Moral Agency and the Family: The Case of Living Related Organ Transplantation.Robert A. Crouch &Carl Elliott -1999 -Cambridge Quarterly of Healthcare Ethics 8 (3):275-287.detailsLiving related organ transplantation is morally problematic for two reasons. First, it requires surgeons to perform nontherapeutic, even dangerous procedures on healthy donors—and in the case of children, without their consent. Second, the transplant donor and recipient are often intimately related to each other, as parent and child, or as siblings. These relationships challenge our conventional models of medical decisionmaking. Is there anything morally problematic about a parent allowing the interests of one child to be risked for the sake of (...) another? What exactly are the interests of the prospective child donor whose sibling will die without an organ? Is the choice of a parent to take risks for the sake of her child truly free, or is the specter of coercion necessarily raised? (shrink)
A Philosophical Disease: Bioethics, Culture, and Identity.Carl Elliott -1999 - Routledge.detailsFirst published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.
Pursued by Happiness and Beaten Senseless Prozac and the American Dream.Carl Elliott -2000 -Hastings Center Report 30 (2):7-12.detailsSince the publication of Listening to Prozac there have been many debates about how and why Prozac and other similar drugs are prescribed. The articles that follow take up debates about what conditions such drugs can and should address, questions about authenticity in using drugs for psychic well‐being, and concerns about what means we morally endorse in projects of self‐creation. The contributions from Carl Elliott, Peter Kramer, James Edwards, and David Healy derive from a project supported by the Social Sciences (...) and Humanities Research Council of Canada, “Enhancement Technologies and Human Identity.” Psychiatry, like the Prozac it prescribes, aims to enhance the patient's internal psychic well‐being. Yet what ails many may be not an internal state like depression or anxiety, but alienation. And the experts of the self to whom we turn cannot “cure” our collective form of life in which alienation takes root. (shrink)
The Rules of Insanity: Moral Responsibility and the Mentally Ill.Carl Elliott -1996 - SUNY Press.detailsIn The Rules of Insanity, Carl Elliott draws on philosophy and psychiatry to develop a conceptual framework for judging the moral responsibility of mentally ill offenders. Arguing that there is little useful that can be said about the responsibility of mentally ill offenders in general, Elliott looks at specific mental illnesses in detail; among them schizophrenia, manic-depressive disorders, psychosexual disorders such as exhibitionism and voyeurism, personality disorders, and impulse control disorders such as kleptomania and pyromania. He takes a particularly hard (...) look at the psychopath or sociopath, who many have argued is incapable of understanding morality. Making extensive use of psychiatric case histories, Elliott explores the various ways in which mental illness can affect a person's intentions and thus excuse him or her from moral responsibility. (shrink)
Throwing a bone to the watchdog.Carl Elliott -2001 -Hastings Center Report 31 (2):9-12.detailsBioethics is now taken seriously. Is there a danger of its being taken in or taken over? Might it be influenced in other ways, less visible and less easily avoided? As private corporations and bioethicists build relationships with each other, bioethicists must ask themselves about the opportunities, the constraints, and the subtle shifts in attitude and focus that such ties might create.
Response—The Corruption of Character in Medicine.Carl Elliott -2022 -Journal of Bioethical Inquiry 19 (1):117-122.detailsSome people change dramatically over time, and often those changes result partly from what they have chosen to do for a living. Drawing on the work of Richard Sennett and Sandeep Jauhar, I explore how practicing in a market-driven medical system can corrupt the character of doctors.
Diagnosing blame: Responsibility and the psychopath.Carl Elliott -1992 -Journal of Medicine and Philosophy 17 (2):199-214.detailsThe diagnosis of psychopathy is controversial largely because of two notions: first, that because of their defects, psychopaths cannot understand morality, and second, that these defects should thus excuse psychopaths from moral responsibility for their actions. However, it is not clear just what is involved in understanding morality. The argument that the psychopath is ignorant of morality in the same way that one might be ignorant of facts is difficult to sustain. However, a closer examination of the psychopath's peculiar deficiencies (...) reveals that the psychopath's understanding of morality might be impaired in other ways. Keywords: disease, ethics, philosophy, psychopathy, psychiatry, responsibility. (shrink)
Avoiding Exploitation in Phase I Clinical Trials: More than (Un)Just Compensation.Matt Lamkin &Carl Elliott -2018 -Journal of Law, Medicine and Ethics 46 (1):52-63.detailsLowering compensation to research subjects to protect them from “undue inducement” is a misguided attempt to shoehorn a concern about exploitation into the framework of autonomy. We suggest that oversight bodies should be less concerned about undue influence than about exploitation of subjects. Avoiding exploitation in human subjects research requires not only increasing compensation, but enhancing the dignity of research participation.
