Cheng Qian

BackgroundThe brain death standard allowing a declaration of death based on neurological criteria is legally endorsed and routinely practiced in the West but not in Asia. In China, attempts to legalize the brain death standard have occurred several times without success. Cultural, religious, and philosophical factors have been proposed to explain this difference, but there is a lack of empirical studies to support this hypothesis.Methods476 medical providers from three academic hospitals in Hunan, China, completed a selfadministered survey including a 12-question brain death clinical knowledge assessment and hypothetical vignettes describing brain dead patients.ResultsThe response rate was 95.2 %. Almost all of the providers had heard of the term “brain death.” More than half have encountered presumed brain dead patients. Two-thirds accepted brain death as an ethical standard to determine human death. The mean knowledge score was 8.50 ± 1.83 out of 12. When given the description of a brain dead patient, 50.7 % considered the patient dead, 51.9 % would withdraw life support, and 40.6 % would allow organ procurement. Both provider and patient characteristics contributed to the providers’ decisions. Ethical acceptance was the most important independent predictor for brain death acknowledgement, followed by high knowledge scores, and the belief that the soul lives in the brain. Religious faith and associated beliefs did not have a significant effect.ConclusionsNotwithstanding scarce official accounts, recognition of the brain death standard is not uncommon in China. Chinese medical providers can adequately define the medical characteristics of brain death and accept it in theory, but hesitate to apply it to practice in the vignettes. Legalization is paramount in providing the protection providers need to comfortably declare brain death. However the medical decision-making surrounding brain death is complex and the provider's past experiences and emotions may also influence the process

Using Chinese listed companies as research setting, this paper constructs a measure of corporate competing culture through textual analysis on firms’ management discussion and analysis disclosures, and examines the impact of corporate competing culture on environmental investment. The results show that competing culture has a significant and positive impact on firms’ environmental investment, and the results remain robust to a battery of robustness tests. Moreover, the mediating analysis indicates that competing culture promotes corporate environmental investment through enhancing firms’ internal control quality. Furthermore, the heterogeneity results show that the positive impact of corporate competing culture on environmental investment is more pronounced in firms with larger size, stronger corporate governance, in high-polluting industry, and located in less developed regions. Our findings shed light on the importance of corporate competing culture and provide practical implications for corporate sustainable development.

In 2012, China officially declared, as a national strategy of governance, the development of ecological consciousness, the promotion of what has been called “eco-civilization,” and the development of “ecological citizens.” In this paper, we argue that the concept of green burial reflects a number of the values underlying “eco-civilization” and ecological citizenship: respect for nature, respect for humanity, and the ecologically-sensitive rational awareness of the “harmony between nature and humanity, as in the saying “天人合一” Tian Ren He Yi = “Nature and human beings combine into an integral whole”). The practice of green burial can play a valuable role in promoting the construction of an eco-civilization, although many people in China—and elsewhere—may be reluctant to accept it. One reason for this may be that the concept and practice of green burial are so new that it does not yet have a place in the ecological awareness of China’s citizens, who are the main subjects of the construction of eco-civilization. In our view, it is necessary to increase citizen awareness of green burials and their value, and to encourage people to participate in the practice. This is a reflection of the values that underlie ecological citizenship, but also serves to promote these values. While our proposal in this paper is to argue for green burial as an element in realizing this model of “eco-civilization” in China, its relevance clearly extends beyond the Chinese context.