Índice C en médicos de dos centros hospitalarios chilenos según el test de competencia moral de Lind / Assessment of moral competence of physicians

Background: Moral competence (MC) in physicians is fundamental, given the increasing complexity of medicine. The "Moral Competence Test" (MCT © Lind) evaluates this feature and its indicator is the C Index (CI). Aim: To explore moral competence and its associated factors among physicians working in Chile. Material and Methods: The MCT was answered by 236 physicians from two medical centers who voluntarily participated in the study. Besides the test, participants completed an encrypted form giving information about gender, years in practice and post-graduate studies. Results: The average CI value of the participants was 20,9. Post-graduate studies had a significant positive influence on CI. There was a significant decrease in CI, between 16 and 20 years of professional exercise. Gender and the area of post-graduate studies did not have a significant influence. Conclusions: The studied physicians showed a wide range of CI which was positively affected by the postgraduate studies performed. The years of professional practice had a negative influence. Expanding training opportunities during professional practice could have a positive effect on CM as measured by CI.

[Assessment of moral competence of physicians]. / Índice C en médicos de dos centros hospitalarios chilenos según el test de competencia moral de Lind.

BACKGROUND: Moral competence (MC) in physicians is fundamental, given the increasing complexity of medicine. The "Moral Competence Test" (MCT © Lind) evaluates this feature and its indicator is the C Index (CI). AIM: To explore moral competence and its associated factors among physicians working in Chile. MATERIAL AND METHODS: The MCT was answered by 236 physicians from two medical centers who voluntarily participated in the study. Besides the test, participants completed an encrypted form giving information about gender, years in practice and post-graduate studies. RESULTS: The average CI value of the participants was 20,9. Post-graduate studies had a significant positive influence on CI. There was a significant decrease in CI, between 16 and 20 years of professional exercise. Gender and the area of post-graduate studies did not have a significant influence. CONCLUSIONS: The studied physicians showed a wide range of CI which was positively affected by the postgraduate studies performed. The years of professional practice had a negative influence. Expanding training opportunities during professional practice could have a positive effect on CM as measured by CI.

Julgamento na auditoria: um estudo das características das pesquisas científicas / Judgment in auditing: a study of the profile of scientific research

Este estudo tem como objetivo principal delinear um perfil das pesquisas científicas que versam sobre o julgamento da auditoria. Para isso, foi realizado um estudo descritivo, tendo-se como instrumento de coleta dos dados artigos selecionados em periódicos via portal de periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). Para a seleção dos artigos, foram utilizadas as palavras-chaves: audit, judgement, behavior, accounting e bias. Como técnica de coleta de dados foi realizada análise do artigo, identificando:temática, objetivo, número de autores, tipo de pesquisa e instrumento estatístico utilizado na análise dos resultados. Nos resultados foram identificadas publicações com a existência de coautores, com predominância do tipo de pesquisa experimental e empírico-analítico, sendo as análises de regressão e fatorial os instrumentos mais utilizados. Os estudos revelam preocupação dos autores em verificar a relação do julgamento na auditoria e seus efeitos em questões como o gerenciamento de resultados e relacionadas ao padrão ético, bem como ao grau de independência, confiabilidade, materialidade e, principalmente,de influências comportamentais, tais como o excesso de confiança e alcances no resultado final dos serviços prestados

This study aims at sketching out a profile of scientific papers dealing with judgments in the auditing. A descriptive study was carried out with data gathered from articles in journals found on the CAPES (government agency for higher education training) website. The keywords audit,judgment, behavior, accounting and bias were used for the selection of the articles. As a data collection technique, the articles were scanned for theme, aim, number of authors, type of research and statistical instrument used in the analysis of the results. Results showed the existence ofco-authored publications; most of them were based on experimental and empirical-analytic research; regression and factor analyses were the instruments most used. The studies show a concern by the authors in verifying the relationships between judgments in the auditing and their effects on issues such as results management,issues related to their ethical standards as well as the degree of independence, reliability and materiality, and especially that of behavioral influences such as overconfidence and the scope of the final results of the services provided

Risk assessment in mental health care: values and costs.