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The Soul of a New Machine: Bioethicists in the Bureaucracy.Carl Elliott -2005 -Cambridge Quarterly of Healthcare Ethics 14 (4):379-384.detailsIn a recent issue of The Lancet, the historian Roger Cooter predicted that the field of bioethics will soon die of self-inflicted wounds. “Conspiring against it,” he wrote, “is exposure of the funding of some of its US centres by pharmaceutical companies; exclusion of alternative perspectives from the social sciences; retention of narrow analytical notions of ethics in the face of popular expression and academic respect for the place of emotions; divisions within the discipline ; and collusion with, and appropriation (...) by, clinical medicine.” Cooter's prognosis? “Hardly wet behind the ears, bioethics seems destined for a short lifespan.”. (shrink)
Curing the Disobedient Patient: Medication Adherence Programs as Pharmaceutical Marketing Tools.Matt Lamkin &Carl Elliott -2014 -Journal of Law, Medicine and Ethics 42 (4):492-500.detailsAbout a week after Maran Wolston was prescribed Copaxone, a drug for multiple sclerosis, she got a phone call from a nurse at an organization called Shared Solutions. The organization was familiar to Wolston; when her neurologist had asked permission to share her health information with Shared Solutions, Wolston had agreed, assuming it was connected to her health insurance.The nurse who called Wolston was checking in to see how the treatment was going. It was not going well. While Copaxone is (...) not typically associated with some of the unpleasant side effects of other MS drugs, it does have at least one serious drawback: the drug must be injected every day. The injections can be brutally painful. “No matter where I injected the drug each day, the injection site swelled up into a huge welt and felt like a gigantic bee sting,” Wolston writes. (shrink)
Moral insanity and practical reason.Carl Elliott &Grant Gillett -1992 -Philosophical Psychology 5 (1):53 – 67.detailsThe psychopathic personality disorder historically has been thought to include an insensitivity to morality. Some have thought that the psychopath's insensitivity indicates that he does not understand morality, but the relationship between the psychopath's defects and moral understanding has been unclear. We attempt to clarify this relationship, first by arguing that moral understanding is incomplete without concern for morality, and second, by showing that the psychopath demonstrates defects in frontal lobe activity which indicate impaired attention and adaptation to environmental conditions (...) which are relevant to the formation of complex intentions. We argue that these frontal lobe defects can help to explain both the psychopath's apparent insensitivity to morality and his characteristic imprudence. (shrink)
Slow Cures and Bad Philosophers: Essays on Wittgenstein, Medicine, and Bioethics.Carl Elliott (ed.) -2001 - Durham, N.C.: Duke University Press.details_Slow Cures and Bad Philosophers_ uses insights from the philosophy of Ludwig Wittgenstein to rethink bioethics. Although Wittgenstein produced little formal writing on ethics, this volume shows that, in fact, ethical issues permeate the entirety of his work. The scholars whom Carl Elliott has assembled in this volume pay particular attention to Wittgenstein’s concern with the thick context of moral problems, his suspicion of theory, and his belief in description as the real aim of philosophy. Their aim is not to (...) examine Wittgenstein’s personal moral convictions but rather to explore how a deep engagement with his work can illuminate some of the problems that medicine and biological science present. As Elliott explains in his introduction, Wittgenstein’s philosophy runs against the grain of most contemporary bioethics scholarship, which all too often ignores the context in which moral problems are situated and pays little attention to narrative, ethnography, and clinical case studies in rendering bioethical judgments. Such anonymous, impersonal, rule-writing directives in which health care workers are advised how to behave is what this volume intends to counteract. Instead, contributors stress the value of focusing on the concrete particulars of moral problems and write in the spirit of Wittgenstein’s belief that philosophy should be useful. Specific topics include the concept of “good dying,” the nature of clinical decision making, the treatment of neurologically damaged patients, the moral treatment of animals, and the challenges of moral particularism. Inspired by a philosopher who deplored “professional philosophy,” this work brings some startling insights and clarifications to contemporary ethical problems posed by the realities of modern medicine. _Contributors._ Larry Churchill, David DeGrazia, Cora Diamond, James Edwards, Carl Elliott, Grant Gillett, Paul Johnston, Margaret Olivia Little, James Lindemann Nelson, Knut Erik Tranoy. (shrink)
Where Ethics Comes from and What to Do about It.Carl Elliott -1992 -Hastings Center Report 22 (4):28-35.detailsThe practical difficulty with applying ethical theories to particular problems is that ordinarily people pay little attention to theories when they make moral decisions. Instead, we are guided by our ethical beliefs, which are primarily the result of cultural factors beyond our reach—factors subject to rational scrutiny and to change, but largely out of our control.
