Ethical Considerations in the Use of Direct-To-Consumer Advertising and Pharmaceutical Promotions: The Impact on Pharmaceutical Sales and Physicians

The influence of direct-to-consumer advertising and physician promotions are examined in this study. We further examine some of the ethical issues which may arise when physicians accept promotional products from pharmaceutical companies. The data revealed that direct-to-consumer advertising is likely to increase the request rates of both the drug category and the drug brand choices, as well as the likelihood that those drugs will be prescribed by physicians. The data further revealed that the majority of responding physicians were either neutral or did not feel that accepting some types of gifts from pharmaceutical companies affected their ethical behaviors.     

Understanding how attitudes affect physician compliance with legal behavioral constraints

The following study investigates how physicians in one state (Illinois) attitudinally cope with a recent law mandating physician behaviors. Specifically, this study focuses on OB/GYN physician compliance with The Sexual Assault Survivors Emergency Treatment Act (Public Law 92-156, 2002), which requires hospitals in the state of Illinois to have an approved plan for treating sexual assault survivors. What makes this research setting interesting are the potential linkages between the legal mandate, physician attitudes, and the ongoing controversy concerning abortion. The results of a census of OB/GYN physicians within the state suggest (1) this physician group is largely supportive of the letter and spirit of this law, (2) the emerging attitude models such as Perugini and Bagozzi's (2001) MGB model explaining the formation of behavioral intentions must be treated with caution when generalizing to situations mandating legal behaviors, and (3) moderating influences such as attitude strength and religiosity have no apparent effect in how attitudes relate to physician motivation to comply with such laws. The managerial and research implications of the reported study are presented and discussed.     

Therapy,Enhancement, and Medicine: Challenges for the Doctor–Patient Relationship and Patient Safety

There are ethical guidelines that form the foundation of the traditional doctor–patient relationship in medicine. Health care providers are under special obligations to their patients. These include obligations to disclose information, to propose alternative treatments that allow patients to make decisions based on their own values, and to have special concern for patients’ best interests. Furthermore, patients know that these obligations exist and so come to their physicians with a significant level of trust. In this sense, therapeutic medicine significantly differs from straightforward business practices such as the buying and selling of houses, cars, cell phones, etc. However, we argue that this relationship differs when medicine is used for enhancement rather than therapy. When patients seek enhancements they are not as vulnerable as when they are ill. And in an enhancement setting, physicians have little role outside of medical risks to discuss motivation and alternatives. Therefore, we conclude that a more reasonable alternative may be for doctors and patients to use ethical norms associated more with straightforward business practices, specifically sales. We believe that full disclosure of this different set of norms will benefit both physicians and patients.     

Covenants and Small Business Lending: The Finnish Case

This study examines the use and determinants of covenants in Finnish small firms' loans. The results show that 72 of the 642 loan contracts examined include at least one covenant. Negative covenants are more common than affirmative covenants in our sample. We use loan characteristics, firm characteristics, and bank relationship variables to explain the use of covenants. Our results suggest that loans with real estate collateral are less likely to contain covenants than loans with other types of collateral. Larger firms are more likely to offer covenants, while the inverse holds for manager-owned firms. Firms with high corporate leverage, a high level of investments and a high sales growth rate offer covenants more often than other firms. Bank relationship length, changes of main bank and interbank competition also affect the use of covenants.     

Mitigation of Moral Hazard and Adverse Selection in Venture Capital Financing: The Influence of the Country's Institutional Setting

A venture capitalist (VC) needs to trade off benefits and costs when attempting to mitigate agency problems in their investor‐investee relationship. We argue that signals of ventures complement the VC's capacity to screen and conduct a due diligence during the preinvestment phase, but its attractiveness may diminish in institutional settings supporting greater transparency. Similarly, whereas a VC may opt for contractual covenants to curb potential opportunism by ventures in the postinvestment phase, this may only be effective in settings supportive of shareholder rights enforcement. Using an international sample of VC contracts, our study finds broad support for these conjectures. It delineates theoretical and practical implications for how investors can best deploy their capital in different institutional settings while nurturing their relationships with entrepreneurs.     