Risk assessment has assumed increasing salience in mental health care in a number of countries. The frequency of serious violent incidents perpetrated by people with a mental illness is an insufficient explanation. Understandings of mental illness and of the role of those charged with their care (or control) play a key role. "Moral outrage", associated with an implied culpability when certain types of tragedy occur, is very significant. This leads to tensions concerning the role of post-incident inquiries, and contributes to a flawed conception of what such inquiries can offer. At the same time, understanding of probability and prediction is generally very poor, among both professionals and the public. Unrealistic expectations for risk assessment and management in general psychiatric practice carry a variety of significant costs, taking a number forms, to those with a mental illness, to mental health professionals and to services. Especially important are changes in professional practice and accountabilities that are significantly divorced from traditional practice, implications for trust in patient-clinician relationships and the organisations in which mental health professionals work, and practices that often breach the ethical principle of justice (or fairness) and heighten discrimination against people with mental illness.

The Stateville penitentiary malaria experiments: a case study in retrospective ethical assessment.

During World War II, malaria research was conducted in prisons. A notable example was the experiments at Stateville Penitentiary in Illinois, in which prisoner-subjects were infected with malaria for the purpose of testing the safety and efficacy of novel anti-malaria drugs. Over time, commentators have shifted from viewing the malaria research at Stateville as a model of ethical clinical research to seeing the experiments as paradigmatic of abusive human experimentation. This essay undertakes a retrospective ethical assessment of the Stateville malaria research during the 1940s in light of basic ethical principles and the Nuremberg Code, as well as contemporary malaria research. In addition to its historical interest, this case study provides a rich context for addressing basic issues of research ethics, including the voluntariness of consent, the justification of risks, and the exploitation of vulnerable subjects.

Power increases hypocrisy: moralizing in reasoning, immorality in behavior.

In five studies, we explored whether power increases moral hypocrisy (i.e., imposing strict moral standards on other people but practicing less strict moral behavior oneself). In Experiment 1, compared with the powerless, the powerful condemned other people's cheating more, but also cheated more themselves. In Experiments 2 through 4, the powerful were more strict in judging other people's moral transgressions than in judging their own transgressions. A final study found that the effect of power on moral hypocrisy depends on the legitimacy of the power: When power was illegitimate, the moral-hypocrisy effect was reversed, with the illegitimately powerful becoming stricter in judging their own behavior than in judging other people's behavior. This pattern, which might be dubbed hypercrisy, was also found among low-power participants in Experiments 3 and 4. We discuss how patterns of hypocrisy and hypercrisy among the powerful and powerless can help perpetuate social inequality.

From sucker to saint: moralization in response to self-threat.

When people's rationality and agency are implicitly called into question by the more expedient behavior of others, they sometimes respond by feeling morally superior; this is referred to as the sucker-to-saint effect. In Experiment 1, participants who completed a tedious task and then saw a confederate quit the same task elevated their own morality over that of the confederate, whereas participants who simply completed the task or simply saw the confederate quit did not. In Experiment 2, this effect was eliminated by having participants contemplate a valued personal quality before encountering the rebellious confederate, a result suggesting a role for self-threat in producing moralization. These studies demonstrate that moral judgments can be more deeply embedded in judges' immediate social contexts-and driven more by motivations to maintain self-image-than is typically appreciated in contemporary moral-psychology research. Rather than uphold abstract principles of justice, moral judgment may sometimes just help people feel a little less foolish.

Vozes do Camboja: formas locais de responsabilização por atrocidades sistemáticas / Imaginando respuestas de inspiración local a las atrocidades masivas que se cometieron: voces de Camboya / Imagining locally-motivated accountability for mass atrocities: voices from Cambodia

Este artigo procura defender três proposições. Primeiramente, é improvável que as Câmaras Extraordinárias nos tribunais do Camboja (conhecidas informalmente como Julgamentos do Khmer Vermelho) alcancem os principais objetivos apresentados por seus proponentes. Em segundo lugar, esse tribunal corre o risco de causar danos. Em terceiro lugar, outros processos culturalmente específicos têm uma chance maior de causar um impacto de longo prazo e satisfazer as vítimas.

