This thesis analyses information disclosure in clinical practice from a legal, ethical and professional perspective. It examines therapeutic privilege, the duty of candour and the application of virtue ethics to truth-telling in nursing practice. I argue that each of these areas requires further clarity, articulation and application in order to assist the decision-making process of health care professionals and improve disclosure practices. In analysing these areas this thesis recognises the context of disclosure practices in relation to respect for patient autonomy and trust in the patient-health care professional relationship. The first published paper at the core of this thesis considers the status of therapeutic privilege in English law and concludes that further clarification is needed to establish its legitimacy. I argue that the shift in English law towards a disclosure standard judged by reference to the reasonable patient requires a doctrine of therapeutic privilege. There are strong ethical arguments in favour of information disclosure, particularly founded on respect for patient autonomy. As such, further clarification is needed to identify and define the grounds on which this exception exists, when the information can lawfully be withheld and how this exception extends to the rest of the health care team, particularly nurses. The second paper examines the ethical and practical considerations that underpin the disclosure of medical errors to patients. This provides a foundation for a discussion of how the law can best support a duty of candour. I argue for the introduction of a statutory duty of candour and analyse the current legal mechanisms and proposals for addressing this issue. The final paper argues that virtue ethics is a useful approach from which to explore decisions relating to information disclosure. Its explicit focus upon moral character, the role of emotion, intention and the importance of practical judgement are considered from the nurse's perspective. This thesis contributes to the dialogue on information disclosure on a number of levels. In terms of methodological approach, it recognises the importance of the synthesis of law and ethics in addressing issues in clinical practice. It uses an interdisciplinary approach, incorporating both legal and ethical perspectives, to examine the substantive questions as well as incorporating reference to empirical research to further underpin its normative claims. Moreover, this thesis considers the nursing perspective in relation to issues of information disclosure to explore the role of the nurse in decision-making regarding disclosure practices.

<p>The increased use of information disclosure in environmental policy raises questions of whether and how provision of information motivates changes in behavior. Accurate assessment of the value of information provision in reducing environmental risks requires understanding how actors respond to risk information. Chapter two examines the effects of disclosure of information on risk perception, knowledge about risks, and actions to mitigate risk from arsenic in private drinking well water. We conduct an experiment where we manipulate how information about the health risks posed by arsenic in drinking water is presented to users of private wells. This is one of the first field experiments to look at framing effects for long-term, latent environmental health risks. In contrast to much of the existing literature, we find that information frame does not affect risk perception or actions taken to address risk for low level of risk. </p><p>Chapter three examines how risk perceptions are affected by variations in risk communication, specifically addressing questions raised in the field experiment. We conduct an experiment about the health risks posed by arsenic in drinking water and introduce four manipulations in communication with experimental subjects: arsenic level, information framing, bright lines and relative risk. Chapter three suggests careful consideration must be taken in designing the disclosure of moderate levels of risk to ensure that information disclosure programs effectively convey health-based recommendations. Without these considerations, information disclosure programs may unwittingly and unnecessarily heightening concern among people facing moderate levels of risk. We consider this finding especially important because a broad number of environmental and environmental health risks that are currently unregulated pose moderate levels of risk. </p><p>The final chapter asks if the act of disclosing information changes the behavior of those who provide the information. Chapter four seeks to determine the degree to which information disclosure, in the form of TRI, results in improvements in environmental performance. Our work isolates the effect of information disclosure by using changes in the TRI reporting requirements to help identify the causal effect of disclosure from other potential explanations of changes in environmental performance. We find limited evidence that facilities newly reporting for a chemical have greater proportional decreases in total releases. The policy implications of Chapter 4 suggest that information disclosure should not be considered a substitute for regulation of toxic chemicals.</p> / Dissertation

The objectives of this research are, first to develop a greater understanding of open book management, secondly to survey the current national status of open book management, and thirdly to conduct a preliminary examination on how employee attitudes are directly influenced by the open book management intervention. In this study, a questionnaire survey is conducted on 307 middle-level managers. The data is used to analyze the influence of the open book management over organization commitment and job satisfaction; then individual control variables, as well as business literacy training and pay-for-performance of the open book management are included as intervening variables to examine the effect. The study findings include the following five aspects. First, the domestic companies are more conservative in the financial disclosure. Second, the financial disclosure has positive effect on intrinsic job satisfaction and this effect is reinforced if companies implement pay-for-performance programs. Third, unless companies implement pay-for-performance programs, the financial disclosure would have no effect on recognition to the organization and extrinsic job satisfaction. Fourth, financial disclosure has positive effect on centripetal force to the organization but no significant effect after taking the intervening variables into account. It means that the centripetal force to the organization is not influenced regardless of the increased level of financial disclosure or implementation of pay-for-performance programs. Fifth, the hypothesis that the effect of business literacy training will influence the relationship between financial disclosure and employee attitude is not confirmed

