Chih Ju Lin

This study aimed to investigate and compare the longitudinal impacts of mandatory clinical ethics consultation (CEC) on resource use and ethical conflicts among critically ill neurologic and non-neurologic patients. It also sought to identify relevant predictive factors and determine family member satisfaction with CEC. This combined retrospective and prospective cohort study was conducted at a tertiary academic medical centre. During the eight-year study period, 1,150 adult patients participated in this study (437 neurological and 713 non-neurological). In both groups, the ICU length of stay and days of ventilator use significantly decreased each year. Secular trends in the incidence rates of ethical conflicts significantly decreased each year in neurological patients. Neurological patients exhibited a greater decrease in resource usage and significantly higher incidence rates of ethical conflicts than non-neurological patients. Family members of both groups expressed high levels of satisfaction and agreed that CEC was beneficial. In the local healthcare context, the implementation of CEC policies may reduce resource usage, ethical conflicts, and improve the knowledge base of CEC and clinical teams, helping them in approaching the distinct issues raised by various patient characteristics. However, these findings should be interpreted with caution as their applicability to other healthcare systems may vary.

This article sets out to undertake a thorough, point-by-point examination of the theory postulated by Campbell (2007), in which an attempt is made to specify the conditions under which corporations may or may not act in socially responsible ways. In order to ensure the overall reliability of our study, and to attempt to provide a new understanding of, and greater insights into, whether corporate social responsibility (CSR) is affected by financial and institutional variables, we empirically investigate a total of 520 financial firms in 34 countries, between the years 2003 and 2005. Our empirical findings are: (i) finns with larger size are more CSR minded, and the financial performance and CSR are not related; (ii) finns would actually act in more socially responsible ways to enhance their competitive advantages when the market competitiveness is more intense; (iii) financial firms in countries with stronger levels of legal enforcement tend to engage in more CSR activities; however, interestingly and rather strikingly, those finns in countries with stronger shareholder rights tend to engage in less CSR activities; and (iv) self-regulation within the financial industry has a significantly positive effect on CSR, with firms being found to act in more socially responsible ways in those countries which have more cooperative employer-employee relations, higher quality management schools, and a better macroeconomic environment.

To many, recent allegations of accounting fraud (or earnings management; EM) at Enron, coupled with similar ones at many other corporations, are a strong indication of a serious decay in business ethics. In academics, this raises the concern between EM and corporate social responsibility (CSR). Since it has neither been documented, nor globally tested whether CSR mitigates or increases the extent of EM, three kinds of EM are studied: earnings smoothing, earnings aggressiveness, and earnings losses and decreases avoidance. The extents to which financial characteristics and institutional variables have an impact on the extent to which companies conduct EM are also tested. Our study investigates whether the CSR-related features of 1,653 corporations in 46 countries had a positive or negative effect on the quality of their publicly released financial information during the 1993-2002 period. There is no question that with a greater commitment to CSR, the extent of earnings smoothing is mitigated, that of earnings losses and decreases avoidance is reduced, but the extent of earnings aggressiveness is increased.