Objective: To determine if the medical record might overestimate the quality of care through false, and potentially unethical, documentation by physicians.Design: Prospective trial comparing two methods for measuring the quality of care for four common outpatient conditions: structured reports by standardised patients who presented unannounced to the physicians’ clinics, and abstraction of the medical records generated during these visits.Setting: The general medicine clinics of two veterans affairs medical centres.Participants: Twenty randomly selected physicians from among eligible second and third year internal (...) medicine residents and attending physicians.Main measurements: Explicit criteria were used to score the medical records of physicians and the reports of SPs generated during 160 visits . Individual scoring items were categorised into four domains of clinical performance: history, physical examination, treatment, and diagnosis. To determine the false positive rate, physician entries were classified as false positive , false negative, true positive, and true negative.Results: False positives were identified in the medical record for 6.4% of measured items. The false positive rate was higher for physical examination and diagnosis than for history and treatment . For individual physician subjects, the false positive rate ranged from 0.098 to 0.397.Conclusions: These data indicate that the medical record falsely overestimates the quality of important dimensions of care such as the physical examination. Though it is doubtful that most subjects in our study participated in regular, intentional falsification, we cannot exclude the possibility that false positives were in some instances intentional, and therefore fraudulent, misrepresentations. Further research is needed to explore the questions raised but incompletely answered by this research. (shrink)

Both philosophy and linguistics have emphasized the importance of language as a means of dialogue. Despite the fact that Wittgenstein added a new layer of complication to this point of view, the Sapir-Whorf theory, proposed by Edward Sapir and his colleague Benjamin Lee Whorf, helped the impact of language on the mind acquire notoriety. With this idea, language not only continued to be a means of communication but also received recognition in the social science curriculum as a crucial element in (...) the development of personal identities and the process of knowledge assimilation. The effect of language on morality and ethics was the most significant element that philosophers and linguists overlooked in their extensive study. For instance, little is known about how the terms we choose can influence how we understand morality and ethics. The sole subject of this article will be how language influences the moral and ethical decisions we make. To put it another way, how we make choices is greatly influenced by the language or beliefs we use in both public and private life. This means that in order to understand a country’s law or socially accepted norms, it is crucial to closely examine the language that country uses. The options or goals that are publicly acceptable are also closely related to the language, metaphors, and discourses used by a specific society. The contemporary world does not analyze these incidents from a linguistic perspective, but language has contributed to the creation of accepted legal and social standards. (shrink)

Este artigo apresenta uma noção do embate velado entre a Igreja Católica e o Estado brasileiro para dominar a sociedade civil na transição império – república, um para não perder sua influência secular, o catolicismo, e outro, o Estado, para não se deixar influenciar pela ideologia antagonista ao projeto positivista-liberal a ser implementado naquele contexto onde o slogan fala por si "ordem e progresso".

Today's complex and decentralized organization gives rise to organizational needs for both loyalty and institutionalized whistle blowing. However, ethicists see a contradiction between both needs. This paper argues there is no such contradiction. It shows why earlier attempts to go beyond the dilemma are not satisfying. The solution proposed in this paper starts from an organizational perspective instead of an individual one. It does so by reframing the concept of loyalty into “rational loyalty”. This means that the object of loyalty (...) is not the physicality of an organization, but its corpus of explicit mission statement, goals, value statement and code of conduct. An implication is that organizations are – as their side of the duty of loyalty – obliged to institutionalize whistle blowing. (shrink)

Socioscientific issues receive considerable public attention and there are concerns that people in general are not able or willing to deal with information at odds with what they believe to be true. In this study, we focused on students’ beliefs about two controversial issues: whether consumption of the artificial sweetener aspartame and use of cell phones, respectively, represent any serious health risks. Our aim was to investigate whether students’ trust in the information was related to prior beliefs, the nature of (...) the message, and students’ critical reading strategies. Results showed interactions between prior beliefs about the issues and text condition (risk vs. no risk) on trust in conclusions that indicated a confirmation bias assumption. Additionally, students trusted conclusions ascertaining that there were risks more than conclusions ascertaining that there were no risks. Finally, students’ self-reported use of critical reading strategies implied less trust in both types of conclusions. (shrink)

O Concílio Vaticano II foi um dos eventos mais importantes da história da Igreja do século XX. Partindo de sua história e dos documentos aprovados pelos bispos conciliares, o pós-concílio caracteriza-se, nesses seus 40 anos, por um debate acalorado e por luta identitária sobre como ele deve ser recepcionado pela Igreja universal e pelas igrejas particulares. Dessa forma, o presente artigo tem como objetivo apresentar as principais linhas hermenêuticas do Vaticano II, apontando alguns autores e obras sobre a discussão.