Carl Elliott - Academia.edu (original) (raw)
Papers by Carl Elliott
New York Review of Books, 2020
New Scientist, 2016
Elliott reviews The Geography of Madness: Penis thieves, voodoo death, and the search for the mea... more Elliott reviews The Geography of Madness: Penis thieves, voodoo death, and the search for the meaning of the world's strangest syndromes by Frank Bures.
Philosophy Psychiatry Psychology, May 31, 1994
There is a tendency to regard medical conditions, but not psychological ones, as factors that abs... more There is a tendency to regard medical conditions, but not psychological ones, as factors that absolve a person of responsibility for criminal behavior. Wittgenstein's recently published "Lecture on Freedom of the Will" provides some clues as to why this is so. In this essay I suggest that psychiatrists have at least two different ways of speaking about persons: the language of mechanism and the language of ordinary life. I explore Wittgenstein's suggestion that when we look at something mechanistically we take up an attitude of "fatalism," the attitude that things could not have happened otherwise, and I argue that we are inclined to take up a similar attitude when we look at certain types of psychiatric patients. I also argue that both biological and psychodynamic explanations of human behavior embed deterministic assumptions, which may further undermine ordinary notions of moral responsibility. I conclude by examining a thought experiment by Wittgenstein, which suggests that in order to undermine conventional notions of moral responsibility it is not enough to show that all actions are compelled; rather, one must undermine the distinction that we ordinarily make between action that is compelled and that which is not. I argue that this supports our ordinary practice of holding persons with personality disorders morally responsible for their actions.
New scientist (1971), Jan 11, 1992
Encyclopedia of Life Sciences, 2009
The Hastings Center Report, 2004
W hat's the difference between medical education and pharmaceutical public relations? Not much, a... more W hat's the difference between medical education and pharmaceutical public relations? Not much, according to the people who do it. "(T)he broad distinction between healthcare PR and medical education is becoming obsolete," writes Neil Kendle, chief executive officer of Lowe Fusion Healthcare, in a recent issue of Pharmaceutical Marketing magazine. So slender is the difference between education and PR than that Kendle cannot even say for certain which business he is in. "Sometimes I describe Lowe Fusion as a 'PR consultancy', sometimes as a 'healthcare communications agency'. Sometimes I just cop out and list the things we do." 1 Here's how the business works. The pharmaceutical industry puts up the money, usually in the form of an "unrestricted educational grant." The grant goes to a forprofit medical education and/or communications company (MECC), which, in consultation with its pharma sponsor, puts together an "educational program." 2 The company and the MECC recruit academic physicians to
BMJ, 1995
the intensive care unit'6 and of deaths after discharge.'7 Comorbidity, physiological instability... more the intensive care unit'6 and of deaths after discharge.'7 Comorbidity, physiological instability, tachypnoea, hypotension, and impaired mentation have all been identified as predictors of critical illness and cardiorespiratory arrest. If such features could be incorporated into an index of prior risk for use in ordinary wards it might provide the opportunity for earlier intervention with better outcomes at lower cost. It might also facilitate discussions with individual patients about how much treatment they would want'8 and encourage the use of advance directives. Junior doctors and nurses should also receive better training in basic intensive care and preventing critical illness. Risk management will not succeed unless it is accompanied by more resources for high dependency care. Earlier intervention means more detailed monitoring with particular attention to tissue oxygenation. Monitoring response to fluid resuscitation and inotropic drugs in patients at risk920 cannot be provided safely in ordinary wards. High dependency care units allow preventive care to be delivered with nurse staffing levels that are half those of intensive care units21 and are also less intimidating than intensive care units, which may facilitate earlier referral of patients by junior medical staff. The introduction of a high dependency unit has been shown to reduce cardiac arrests in hospital and overall mortality,22 and the fact that only 15% of British hospitals have identifiable high dependency units should concern both purchasers and providers ofhealth care."I Britain is uniquely placed to examine these issues because constraints on resources may provide a natural experiment from which to assess how much benefit accrues from different levels of treatment. Although regionalisation of intensive care, better transport, and improved medical staffing are urgently needed in Britain, the internal market inhibits sharing of costs and services between trusts and makes these developments unlikely. Rationing and triage are inevitable and should be open to public debate informed by scientific research. There should be no place for secrecy and guesswork in the rationing of critical care when evidence suggests that the limitations placed on funding are resulting in inefficiencies and avoidable illness and deaths.