Information transparency enhances corporate governance. In an attempt to reduce the information asymmetry between business insiders and outsiders and to allow outsiders to have more information for decision making by disclosing more corporate information voluntarily, the Taiwan Stock Exchange Corporation (TSEC) and Over-The-Counter Securities Exchange (OTCE) requested the Securities & Futures Institute (SFI) to implement an information disclosure and evaluation system for all publicly traded and OTC companies listed in TSEC. This study investigates the effects of the system on decision behavior of the investors, analysts, and auditors. Empirical results indicate that investors¡¦ ability of future earnings evaluation increases, analysts¡¦ earnings forecasts are more accurate, and the earnings forecasts dispersion among the analysts decreases after the system has been implemented. However, the implementation of the system has no effects on the types of audit opinion issued by auditors. Besides, the analysts¡¦ earnings forecasts are more accurate for the ¡§more transparent¡¨ companies. However, the differences of future earnings evaluation, earnings forecasts dispersion among the analysts and types of audit opinion between ¡§more transparent¡¨ and ¡§less transparent¡¨ companies are not significant. These results may provide implication to authorities for making related policies.

This dissertation consists of three essays linking the business models of rating agencies to the rating decisions these agencies make as market intermediaries between buyers and sellers. The first study examines the link between a rating agency‟s primary revenue source and its rating decisions. Theoretically, rating payments could influence rating agency decisions or be counterbalanced by reputational rewards for rating accuracy. I explore this relationship in U.S. corporate credit ratings, where some agencies are primarily paid by bond issuers (sellers) and others by investors (buyers). Analysis of a balanced panel of 338 companies rated between 2005 and 2009 reveals that agencies produce differing ratings consistent with the preferences of their paying customers. Changes in buyer-paid ratings are more frequent and generally precede corresponding seller-paid rating changes. Seller-paid ratings are slower to incorporate negative information, particularly for rated firms in the financial services sector and firms with ratings above a critical grading cutoff. The second study complements the first by estimating the gap between the rating information disclosed by sellers and the information sought by buyers, again using evidence from U.S. corporate credit ratings. While seller willingness to pay for an additional rating is highly concentrated among a subset of relatively high-quality firms, buyers demonstrate more uniform interest in additional ratings for firms at all quality levels. This finding highlights an information gap among high-risk firms that is not a major focus of existing regulation. The third study focuses on rating decisions by government rating agencies, an alternative rating model to those examined in the first two studies. The empirical setting is Canadian film classification where the existence of multiple regional regulators has been justified by claims of variation in community standards. I find significant and increasing consistency in the regulatory decisions of these agencies, suggesting institutional isomorphism that brings into question the persistence of the parallel regional structure. Overall, these studies provide new empirical insight into the relevance of rating agency heterogeneity to firm strategy and policy. The findings may also be relevant to a variety of other settings involving information disclosure such as environmental impact and corporate social responsibility.

This dissertation consists of three essays linking the business models of rating agencies to the rating decisions these agencies make as market intermediaries between buyers and sellers. The first study examines the link between a rating agency‟s primary revenue source and its rating decisions. Theoretically, rating payments could influence rating agency decisions or be counterbalanced by reputational rewards for rating accuracy. I explore this relationship in U.S. corporate credit ratings, where some agencies are primarily paid by bond issuers (sellers) and others by investors (buyers). Analysis of a balanced panel of 338 companies rated between 2005 and 2009 reveals that agencies produce differing ratings consistent with the preferences of their paying customers. Changes in buyer-paid ratings are more frequent and generally precede corresponding seller-paid rating changes. Seller-paid ratings are slower to incorporate negative information, particularly for rated firms in the financial services sector and firms with ratings above a critical grading cutoff. The second study complements the first by estimating the gap between the rating information disclosed by sellers and the information sought by buyers, again using evidence from U.S. corporate credit ratings. While seller willingness to pay for an additional rating is highly concentrated among a subset of relatively high-quality firms, buyers demonstrate more uniform interest in additional ratings for firms at all quality levels. This finding highlights an information gap among high-risk firms that is not a major focus of existing regulation. The third study focuses on rating decisions by government rating agencies, an alternative rating model to those examined in the first two studies. The empirical setting is Canadian film classification where the existence of multiple regional regulators has been justified by claims of variation in community standards. I find significant and increasing consistency in the regulatory decisions of these agencies, suggesting institutional isomorphism that brings into question the persistence of the parallel regional structure. Overall, these studies provide new empirical insight into the relevance of rating agency heterogeneity to firm strategy and policy. The findings may also be relevant to a variety of other settings involving information disclosure such as environmental impact and corporate social responsibility.