Non-compete agreements: How fiduciary duty and covenants not to compete restrict managers’ mobility

Companies spend time and money training employees; in the case of a merger or acquisition, they spend resources such as cash, stock, and debt. It makes sense, then, that they do not want an employee to take the expertise the company underwrote to a competitor. Thus, employment contracts will often include non-compete clauses—sometimes known as covenants not to compete—which state that the employee cannot move to a competitor for a certain period of time. Though not all employees have the heightened fiduciary duty of board members and officers, they frequently have signed agreements that, at least on paper, restrict their employment mobility. Not only have officers and board members often signed such agreements as well, but they also have fiduciary duties further restricting their new employment plans. In decades of teaching courses in the legal environment of business as well as in business ethics, no topic flummoxes students more than this one. After all, in a free country, a person should be able to work where they wish, right? How can such restrictions be fair? Legally and ethically, this is a complicated area and one in which the old lawyer’s answer—it depends—is true. This article provides some parameters for employees and employers to know when fiduciary duty precludes certain employees from moving to a new company, including when those are legal in what ways they are fair.     

Customer perception and response to ethical norms in legal services marketing

The study here examines the relationship between ethical marketing norms, relationship quality (RQ), and commitment in the context of legal services. Through a survey of customers of legal services providers in Malaysia, data were collected. Results from a standard analysis of data show that the four dimensions of ethical marketing norms contribute significantly and explain a significant amount of variance in RQ and commitment. The results further show that three dimensions of ethical norms namely price and distribution norm, information and contract norm, and general honesty and integrity norm are significantly associated with relationship quality and commitment. Product and promotion norm has no significant relationship with relationship quality and commitment. RQ plays a mediating role in the relationship between marketing norms and commitment. The study reveals that the same three dimensions of marketing norms predict both RQ and commitment, and are useful for effective legal services marketing. These findings lead to research, managerial, contextual and policy implications that conclude the paper.     

When does Ethical Code Enforcement Matter in the Inter-Organizational Context? The Moderating Role of Switching Costs

Drawing on signaling theory, we suggest that a supplier’s enforcement of ethical codes sends signals about the supplier that affect a buyer’s decision to continue their commitment to the supplier. We then draw on side-bet theory to hypothesize how switching costs influence the importance of a supplier’s enforcement of ethical codes in predicting a buyer’s continuance commitment to a supplier. We empirically test our model with data from 158 purchasing managers across three manufacturing industries. Results confirm the connection between ethical code enforcement and continuance commitment, but suggest that a supplier’s enforcement of ethical codes matter less when switching suppliers is perceived as too costly.     

Ethics and Law: Guiding the Invisible Hand to Correct Corporate Social Responsibility Externalities

Tokenistic short-term economic success is not good indicia of long-term success. Sustainable business success requires sustained existence in a corporation’s political, economic, social, technological, legal and environmental contexts. Far beyond the traditional economic focus, consumers, governments and public interest groups alike increasingly expect the business sector to take on more social and environmental responsibilities. Corporate social responsibility (CSR) is the model in which economic, social and environmental responsibilities are fulfilled simultaneously. However, there is insufficient empirical evidence that demonstrates genuine widespread adoption of CSR in practice, and its underlying reasons. Though research in CSR has been rapidly growing, its commercial reality and implications need to be further improved if it is to inspire corporations to voluntarily adopt CSR. In the literature, Carroll’s four-dimensional (economic, legal, ethical and discretionary) CSR framework offers a theoretical basis for developing an empirically based model to explain why and how profit-motivated managers take up CSR voluntarily. Our study has developed a structural equation model to identify the key factors and their interactions that influence economically motivated managers to take on voluntary CSR, and validate Carroll’s four-dimensional construct. The results support Carroll’s four-dimensional CSR framework, with the exception of the link pertaining to the relationship between economic and discretionary/voluntary responsibility. This characterises the economic reality that financial market-driven economic responsibility does not automatically translate into social responsibility. Nevertheless, the empirical results demonstrate that corporations can be led to engage in more voluntary CSR activities to achieve social good when appropriate legal and ethical controls are in place.     

Ethics and Equity: Enforcing Ethical Standards in Commercial Relationships

Lawyers and the legal system have been much criticized in recent years. Despite popular perceptions, the legal system contains numerous mechanisms and rules designed to ensure fair results. This paper shows how the legal system tries to implement, in commercial transactions, the ethical principles of truthfulness and fairness. The Anglo-American development of Equity Courts is reviewed briefly. Several examples of the Law's enforcement of ethical principles are presented, in four different legal areas: Contracts, Securities, Goods, and Real Estate. The intent here is to present an overview of the problem, with area-specific illustrations, rather than a comprehenisve examination of the cases in just one area.     