This article seeks to defend three propositions. First, the Extraordinary Chambers in the Courts of Cambodia (informally known as the Khmer Rouge Trials) is unlikely to achieve any of the primary goals put forward by its proponents. Second, the Court runs the risk of doing harm. Third, it becomes apparent that other culturally-specific processes have a greater chance at making a long-term impact and satisfying victims.

Este artículo intenta defender tres propuestas. En primer lugar, es muy improbable que las Cámaras Extraordinarias de los Tribunales de Camboya (informalmente conocidas como los Juicios de los Jémeres Rojos) consigan alcanzar alguno de los objetivos fundamentales fijados por sus partidarios. En segundo lugar, la Corte corre el riesgo de hacer daño también. En tercer lugar, otros procesos de mayor especificidad cultural tendrán mayores posibilidades de influir a largo plazo y de satisfacer a las víctimas.

Desarrollo moral infantil y juvenil y variables asociadas en estratos socio-económicos 1 y 2 de la ciudad de Bogotá / Moral development and associated variables in low-class children and Adolescents at Bogotá city

En este artículo se presentan los resultados de la prueba de Desarrollo Moral construida para la población colombiana por Villegas de Posada (1997) y las relaciones entre desarrollo moral y otras variables como competencia parental, juicio sociomoral de los padres, ambiente familiar y auto-estima. La muestra del estudio es parte de una muestra mayor del proyecto de investigación sobre los factores de riesgo de la conducta agresiva y violenta en los niños y jóvenes de clase socio-económica baja de Bogotá. Los resultados indican que el desarrollo moral en niños y niñas de 10 y 15 años clasificados como ajustados no difiere significativamente del desarrollo moral en niños y niñas no ajustados. Tampoco se encontraron diferencias por género. Los niños y niñas de 15 años mostraron un mayor nivel de desarrollo moral que los de 15 años. Los padres y las madres. Así como los hijos /as se ubican en general en un nivel convencional, de cumplimiento de la norma por sí mismos y de cumplimiento de la norma teniendo en cuenta consecuencias sociales y personales. Los modelos estructurales confirman la relación significativa entre el juicio socio moral de los padres y sus competencias parentales, sin embargo su valor predictivo sobre el desarrollo moral infantil no es significativo. El desarrollo moral está en función de la auto-estima, las competencias parentales y el ambiente familiar reportado por los mismos niños y niñas. Se discuten las consistencias con otros hallazgos en el área y las limitaciones en el estudio del desarrollo moral.

A theory of international bioethics: multiculturalism, postmodernism, and the bankruptcy of fundamentalism.

The first of two articles analyzing the justifiability of international bioethical codes and of cross-cultural moral judgments reviews "moral fundamentalism," the theory that cross-cultural moral judgments and international bioethical codes are justified by certain "basic" or "fundamental" moral priniciples that are universally accepted in all cultures and eras. Initially propounded by the judges at the 1947 Nuremberg Tribunal, moral fundamentalism has become the received justification of international bioethics, and of cross-temporal and cross-cultural moral judgments. Yet today we are said to live in a multicultural and postmodern world. This article assesses the challenges that multiculturalism and postmodernism pose to fundamentalism and concludes that these challenges render the position philosophically untenable, thereby undermining the received conception of the foundations of international bioethics. The second article, which follows, offers an alternative model -- a model of negotiated moral order -- as a viable justification for international bioethics and for transcultural and transtemporal moral judgments.

A defense of fundamental principles and human rights: a reply to Robert Baker.

This article seeks to rebut Robert Baker's contention that attempts to ground international bioethics in fundamental principles cannot withstand the challenges posed by multiculturalism and postmodernism. First, several corrections are provided of Baker's account of the conclusions reached by the Advisory Committee on Human Radiation Experiments. Second, a rebuttal is offered to Baker's claim that an unbridgeable moral gap exists between Western individualism and non-Western communalism. In conclusion, this article argues that Baker's "nonnegotiable primary goods" cannot do the work of "classical human rights" and that the latter framework is preferable from both a practical and a theoretical standpoint.