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EDITORIAL
Corporate social responsibility (CSR) is not understood in the same way by everyone. For those who do not consider ethical deliberation or conduct to be intrinsic to doing business, it is often regarded as a drain on management and resource, at cost to profit and competitiveness. The more receptive may consider the CSR agenda to be a necessary cost to business, particularly in an age of social media, where reputation and public opinion matter. In recent years, more enlightened views have been articulated by business leaders. Taking CSR seriously is fundamental to building and sustaining public trust, as well as investor confidence. It is also a means of attracting talent and motivating staff, as even monetary gain is not impervious to the law of diminishing marginal utility. Not surprisingly, there are now rankings for the world’s most ethical companies, such as the annual list put forward by the Ethisphere Institute.

As a matter of public interest, advancing the CSR agenda is important. Corporations have a critical role in developed economies, and their presence will grow as domestic markets become more integrated with the international economy. A problem is that the CSR agenda is not always clear. At a basic level, corporations must observe their legal obligations. Possessing a legal personality, corporations can sue and be sued, and in some jurisdictions, they can incur criminal liability. But the presence of a distinct legal personality does not mean that individual employees and the management of corporations are beyond scrutiny. In some instances, legal liability could pierce the “corporate veil” and be attributed to a corporation’s management or shareholders. While a concern over potential legal liability could influence corporate culture, it is not (and should not be) the determinant of the corporation’s shared attitudes, values and philosophy. At a higher level, the moral or ethical personality of a corporation is shaped by its corporate culture and aspirations, as well as its ability to balance economic interests with the expectations of those affected by its actions. However, expectations could be extremely varied among different stakeholders and in relation to different industries. A broad discussion platform is often required for promoting dialogue across different silos and in setting realistic expectations. Where health and healthcare are concerned, this was an intended function of the World Health Summit Regional Meeting that was held in Singapore from 8 to 10 April 2013. The featured papers in this edition are intended to continue some of the discussions taken up at that forum.

Michael Gusmano, a research scholar with one of the oldest bioethics centers in the United States (US) and among the most recognized institution on bioethics internationally, provides an account of how the notion of hospital community benefits emerged. For health care organizations in the US, their CSR is to a large extent defined by a broad definition of community benefit. But what should count as benefit is not always clear. The difficulty in determining ethically appropriate and fair benefits in clinical trials conducted across different jurisdictions is discussed in the next paper by Karel Caals and myself. Although there is no standard definition of “fair benefits” that research participants should receive, a number of considerations are set out to guide deliberation on this question. Closely related to the subject of clinical trials are issues relating to access to medicines. As Klaus Leisinger and Anita Wagner observe, more than two billion people in low- and middle-income countries lack adequate access to essential medicines. In their paper, they propose a framework that defines a pharmaceutical company’s corporate responsibilities (in terms of actions that must be done, that ought to be done, and that can be done) and make recommendations on strategies to improve access to medicines. These authors write with especial authority. Klaus Leisinger is the chair of a foundation of one of the world’s largest pharmaceutical company and, as a scholar, has published extensively on CSR. Anita Wagner has vast experience with the subject of access to medicines and her (as well as her organization’s) expertise is recognized internationally. The final feature paper is a contribution by myself, and it is intended as an invitation for pharmaceutical companies and their stakeholders to re-consider their CSR agenda in solidaristic terms. This may seem an obvious point to make, but the extent to which other stakeholders have ownership of a pharmaceutical company’s CSR initiatives is as yet unclear. Perhaps finding solidarity is a good place to start.

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