A reexamination of the Internal Auditors' Code of Ethics

This study empirically examined the views of Certified Internal Auditors (CIAs) concerning the role of Code of Ethics for members of the Institute of Internal Auditors. It is a continuation of an earlier study which examined the usefulness of the Code to CIAs. Among the questions asked were what is the primary reason for the Code of Ethics, how useful is it, have you used it, should more enforcement actions be taken against members who violate the Code, and what are the legal and moral responsibilities of the CIA to report serious ethical violations, e.g., environmental pollution, to outsiders when top management and the board of directors are aware of the matter but are not doing anything to correct it. The results indicate strong support for the Code, its enforcement, and use as an instrument to encourage the internal flow of ethical behavior by embers and others.Philip H. Siegel is currently the Fiesta Mart Professor of Accounting at the University of Houston-Downtown. Formerly the Coopers & Lybrand Professor at San Francisco State University, Dr. Siegel received his Ph.D. in 1985. He holds CPA certification in Florida.John O'Shaughnessy is Associate Professor at San Francisco State University. Currently the Director of the Internal Audit Program at SFSU, Dr. O'Shaughnessy received his Ph.D. in 1990. He holds CPA and CIA certification.John T. Rigsby is Associate Professor at Mississippi State University. Author of numerous papers published in leading academic journals, Dr. Rigsby received his Ph.D. in 1986. He holds CPA certification.     

Ethical judgment in business: culture and differential perceptions of justice among Italians and Germans

This study focuses on the cultural context of ethical decision making by considering the relationship between power distance and ethical judgment. Specifically, we propose that this relationship exists because of the influence of peers on ethical judgment and perceptions of justice. Considering the importance of peers in stage three of Kohlberg's model of moral development, we argue that peers are the basis for social comparisons, social cues and social identification and, hence, are critical to an individual's beliefs about justice. Using scenarios developed by Reidenbach and Robin, data were collected from German and Italian graduate business students. Germany and Italy differ substantially in power distance, but not in the three other cultural dimensions of Hofstede. Results show that the ethical assessment of the respondents from the two countries differs when justice criteria are used. Theoretical and practical implications of the results are discussed.     

Accounting and Medicine: An Exploratory Investigation into Physicians’ Attitudes Toward the Use of Standard Cost-Accounting Methods in Medicine

Research studies demonstrate wide variation in how physicians diagnose and treat patients with similar medical conditions and suggest that at least some of the variation reflects inefficiencies and unnecessary medical costs. Health care researchers are actively examining ways to reduce variations in practice through standardization of medicine to reduce the cost of treatment and ensure the quality of outcomes. The most widely accepted form of this standardization is Evidence Based Best Practices (EBBP). Furthermore, financial health care providers such as hospitals and managed care organizations are investigating methods to tie resource usage to medical protocols in their efforts to monitor and control health care costs. Such proposals are contentious because they report on physicians’ medical practice behaviors (such as the number of tests ordered, use of specific therapies, etc.) and such reports could potentially be used to influence their clinical behaviors. The intent of this exploratory study was to examine physicians’ perceptions about linking a standard costing system to EBBP guidelines. The authors interviewed nine practicing physicians asking each physician to respond to the question, ‘As a physician working in a hospital environment, what are your reactions to and concerns with combining standard costing techniques with EBBP?’ The interviews were in-depth and free form in nature. The physicians’ responses were recorded and analyzed using Grounded Theory Methodology. Using this methodology the field data was categorized into two major themes. The most important theme centered on ethics and the second theme was concerned with the implementation and use of a standard cost system in regard to EBBP. If physicians’ worries about ethical dilemmas and implementation issues are not resolved, then it is likely that doctors would be unwilling to participate in any efforts to develop or use a standard cost-reporting system in medicine. While this study was exploratory in nature, it should provide future guidance to accountants, health care researchers and health care providers about physicians’ issues with the use of standard costing methods in medicine.     

When Kamay Met Hill: Organisational Ethics in Practice

The Kamay and Hill insider trading conviction in Australia highlights many of the issues and problems involved in the prevention, detection and prosecution of insider trading. The case uniquely highlights how ethical behaviour is instilled at home, in school and in society, and the need for ethical responsibility at the personal and organisational level to complement legal rules and enforcement. We use the Kamay and Hill case to explore the reasons behind the failure of the traditional top-down approach to insider trading prevention, where institutional ethical codes of conduct largely reflect and rely upon national rules, norms, and regulation. We propose a bottom-up approach to ensure that individual and organisational behaviour is ethical, where emphasis is not on compliance but on a set of core ethical values that allow individual and corporate expression. It is our strong belief that compliance cannot replace ethics.     