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This thesis looks at the economics of mass media from a variety of perspectives. The main aim is to analyse the key factors that influence media reporting behaviour, and in turn the impact of reportage on individual decision-making processes. The first chapter provides a brief summary of the contextual background of this thesis, by presenting the main points tackled in the subsequent chapters as well as a concise overview of the main contributions across various fields of study. The second chapter explores the relationship between advertisers and the media using a simple model of horizontal and vertical product differentiation in a duopolistic setting. In this framework, when a news story is published one firm will benefit in terms of higher consumer demand and profits, while the other will suffer. Firms can influence the media's decision to publish the news story or withhold it via advertising expenditure. The main result shows that in equilibrium when news signals conform to people's prior beliefs, extreme or strong stories will be withheld from publication by the media. This is because strong stories will result in a drastic decline in profits for one firm, thus providing it with an incentive to switch over and change its production process to mimic the other (beneficiary) firm, thereby eliminating vertical product differentiation. Therefore, the beneficiary firm would have an incentive to ensure that the news story is withheld to prevent this increase in competition and the subsequent erosion of its profit margins. The results provide an alternative rationale to explain recent evidence on under-reporting by the U.S. media in relation to various issues like climate change and the nutritional content of food. The third chapter looks at the responsiveness of individual private behaviour to media coverage of a particular news story. Survey data on charitable gift-giving in the U.S. are used in order to analyse the impact of newspaper coverage of the 2004 Indian Ocean tsunami on both the likelihood and magnitude of monetary disbursements towards the relief effort. The identification strategy employed in this paper exploits differences in county-level growth rates of violent crime in order to account for the variation in newspaper coverage of the tsunami, thus circumventing potential endogeneity problems. The results show that media coverage only had a modest effect on people's decision to donate or not, but conversely had a significant and non-trivial impact on the amount of money donated. Furthermore, this impact was larger for young adults within the 25-34 age bracket and individuals who had undertaken some form of voluntary work in the previous year. These results hold even after the implementation of various robustness tests, and serve to highlight the growing influence of the media on people's behaviour. The final chapter analyses the impact of media reports on electoral outcomes, and in particular the extent to which soft or sensationalist news reportage influences voting. Survey data on individual voting behaviour during the 2000 U.S. Presidential election is used, together with a novel dataset on the amount of coverage afforded to the Monica Lewinsky scandal over the period January 17, 1998 to August 31, 2000. We first show that Lewinsky coverage was not driven by the newspapers' political bias, but rather by other factors including tabloid journalism. This independence enables us to focus solely on the impact of media reports on voting, in contrast to the rest of the literature which deals with the electoral influence of politically-biased media outlets. We then look at how newspaper coverage of the Lewinsky scandal influenced voting patterns in the 2000 U.S. Presidential election. To account for potential endogeneity issues we use county-level variation in the number of deaths caused by extreme weather events as an instrument for Lewinsky articles. We find that media coverage of the scandal had a positive and statistically significant impact on the likelihood of voting for George W. Bush, and conversely a negative influence on the probability of voting for Al Gore: this pattern is visible among both Democrats and Republicans. The results are robust to various tests, and raise several questions regarding the media's role within the democratic process.

We examined the arrest experience and information disclosure of parents arrest to 17 children of incarcerated parents and their caregivers. Using in-depth interviews with children and their caregivers, data were gathered on the experience of children during their parents’ arrest, and how information on parents’ arrest was disclosed to children who were not available during their parents’ arrest. Analyses of interview transcripts thematically showed that 6 out of the 17 children were available during the arrest of their parents. This happened as police officers did not make enquires on presence of children before arriving at their arrest venue. Further, most of these children were exposed to their parents been violently treated by police officers which had emotional effect on them, while some retain vivid memories of the arrest. Our results also suggest that, there was little or no preparation of children who were not available during their parents’ arrest psychologically for the receiving of information on their parents’ arrest. As some got to know about their parents’ arrest while in school, others got to know through teasing by their friends as their caregivers lied to them concerning their parents’ whereabouts. Disclosure of information on parents’ arrest to children led to some children been emotionally traumatized. In comparison of children with incarcerated mothers to children with incarcerated fathers, children with incarcerated mothers were more likely to have witnessed the arrest of their mothers. Implications for these findings are discussed in the study.

京都大学 / 0048 / 新制・課程博士 / 博士(地球環境学) / 甲第18486号 / 地環博第120号 / 新制||地環||25(附属図書館) / 31364 / 京都大学大学院地球環境学舎地球環境学専攻 / (主査)教授 宇佐美 誠, 教授 ショウ ラジブ, 准教授 森 晶寿 / 学位規則第4条第1項該当 / Doctor of Global Environmental Studies / Kyoto University / DFAM