Journal of Medical Ethics, 1997
University of Richmond Law Review, 2017
Human subjects research has a shameful history of abuses committed against institutionalized peop... more Human subjects research has a shameful history of abuses committed against institutionalized people. Decades after the Nuremburg court condemned Nazi doctors to death for experimenting on prisoners in concentration camps, researchers in the United States continued to expose prisoners to measles, malaria, radioactive isotopes, and other painful and damaging interventions. 1 On his first visit to the Holmesburg prison in Pennsylvania, Dr. Albert Kligman reported seeing in this captive population ―acres of skin‖ on which he could conduct dermatological experiments, including toxins that left prisoners scarred and blistered. 2
Hastings Center Report, 2018
The virtual mentor : VM, 2005
The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 2014
Pharmaceutical companies have long focused their marketing strategies on getting doctors to write... more Pharmaceutical companies have long focused their marketing strategies on getting doctors to write more prescriptions. But they lose billions in potential sales when patients do not take their prescribed drugs. Getting patients to "adhere" to drug therapies that have unpleasant side effects and questionable efficacy requires more than mere ad campaigns urging patients to talk to their doctors. It requires changing patients' beliefs and attitudes about their medications through repeated contact from people patients trust. Since patients do not trust drug companies, these companies are delivering their marketing messages through nurses, pharmacists, and even other patients - leveraging patients' trust in these intermediaries to persuade them to consume more brand name drugs. Armed with the premise that better adherence improves patients' health, drug companies justify manipulating patients by reframing reasonable decisions to decline therapy as pathological, and p...
American Journal of Bioethics, 2001
New England Journal of Medicine, 2008
Medicine, Health Care and Philosophy, 2007
We may not be able to make you love reading, but against happiness will lead you to love reading ... more We may not be able to make you love reading, but against happiness will lead you to love reading starting from now. Book is the window to open the new world. The world that you want is in the better stage and level. World will always guide you to even the prestige stage of the life. You know, this is some of how reading will give you the kindness. In this case, more books you read more knowledge you know, but it can mean also the bore is full.
Journal of General Internal Medicine, 2006
New York Review of Books, 2020
New Scientist, 2016
Elliott reviews The Geography of Madness: Penis thieves, voodoo death, and the search for the mea... more Elliott reviews The Geography of Madness: Penis thieves, voodoo death, and the search for the meaning of the world's strangest syndromes by Frank Bures.
Philosophy Psychiatry Psychology, May 31, 1994
There is a tendency to regard medical conditions, but not psychological ones, as factors that abs... more There is a tendency to regard medical conditions, but not psychological ones, as factors that absolve a person of responsibility for criminal behavior. Wittgenstein's recently published "Lecture on Freedom of the Will" provides some clues as to why this is so. In this essay I suggest that psychiatrists have at least two different ways of speaking about persons: the language of mechanism and the language of ordinary life. I explore Wittgenstein's suggestion that when we look at something mechanistically we take up an attitude of "fatalism," the attitude that things could not have happened otherwise, and I argue that we are inclined to take up a similar attitude when we look at certain types of psychiatric patients. I also argue that both biological and psychodynamic explanations of human behavior embed deterministic assumptions, which may further undermine ordinary notions of moral responsibility. I conclude by examining a thought experiment by Wittgenstein, which suggests that in order to undermine conventional notions of moral responsibility it is not enough to show that all actions are compelled; rather, one must undermine the distinction that we ordinarily make between action that is compelled and that which is not. I argue that this supports our ordinary practice of holding persons with personality disorders morally responsible for their actions.