Ethical Reasoning in an Equitable Relief Innocent Spouse Context

This study assessed the relationship between ethical reasoning and the decision to grant equitable relief using an innocent spouse vignette where a wife had partial knowledge of her husband's tax fraud. A path model derived from various ethics theories was tested using a sample of 357 accounting, legal, and human resource professionals, and after careful examination of the measurement and structural relationships in the path model, the results provided partial support for the study's hypotheses. Moral intensity was marginally associated with an increased recognition of an ethical issue and positively related ethical judgments made in an innocent spouse situation, and moral intensity was also negatively related to the decision to grant relief. The ethical judgment variable was positively related to the decision to grant relief, while ethical issue awareness was marginally associated with the decision to deny relief. The implications of these findings are discussed, along with the limitations of the study and suggestions for future research.     

Hospital demand for physicians

This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines.     

Determinants of Ethical Behavior: A Study of Autosalespeople

This study proposes a model that explains the ethical behavior of automobile salespeople in terms of their ethical perception, legal perception, method of compensation (commission-based or salary-based), age, and education. The model is estimated by using five scenarios that involve ethical issues commonly found in the automobile industry and responses from 184 automobile salespeople in a mid-Atlantic metropolitan area. The findings suggest that ethical perception is the most important determinant of ethical behavior. Also, method of compensation is a major determinant in four of five scenarios, and legal perception in two out of five scenarios. However, age and education are not significantly related to ethical behavior. A discussion of the results, limitations, and implications is presented for managers.     

‘The Impact of Corporate Ethical Values and Enforcement of Ethical Codes on the Perceived Importance of Ethics in Business: A Comparison of U.S. and Spanish Managers’

This two country study examines the effect of corporate ethical values and enforcement of a code of ethics on perceptions of the role of ethics in the overall success of the firm. Additionally, the impact of organizational commitment and of individual variables such as ethical idealism and relativism was examined. The rationale for examining the perceived importance of the role of ethics in this manner is to determine the extent to which the organization itself can influence employee perceptions regarding ethics and social responsibility. Results indicate that all of the variables tested, except relativism, impacted upon one’s perceptions of the importance of ethics and social responsibility. Perceptions of the importance of ethics and social responsibility also varied depending upon country of residence with the U.S. sample having somewhat higher perceptions concerning the importance of ethics and social responsibility than their counterparts in Spain. Furthermore, when comparing the two samples, the U.S. sample had significantly higher corporate ethical values, greater enforcement of ethical codes, less organizational commitment and both lower idealism and relativism.     

Corporate social responsibility and employee attitudes: The moderating role of employee age

This study examines the role of corporate social responsibility (CSR) on employee engagement and job satisfaction. Using 322 responses from employees of selected companies in Ghana, and employing hierarchical regression analysis, the study examines the direct impact of economic, legal, ethical and discretionary CSR practices on employee satisfaction and engagement in organisations. The study further explores the moderating role of employee age on the relationship between CSR and employee engagement and satisfaction. The results provide evidence that economic, legal, ethical and discretionary CSR practices influence higher employee engagement and satisfaction levels at work. However, the study finds no evidence of employee age moderating the association between each of the four CSR dimensions and employee job attitudes (engagement and satisfaction). These findings are insightful and provide a response to calls for research on these issues. The study contributes to the literature by demonstrating that ethical CSR practices strongly influence employees' satisfaction and engagement levels; legal and discretionary CSR activities also have an influence, though to a lesser extent; and the economic dimension of CSR activities has the least impact. The managerial, practical and further research implications of these findings are discussed.     

The case against Microsoft: An ethical perspective

This paper discusses the complex Microsoft anti-trust trial and the company 's questionable behavior during the browser wars with Netscape.It reviews the essentials of the legal case against Microsoft along with the company 's efforts to refute the charges against it, including the presumption of monopoly power. After laying the groundwork by providing conceptual background on the notion of fair competition, the paper turns to an ethical analysis of Microsoft 's conduct. We conclude that Microsoft 's behavior was excessively opportunistic during the browser wars.The company did not compete constructively or positively, but instead sought to undermine the competitive process.It also developed biased software code that tilted the playing ?eld in its direction.These actions caused harm to the company 's stakeholders by obstructing consumer choice and impeding innovation.