Research Fellow - Ethics
School of Public Health
Faculty of Health and Medical Sciences
Eligible to supervise Masters and PhD - email supervisor to discuss availability.
I am a moral philosopher and health policy researcher who works mostly at the interface of ethics and health economics. I am interested in discussions about the nature of goodness, in how those discussions are best pursued, and in letting those discussions improve the thinking that informs decisions made by health care practitioners and policy makers, especially on questions of resource allocation.
My main research focus is on how health-related resources ought to be allocated. I am particularly interested in identifying what is important besides gaining the maximum possible health for a population. I have examined this in relation to assisted reproductive technologies (like in vitro fertilisation), intensive care triage and national funding decision making for pharmaceuticals and medical services. I am also interested in how qualitative research and deliberative methods can best serve inquiry into health-related ethical matters. Philosophically, I work to extend and apply insights made by the philosophers Ludwig Wittgenstein, Iris Murdoch, Raimond Gaita, and Christopher Cordner.
Since 2009, I have been a Research Fellow in Ethics. I collaborate on research with health services researchers, health economists and social scientists, especially to inform decisions about how governments ought to allocate health care resources.
- My Research
- Grants and Funding
- Professional Activities
My current research focusses on ethical resource allocation.
I am analysing the ethical principles that ought to inform intensive care unit (ICU) admission and discharge, especially when the ICU is full and additional patients require admission. I am also working to identify the ethical principles that formal recommendations on ICU admission and discharge currently embody.
I am involved in several research projects that aim to improve the decision making of health funding bodies that use Health Technology Assessment (HTA) as an evaluation framework. I am researching the ethics of managed-entry agreements, where governments provisionally fund new health interventions on the condition that research is undertaken to reduce uncertainty concerning the intervention's effectiveness or cost-effectiveness, for example. I am also researching how national bodies such as the Pharmaceutical Benefits Advisory Committee (PBAC) and the Medical Services Advisory Committee (MSAC) ought to include more than conventional cost-effectiveness in their judgements of the value for money that a health intervention provides. Other projects examine the unique challenges and opportunities faced by state-level health funding bodies and how to best involve patients and the public in health funding decision making.
Date Position Institution name 2011 Affiliate Adelaide Health Technology Assessment (AHTA), The University of Adelaide 2010 - 2013 Adjunct Lecturer St Barnabas' Theological College, Charles Sturt University 2009 Research Fellow (Ethics) The University of Adelaide
Awards and Achievements
Date Type Title Institution Name Country Amount 2016 Award Ray James Award Australian Health Promotion Association (AHPA) Australia $1000 2012 Research Award Visiting Researcher at Brocher Foundation Brocher Foundation Switzerland $20,000 2010 Research Award 2010 Finalist for the Mark S. Ehrenreich Prize in Healthcare Ethics Research International Association of Bioethics (IAB) — —
Date Institution name Country Title 2003 - 2009 Australian Catholic University Australia PhD in Philosophy 1998 - 2001 University of Melbourne Australia BA(Hons) in Philosophy and History
Research InterestsBioethics Health Economics Health Policy Health Policy & Services History and Philosophy of Medicine Medical Ethics Medicine, Nursing and Health Curriculum and Pedagogy Philosophy Public Health Public Health and Health Services Fertility and Conception Indigenous and Disadvantaged Health Innovative Therapeutics Surgical and Health Systems Innovation Translational Health Outcomes
Year Citation 2018 McGee, A., & Carter, D. A. (2018). The difference between withholding and withdrawing life-sustaining treatment. In N. Emmerich, B. Gordjin, & P. Mallia (Eds.), Contemporary European Perspectives on the Ethics of End of Life Care. Springer. 2016 Carter, D. A. (2016). Conceptualising secondary pain affect: the more personal and elaborate feelings. In S. van Rysewyk (Ed.), Meanings of Pain (1 ed., pp. 251-266). Switzerland: Springer.
