Generative artificial intelligence writing open notes (2024)
- Sociotechnical Cross-Country Analysis of Contextual Factors That Impact Patients' Access to Electronic Health Records in 4 European Countries (2024)
- Psychotherapists’ views on open notes: An online survey from Germany (2024)
- Digital Mental Health for Schizophrenia and Other Severe Mental Illnesses (2024)
- Return of Results in Digital Phenotyping (2024)
- Generative artificial intelligence in mental health care (2024)
- Digital health interventions for schizophrenia (2024)
- ChatGPT and mental healthcare (2023)
- Patient Online Record Access in English Primary Care (2023)
- Errors, Omissions, and Offenses in the Health Record of Mental Health Care Patients (2023)
- It’s not my greengrocer, it’s someone from the medical professional (2023)
- The NORDeHEALTH 2022 Patient Survey (2023)
- Time to reflect on open-label placebos and their value for clinical practice (2023)
- Changes in Documentation Due to Patient Access to Electronic Health Records (2023)
- Digital mental health (2023)
- Users’ Experiences With Online Access to Electronic Health Records in Mental and Somatic Health Care (2023)
- Placebo Effect in Pain and Pain Treatment (2022)
- How do US orthopaedic surgeons view placebo-controlled surgical trials? (2022)
- When patients are victims (2022)
- Sharing online clinical notes with patients (2022)
- Sharing Clinical Notes (2022)
- Open notes in patient care (2022)
- Primary care adapting to transparent medical records (2022)
- Patients, clinicians and open notes (2022)
- Views, Use, and Experiences of Web-Based Access to Pediatric Electronic Health Records for Children, Adolescents, and Parents (2022)
- Long Covid at the crossroads (2022)
- Implications of the changes to patient online records access in English primary care (2022)
- Placebo Studies and Patient Care (2021)
- Treating pain with open-label placebos (2021)
- Psychotherapy is still failing patients (2021)
- Knowledge, power, and patients (2021)
- Association of Patients Reading Clinical Notes With Perception of Medication Adherence Among Persons With Serious Mental Illness (2021)
- Machine learning in clinical psychology and psychotherapy education (2021)
- The benefits and harms of open notes in mental health (2021)
- Patient Access to Mental Health Notes (2021)
- COVID-19 and Open Notes (2021)
- Patients’ Access to Their Psychiatric Notes (2021)
- How do older patients with chronic conditions view reading open visit notes? (2021)
- What should clinicians tell patients about placebo and nocebo effects? (2021)
- “Consensus on Placebo and Nocebo Effects Connects Science with Practice:” Reply to “Questioning the Consensus on Placebo and Nocebo Effects” (2021)
- Lay perspectives of the open-label placebo rationale (2021)
- Open notes become law (2021)
- A step-by-step guide to peer review (2021)
- US policy requires immediate release of records to patients (2021)
- Sharing Clinical Notes and Electronic Health Records With People Affected by Mental Health Conditions (2021)
- Persons over models (2020)
- Putting the art into the art of medicine (2020)
- Primary care providers’ use of and attitudes towards placebos (2020)
- Attitudes about informed consent (2020)
- Open-label placebo clinical trials (2020)
- Empowering patients and reducing inequities (2020)
- US primary care in 2029 (2020)
- Artificial intelligence and the future of psychiatry (2020)
- Sharing notes with mental health patients (2020)
- Open notes in cancer care (2020)
- Does Patient Access to Clinical Notes Change Documentation? (2020)
- Sharing clinical notes in psychotherapy (2020)
- Artificial intelligence and the future of psychiatry (2020)
- The good treatment (2020)
- Placebos are part of the solution, not the problem (2020)
- European Headache Federation recommendations for placebo and nocebo terminology (2020)
- Are conditioned open placebos feasible as an adjunctive treatment to opioids? (2019)
- The role of placebos in family medicine (2019)
- Overcoming disagreement (2019)
- Patients as diagnostic collaborators (2019)
- Artificial intelligence and the future of primary care (2019)
- Myalgic encephalomyelitis/chronic fatigue syndrome and the biopsychosocial model (2019)
- The cognitive behavioural model of chronic fatigue syndrome (2019)
- Hope in medicine (2019)
- A critical (and cautiously optimistic) appraisal of moerman’s" meaning response" (2018)
- Consensus in placebo studies (2018)
- Psychotherapy and placebos (2018)
- Editors’ Introduction to Special Section on Meaning Response and the Placebo Effect (2018)
- Computerization and the future of primary care (2018)
- Are ME/CFS Advocacy Organisations militant? (2018)
- Does disclosure about the common factors affect laypersons’ opinions about how cognitive behavioral psychotherapy works? (2018)
- Informed consent in psychotherapy (2018)
- Implications of placebo and nocebo effects for clinical practice (2018)
- Placebo effects and racial and ethnic health disparities (2018)
- Placebo and psychotherapy (2018)
- Cognitive behavioural therapy in the treatment of chronic fatigue syndrome (2018)
- When a placebo is not a placebo (2018)
- After placebo (2018)
- Healthcare Encounters (2017)
- Informed consent and clinical trials (2017)
- Epistemic injustice in healthcare encounters (2017)
- Living with melanoma for a day (2017)
- In defence of utility (2016)
- Are open-label placebos ethical? (2016)
- Mind the gap (2016)
- The placebo effect and psychotherapy (2016)
- Evidence-based practice and psychological treatments (2016)
- Paternalism, placebos, and informed consent in psychotherapy (2016)
- Paternalism and placebos (2016)
- Go open: (2016)
- Missing the Boat (2015)
- Talking more about talking cures (2015)
- Too many friends, too few likes? (2015)
- Authorized concealment and authorized deception (2015)
- The duty to be well-informed (2014)
- Kuhn, T homas S.(1922–96) (2014)
- Kuhnian Paradigms (2014)
- Electroconvulsive therapy (2013)
- Electroconvulsive therapy, the placebo effect and informed consent (2013)
- Mental health illiteracy? (2012)
- The principle of parity (2012)
- Deception as treatment (2011)
- Biomedical Sciences (2010)
- Scientific progress and the prospects for culture-bound syndromes (2010)
- Adolescents’ and Parents’ Perspectives on Online Record Access Regulations in Sweden
- Pediatric oncology healthcare professionals’ attitudes to and awareness of regulations for minors’ and guardians’ online record access
Chapters
- Psychotherapy Integration as an Ethical Practice (2021)
- In Philosophical Conversation With: Philosophy Ireland ? Building a National P4C Network (2020)
- Patient information on evidence and clinical effectiveness of psychotherapy (2020)
- Informed Consent, the Placebo Effect and Psychodynamic Psychotherapy (2015)
- Informed consent, the placebo effect and psychodynamic psychotherapy (2015)
- Stigmatizing depression (2014)
- Eliminative materialism (2011)
Conferences
- Impact of healthcare education on preferences for electronic health records (2024)
- Adolescents Identifying Errors and Omissions in Their Electronic Health Records (2023)
- Mobile Access and Adoption of the Swedish National Patient Portal (2020)