New scientist (1971), Jan 11, 1992
Encyclopedia of Life Sciences, 2009
The Hastings Center Report, 2004
W hat's the difference between medical education and pharmaceutical public relations? Not much, a... more W hat's the difference between medical education and pharmaceutical public relations? Not much, according to the people who do it. "(T)he broad distinction between healthcare PR and medical education is becoming obsolete," writes Neil Kendle, chief executive officer of Lowe Fusion Healthcare, in a recent issue of Pharmaceutical Marketing magazine. So slender is the difference between education and PR than that Kendle cannot even say for certain which business he is in. "Sometimes I describe Lowe Fusion as a 'PR consultancy', sometimes as a 'healthcare communications agency'. Sometimes I just cop out and list the things we do." 1 Here's how the business works. The pharmaceutical industry puts up the money, usually in the form of an "unrestricted educational grant." The grant goes to a forprofit medical education and/or communications company (MECC), which, in consultation with its pharma sponsor, puts together an "educational program." 2 The company and the MECC recruit academic physicians to
BMJ, 1995
the intensive care unit'6 and of deaths after discharge.'7 Comorbidity, physiological instability... more the intensive care unit'6 and of deaths after discharge.'7 Comorbidity, physiological instability, tachypnoea, hypotension, and impaired mentation have all been identified as predictors of critical illness and cardiorespiratory arrest. If such features could be incorporated into an index of prior risk for use in ordinary wards it might provide the opportunity for earlier intervention with better outcomes at lower cost. It might also facilitate discussions with individual patients about how much treatment they would want'8 and encourage the use of advance directives. Junior doctors and nurses should also receive better training in basic intensive care and preventing critical illness. Risk management will not succeed unless it is accompanied by more resources for high dependency care. Earlier intervention means more detailed monitoring with particular attention to tissue oxygenation. Monitoring response to fluid resuscitation and inotropic drugs in patients at risk920 cannot be provided safely in ordinary wards. High dependency care units allow preventive care to be delivered with nurse staffing levels that are half those of intensive care units21 and are also less intimidating than intensive care units, which may facilitate earlier referral of patients by junior medical staff. The introduction of a high dependency unit has been shown to reduce cardiac arrests in hospital and overall mortality,22 and the fact that only 15% of British hospitals have identifiable high dependency units should concern both purchasers and providers ofhealth care."I Britain is uniquely placed to examine these issues because constraints on resources may provide a natural experiment from which to assess how much benefit accrues from different levels of treatment. Although regionalisation of intensive care, better transport, and improved medical staffing are urgently needed in Britain, the internal market inhibits sharing of costs and services between trusts and makes these developments unlikely. Rationing and triage are inevitable and should be open to public debate informed by scientific research. There should be no place for secrecy and guesswork in the rationing of critical care when evidence suggests that the limitations placed on funding are resulting in inefficiencies and avoidable illness and deaths.
Journal of Medical Ethics, 1997
University of Richmond Law Review, 2017
Human subjects research has a shameful history of abuses committed against institutionalized peop... more Human subjects research has a shameful history of abuses committed against institutionalized people. Decades after the Nuremburg court condemned Nazi doctors to death for experimenting on prisoners in concentration camps, researchers in the United States continued to expose prisoners to measles, malaria, radioactive isotopes, and other painful and damaging interventions. 1 On his first visit to the Holmesburg prison in Pennsylvania, Dr. Albert Kligman reported seeing in this captive population ―acres of skin‖ on which he could conduct dermatological experiments, including toxins that left prisoners scarred and blistered. 2
Hastings Center Report, 2018
The virtual mentor : VM, 2005
The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics, 2014
Pharmaceutical companies have long focused their marketing strategies on getting doctors to write... more Pharmaceutical companies have long focused their marketing strategies on getting doctors to write more prescriptions. But they lose billions in potential sales when patients do not take their prescribed drugs. Getting patients to "adhere" to drug therapies that have unpleasant side effects and questionable efficacy requires more than mere ad campaigns urging patients to talk to their doctors. It requires changing patients' beliefs and attitudes about their medications through repeated contact from people patients trust. Since patients do not trust drug companies, these companies are delivering their marketing messages through nurses, pharmacists, and even other patients - leveraging patients' trust in these intermediaries to persuade them to consume more brand name drugs. Armed with the premise that better adherence improves patients' health, drug companies justify manipulating patients by reframing reasonable decisions to decline therapy as pathological, and p...
American Journal of Bioethics, 2001
New England Journal of Medicine, 2008
Medicine, Health Care and Philosophy, 2007
We may not be able to make you love reading, but against happiness will lead you to love reading ... more We may not be able to make you love reading, but against happiness will lead you to love reading starting from now. Book is the window to open the new world. The world that you want is in the better stage and level. World will always guide you to even the prestige stage of the life. You know, this is some of how reading will give you the kindness. In this case, more books you read more knowledge you know, but it can mean also the bore is full.
Journal of General Internal Medicine, 2006