Year Citation 2018 Carter, D. A., Vogan, A., & Merlin, T. (2018). The need for ethics committees and evaluation agencies in coverage with evidence development: the case of crizotinib in Australia. In [ ]. Townsville. 2018 Hunter, D., & Carter, D. A. (2018). Are you ethical? Sharing practices in assessing medical ethics workshop. In [ ]. Townsville. 2018 McGee, A., & Carter, D. A. (2018). Withholding and withdrawing life-sustaining treatment are not morally equivalent. In [ ]. Townsville. 2017 Gibson, O., Morey, K., Harfield, S., Kite, E., Canuto, K., Gomersall, J., . . . Braunack-Mayer, A. (2017). The CREATE Critical Appraisal Tool: Establishing The Validity, Reliability And Feasibility Of A Tool To Appraise Research From Aboriginal And Torres Strait Islander Perspectives. In [ ]. Melbourne. 2017 Gibson, O., Harfield, S., Morey, K., Kite, E., Canuto, K., Gomersall, J., . . . Braunack-Mayer, A. (2017). The CREATE Critical Appraisal Tool: A Tool To Appraise Research From Aboriginal and Torres Strait Islander Perspectives. In [ ]. Cape Town, South Africa. 2017 Carter, D. A., Merlin, T., & Hunter, D. (2017). Coercing or inducing patients to participate in evidence generation. In [ ]. Adelaide. 2017 Carter, D. A., McGee, A., Braunack-Mayer, A., & Deane, A. (2017). Resource allocation in the intensive care unit [Invited presentation]. In [ ]. Adelaide. 2016 Gomersall, J., Gibson, O., Dwyer, J., O’Donnell, K., Stephenson, M., Carter, D., . . . Brown, A. (2016). Clients’ perceptions of the characteristics and value of Aboriginal Community Controlled Health Organisations: A systematic review of qualitative evidence. In [ ]. Canberra. 2015 Morey, K., Canuto, K., Kite, E., Gibson, O., Brown, A., Harfield, S., . . . Braunack-Mayer, A. (2015). The Development of an Appraisal Tool for Assessing Research Involving Aboriginal and Torres Strait Islander Peoples. In [ ]. Melbourne. 2015 Gomersall, J., Aromataris, E., Brown, A., Dwyer, J., Carter, D. A., O'Donnell, K., . . . Gibson, O. (2015). Characteristics and Value of Aboriginal Community Controlled Health Organisations Primary Health Care. In [ ]. Melbourne. 2015 Lopes McInnes, E., Street, J., Carter, D., & Merlin, T. (2015). Stakeholder views on Australian public- and patient-involvement in HTA. In Online programme. Oslo, Norway. 2015 Carter, D. A., Sendziuk, P. J., Eliott, J. A., & Braunack-Mayer, A. J. (2015). Why Is Pain Still Under-Treated in the Emergency Department? Two New Hypotheses. In Australian and New Zealand College of Anaesthetists (ANZCA) Annual Scientific Meeting (ASM). Adelaide, Australia. 2014 Hutchison, K., Johnson, J., & Carter, D. A. (2014). Social justice and surgical innovation: the case of the Da Vinci robot. In Australasian Association of Philosophy (AAP) Conference. Canberra, Australia. 2013 Carter, D. A. (2013). Pain management relative to other priorities in the emergency department: explicating moral logic with practitioners. In Australasian Association of Bioethics and Health Law (AABHL) Conference. Sydney, Australia. 2013 Lopes do Carmo, E., Street, J. M., Carter, D. A., & Merlin, T. L. (2013). Excluding patient and citizen voices from health-care funding decision-making: what is the public health impact?. In Public Health Association of Australia (PHAA) 42nd Annual Conference. Melbourne, Australia. 2011 Hiller, J. E., Elshaug, A. G., Watt, A. M., Braunack-Mayer, A. J., Moss, J. R., Carter, D. A., . . . for the ASTUTE health study group. (2011). Informing policy makers with an enhanced evidence-base for disinvestment: findings from a multi-stage stakeholder engagement. In Health Technology Assessment International (HTAi) Conference. Rio de Janeiro, Brazil. 