The Looping Effects of Enhancement Technologies.Carl Elliott -2019 -Journal of Bioethical Inquiry 16 (1):127-131.detailsLibertarians often portray the decision to use enhancement technologies purely as a matter of individual choice, affecting the person who uses them but no one else. Yet individual choices often add up to large social changes that profoundly affect the lives of other people, effectively pushing individual choices in a particular direction. It seems plausible that self-reinforcing loops such as those that have driven the adoption of technologies like cars and air-conditioners might also play a role in the adoption of (...) enhancement technologies, effectively exerting pressure on people to use a technology that they might otherwise resist. (shrink)
From Community to Commodity: The Ethics of Pharma-Funded Social Networking Sites for Physicians.Amy Snow Landa &Carl Elliott -2013 -Journal of Law, Medicine and Ethics 41 (3):673-679.detailsIn September 2006, a small start-up company in Cambridge, MA called Sermo, Inc., launched a social networking site with an unusual twist: only physicians practicing medicine in the United States would be allowed to participate. Sermo, which means “conversation” in Latin, marketed its website as an online community exclusively for doctors that would allow them to talk openly about a range of topics, from challenging and unusual medical cases to the relative merits of one treatment versus another. “Sermo enables the (...) private and instant exchange of knowledge among MDs,” the company announced in its first press release. Even better, participation was free and the site carried no advertising. (shrink)
Moral Responsibility, Psychiatric Disorders and Duress.Carl Elliott -1991 -Journal of Applied Philosophy 8 (1):45-56.detailsABSTRACT The paper is a discussion of moral responsibility and excuses in regard to psychiatric disorders involving abnormal desires (e.g. impulse control disorders such as kleptomania and pyromania, psychosexual disorders such as exhibitionism, obsessive‐compulsive disorder and others). It points out problems with previous approaches to the question of whether or not to excuse persons with these disorders, and offers a new approach based on the concept of duress. There is a discussion of duress in regard to non‐psychiatric cases based on (...) the core notion of duress involving a choice between undesirables, and the paper concludes with an argument that moral blame for individuals with these sorts of disorders should often be lessened and in some cases removed entirely. (shrink)
Constraints and heroes.Carl Elliott -1992 -Bioethics 6 (1):1–11.detailsBook Reviws in this ArticleThe Human Body and the Law, 2nd edition by D.W. Meyers, Edinburgh University Press, 1990Classic Cases in Medical Ethics by Gregory E. Pence. New York: McGraw‐Hill Publishing Co. 1990Changing Values in Medical and Health Care Decision Making, edited by Uffejuul Jensen and Gavin Mooney. Chichester: John Wiley & Sons, 1990IVF and Justice by Teresa Iglesias, London: The Linacre Centre For Health Care Ethics, 1990The Practical, Moral and Personal Sense of Nursing: A Phenomenon‐ological Philosophy of Practice by (...) Anne H. Bishop and John R. Scudder, Jr. New York: State University of New York Press, 1990A Companion to Ethics, edited by Peter Singer. Oxford and Cambridge, Mass: Basil Blackwell, 1991.Ethics and Law in Health Care and Research edited by Peter Byrne, Chichester, UK: 1990The Human Embryo edited by G.R. Dunstan, Exeter: Exeter University Press, 1990Everyday Ethics: Resolving Dilemmas in Nursing Home Life by Rosalie A. Kane and Arthur L. Caplan. N.Y.: Springer Publishing Company, 1990Psychiatric Ethics, 2nd edition, edited by S. Bloch and P. Chodoff. Oxford, Oxford University Press, 1991Health Care and Gender by Charlotte Muller. New York: Russell Sage Foundation, 1990. (shrink)
The Anatomy of Research Scandals.Carl Elliott -2017 -Hastings Center Report 47 (3):inside back cover-inside back co.detailsFor the past two years, I have taught a seminar on medical research scandals. The syllabus looks like a highlight reel of exploitation and abuse: children fed plutonium-laced breakfast cereal, prisoners dosed with the active ingredient in Agent Orange, mental patients given psychedelic drugs and massive electroconvulsive therapy before being sent into curare-induced paralysis and a coma. I designed the seminar to crush the idealism of future physicians by illuminating the dark patterns that research scandals typically follow. The most recent (...) scandal we examined happened to be one of the most lurid. (shrink)
Whatever Happened to Human Experimentation?Carl Elliott -2015 -Hastings Center Report 46 (1):8-11.detailsSeveral years ago, the University of Minnesota hosted a lecture by Alan Milstein, a Philadelphia attorney specializing in clinical trial litigation. Milstein, who does not mince words, insisted on calling research studies “experiments.” “Don't call it a study,” Milstein said. “Don't call it a clinical trial. Call it what it is. It's an experiment.” Milstein's comments made me wonder: when was the last time I heard an ongoing research study described as a “human experiment”? The phrase is now almost always (...) associated with abuses. Asking a prospective subject to sign up for a medical experiment would probably get roughly the same response as asking him or her to sign up for a police interrogation. It wasn't always this way. In the early days of American bioethics, scholars used the word “experimentation” in the same neutral way that they later began to use “research study” and “clinical trial.”. (shrink)
Everything is what it is.Carl Elliott -1991 -Inquiry: An Interdisciplinary Journal of Philosophy 34 (4):525-538.details(1991). Everything is what it is. Inquiry: Vol. 34, No. 4, pp. 525-538.
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