2011 Carter, D. A., Watt, A. M., Gordon, J. P., & the ASTUTE health study group. (2011). Different Hopes for Health Care Budgets: Distributing Assisted Reproductive Technology to Women of Different Ages. In Australasian Association of Bioethics and Health Law (AABHL) Conference. Gold Coast, Australia. 2011 Hiller, J. E., Elshaug, A. G., Watt, A. M., Braunack-Mayer, A. J., Moss, J. R., Carter, D. A., . . . Hodgetts, K. S. (2011). Engaging Policy Makers with an Enhanced Evidence-Base for Disinvestment: Case Studies of Assisted Reproductive Technologies and Pathology Testing. In Health Services Research Association of Australia and New Zealand (HSRAANZ) 7th Health Services and Policy Research Conference. Adelaide, Australia. 2011 Carter, D. A. (2011). What is medical need? Competing answers and their implications for patient prioritisation. In Health Services Research Association of Australia and New Zealand (HSRAANZ) 7th Health Services and Policy Research Conference. Adelaide, Australia. 2010 Carter, D. (2010). The ethics of publicly funding assisted reproductive technology. In Australasian Association of Bioethics and Health Law Conference 2010 (pp. 0 pages). Adelaide, Australia. 2010 Carter, D. (2010). The ethics of publicly funding assisted reproductive technology for older women. In Feminist Approaches to Bioethics 2010 Congress (pp. 0 pages). Singapore. 2010 Carter, D. (2010). The deference to nature implicit in public funding arrangements for assisted reproductive technologies. In 10th World Congress of Bioethics 2010 (pp. 0 pages). Singapore. 2010 Street, J. M., Elshaug, A. E., Braunack-Mayer., Wale, J. L., Watt, A. M., Carter, D. A., . . . the ASTUTE Health Study group. (2010). Weaving partisan and non-partisan voices into health policy: to knit or knot?. In Public Health Association of Australia (PHAA) National Conference. Adelaide, Australia.
Year Citation 2018 Kessels, S., Newton, S., Carter, D., & Merlin, T. (2018). The Effectiveness And Ethics Of Prenatal Testing For Cystic Fibrosis. Poster session presented at the meeting of HTAi Annual Meeting 2018. Vancouver. 2017 Harfield, S., Gibson, O., Morey, K., Kite, E., Canuto, K., Glover, K., . . . Braunack-Mayer, A. (2017). The CREATE Critical Appraisal Tool: A Tool To Appraise Research From Aboriginal and Torres Strait Islander Perspectives [Poster]. Poster session presented at the meeting of 6th Annual National Health and Medical Research Council (NHMRC) Symposium on Research Translation. Brisbane. 2017 Muhlack, E. L., Eliott, J., Carter, D., & Braunack-Mayer, A. (2017). Constructions of alcohol consumption among non-problematised middle-aged drinkers: a South Australian study. Poster session presented at the meeting of 15th World Congress On Public Health. Melbourne, Australia. 2016 Morey, K., Gibson, O., Harfield, S., Canuto, K., Kite, E., Glover, K., . . . Braunack-Mayer, A. (2016). Developing a tool to assess research involving Aboriginal and Torres Strait Islander peoples from an Aboriginal and Torres Strait Islander perspective [Poster]. Poster session presented at the meeting of The Lowitja Institute International Indigenous Health and Wellbeing Conference 2016. Melbourne, Australia. 2016 Muhlack, E., Eliott, J., Braunack-Mayer, A., Carter, D., & Morfidis, N. (2016). Responsibility, recreation, and gender: a systematic review of middle-aged non-problematised drinkers’ constructions of their alcohol consumption. Poster session presented at the meeting of Abstracts of Australasian Professional Society on Alcohol and other Drugs Conference 2016, as published in Drug and Alcohol Review. Sydney, NSW: Wiley. 2012 Carter, D. A. (2012). A philosophical analysis of secondary pain affect [Poster]. Poster session presented at the meeting of International Association for the Study of Pain (IASP) 14th World Congress on Pain. Milan, Italy.
Report for External Bodies
Year Citation 2018 Lopes McInnes, E., Carter, D. A., & Street, J. (2018). YourSAy Online engagement with South Australians: an evaluation survey. Adelaide. 2018 Milverton, J., Mittal, R., Carter, D. A., Kessels, S., Newton, S., Schubert, C., . . . Merlin, T. (2018). Processing and cryopreservation of ovarian tissue prior to or after gonadotoxic treatment to preserve fertility in females for the future (MSAC Application 1435 Part B, Assessment Report). Canberra: Commonwealth of Australia. 2018 Milverton, J., Vogan, A., Parsons, J., Kessels, S., Carter, D., Schubert, C., . . . Merlin, T. (2018). Genetic deletion testing for alpha thalassaemia (MSAC Application 1531). Canberra: Commonwealth of Australia. 2017 Morona, J., Mittal, R., Newton, S., Salinger, K., Carter, D. A., Schubert, C., & Merlin, T. (2017). Processing and cryopreservation of semen, sperm and testicular tissue prior to or after gonadotoxic treatment to preserve future fertility (MSAC 1435 Part A, Assessment Report). Canberra: Commonwealth of Australia.
Year Citation 2017 Harwood, A. (2017). An ethical analysis of obesity, weight stigma, and public health. (Master's Thesis, The University of Adelaide). 2014 Lopes McInnes, E. (2014). Public and patient involvement in government health funding decision making in Australia. (Master's Thesis, The University of Adelaide). 2009 Carter, D. A. (2009). Elaboration on a Permissible Theme. (PhD Thesis, Australian Catholic Univesrity). 2001 Carter, D. A. (2001). Iris Murdoch on Tragedy and King Lear. (Undergraduate Dissertation, The University of Melbourne).
Year Citation 2018 Lopes McInnes, E., & Carter, D. (2018). YourSAy online engagement with South Australians: an evaluation survey. 2017 Carter, D. A. (2017). Ethical dimensions of current and future practice. South Australian Health and Medical Research Institute. 2017 Carter, D. A., & Merlin, T. (2017). Sharing risk in the funding of health technologies. School of Public Health.
Year Citation 2015 Carter, D. A. (2015). Rethinking pain’s under-treatment in the ED – Part 1. BodyInMind. 2015 Carter, D. A. (2015). Rethinking pain’s under-treatment in the ED – Part 2. BodyInMind.
2015-2017. Jonathan Karnon, Hossein Haji Ali Afzali, Annette Braunack-Mayer, Stephen Begg, Drew Carter. Increasing population health by making better funding decisions: Estimation of the cost-effectiveness threshold for the Australian health system. National Health and Medical Research Council. Project Grant. Grant ID 1084387. $331,398.
Scoring 6 out of 7, this application scored in the top 5% of the 3800 Project grant applications submitted in 2014. My role in the project is to facilitate translation of the project findings into improved practice by collaborating with national health funding decision makers to identify and overcome challenges associated with implementing an explicit and empirically derived cost-effectiveness threshold when recommending whether the government ought to fund a new health technology.
2013-2018. CIs: Alan Pearson, Alex Brown, Annette Braunack-Mayer, Ngiare Brown, Edoardo Aromataris. AIs: Drew Carter, Carol Davy, Zoe Jordan, Craig Lockwood, Alexa McArthur, Sandeep Moola, Zachary Munn, Suzanne Robertson-Malt, Matthew Stephenson, Jackie Street, Catalin Tufanaru, Renee Williams. Innovation in the synthesis and translation of research evidence to inform the prevention, management and treatment of chronic disease in Indigenous populations. National Health and Medical Research Council. Centre of Research Excellence. App ID 1061242. $2,482,576.
I am actively involved in the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE). I am a member of its Methods Group, working to create a novel tool to assess the quality of research involving Aboriginal and Torres Strait Islander peoples. I am also a member of the Centre's Sustainable Funding Domain, collaborating on systematic reviews concerning the value and funding of health services dedicated to Aboriginal and Torres Strait Islander peoples.
2012-2014. Annette Braunack-Mayer, Jackie Street, Chris Reynolds, Vivienne Moore, Megan Warin, Drew Carter, John Moss, Tracy Merlin, Elizabeth Handsley. Steward or nanny state: Consulting the public about the use of regulations and laws to address childhood obesity. Australian National Preventive Health Agency. Category 1. Preventive Health Research Grant Program 2011-12. $288,381.
My role in the HealthyLaws project has included providing ethical insights to the project's deliberative engagement with citizens and co-supervising a PhD on ethics, obesity and public health policy.
Sep-Oct 2012. Drew Carter and Paul Sendziuk. The morality of using acute pain as a diagnostic tool in emergency medicine, together with a critical history of acute pain measurement. The Brocher Foundation (Switzerland). Visiting Researchers. Approx. $20,000.
This project involved interviewing medical practitioners on the clinical and ethical reasoning underpinning pain management in the emergency department.
I currently teach ethics into the postgraduate course, Health Technology Assessment.
In the past, I have taught health ethics extensively. From 2015 to 2018 I led the teaching of ethics to University of Adelaide medical students. In recent years I also co-ordinated Public Health Ethics and Saving lives or respecting rights? An introduction to health ethics, which I developed from the ground up with Professor Annette Braunack-Mayer.
Current Higher Degree by Research Supervision (University of Adelaide)
Date Role Research Topic Program Degree Type Student Load Student Name 2018 Co-Supervisor Comprehensive Assessment of Interventions and Technology in Complex Health Systems Doctor of Philosophy Doctorate Full Time Dr Abdolvahab Baghbanian 2015 Co-Supervisor An Assessment of the Ethical Justification of Risk Labelling of Alcoholic Beverages in an Australian Context Doctor of Philosophy Doctorate Part Time Mrs Emma Muhlack 2015 Principal Supervisor Patient and Citizen Involvement in Health Technology Assessment Doctor of Philosophy Doctorate Part Time Ms Edilene Lopes McInnes
Past Higher Degree by Research Supervision (University of Adelaide)
Date Role Research Topic Program Degree Type Student Load Student Name 2017 - 2017 Principal Supervisor An Ethical Analysis of Obesity, Weight Stigma, and Public Health Master of Philosophy (Public Health) Master Full Time Ms Alison Harwood 2012 - 2014 Co-Supervisor PUBLIC AND PATIENT INVOLVEMENT IN GOVERNMENT HEALTH FUNDING DECISION MAKING IN AUSTRALIA Master of Philosophy (Public Health) Master Part Time Ms Edilene Lopes McInnes
Date Role Committee Institution Country 2017 - ongoing Member SA Department for Health and Wellbeing Human Research Ethics Committee Government of South Australia Australia 2016 - 2017 Member SA Department for Health and Ageing Human Research Ethics Committee Government of South Australia (Deputy for Annette Braunack-Mayer) Australia 2014 - 2016 Member School Research Committee School of Public Health, The University of Adelaide — 2012 - 2017 Member Early-Career Researcher Committee School of Public Health, The University of Adelaide — 2010 - 2014 Member Human Research Ethics Committee of the Adelaide College of Divinity Flinders University —
Date Role Membership Country 2017 - 2018 Member Australasian Association of Philosophy Australia 2014 - ongoing Member Health Technology Assessment International (HTAi) Interest Sub-Group on Ethical Issues in Health Technology Assessment (HTA) — 2013 - ongoing Member Australasian Association of Bioethics and Health Law (AABHL) — 2012 - 2013 Member International Association for the Study of Pain (IASP) — 2010 - 2011 — International Association of Bioethics (IAB) — 2010 - 2011 Member International Network on Feminist Approaches to Bioethics —
Date Title Engagement Type Institution Country 2018 - ongoing Ethical and legal considerations in breast density Scientific Community Engagement The University of Adelaide Australia
Date Role Editorial Board Name Institution Country 2014 - ongoing Member English Editorial Board of the Health Technology Assessment (HTA) Glossary International HTA Glossary —
Date Office Name Institution Country 2016 - ongoing Co-leader of the Teaching Ethics Stream (with A/Prof David Hunter) Australasian Association of Bioethics and Health Law —
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