Unintended Negative Consequences Research Articles

Do No Harm in Global Health Engagement.

This manuscript examines the principle of "Do No Harm" in DoD Global Health Engagement (GHE) efforts. It highlights the potential positive and negative consequences of health investments and explores how unintentional harm is addressed in a global health context. The manuscript also discusses the involvement of the U.S. military in global health and the concept of dual loyalty faced by military GHE practitioners. The goal is to understand the challenges of doing no harm and identify methods to mitigate or avoid unintended negative consequences in DoD GHE activities.

The Pitfalls of Review Solicitation: Evidence from a Natural Experiment on TripAdvisor

This study examines the effect of firms’ participation in platform-endorsed review solicitation programs on consumers’ online review generation. We leverage a natural experiment on TripAdvisor, which launched a review solicitation program that allows hotels to collect reviews directly from guests after their stays with the aid of certified connectivity partners. Applying a two-stage difference-in-differences approach to a panel data set of online reviews for a matched set of hotels across TripAdvisor and Expedia, we find that hotels’ participation in the review solicitation program results in a 34.3% increase in review volume, a 0.151 increase in review rating, but a 16.9% decrease in review length. Review solicitation, however, generates a notable negative spillover effect on the volume of organic reviews. Specifically, the volume of organic reviews is reduced by 15.5% after hotels start soliciting reviews. We provide evidence that the motivational crowding-out effect plays an important role in driving this negative spillover. Further analyses reveal that the effects of review solicitation are heterogeneous with respect to hotels of different types and consumers with different demographic and behavioral characteristics. Finally, using a novel structural topic model, we detect a significant shift in review content from specific and concrete topics to general and abstract topics. Our findings suggest that review platforms and firms should be cautious about the unintended negative consequences of review solicitation on consumers’ review generation. This paper was accepted by Hemant Bhargava, information systems. Funding: This work was supported by the National Natural Science Foundation of China [Grants 72371192, 72132008, 71872061, and 72061127002] and the Humanities and Social Science Fund of Ministry of Education of China [Grant 22YJA630021]. Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2023.01006 .

Exploring the Impact of In Basket Metrics on the Adoption of a New Electronic Health Record System Among Specialists in a Tertiary Hospital in Alberta: Descriptive Study.

Health care organizations implement electronic health record (EHR) systems with the expectation of improved patient care and enhanced provider performance. However, while these technologies hold the potential to create improved care and system efficiencies, they can also lead to unintended negative consequences, such as patient safety issues, communication problems, and provider burnout. This study aims to document metrics related to the In Basket communication hub (time in In Basket per day, time in In Basket per appointment, In Basket messages received per day, and turnaround time) of the EHR system implemented by Alberta Health Services, the province-wide health delivery system called Connect Care (Epic Systems). The objective was to identify how a newly implemented EHR system was used, the timing of its use, and the duration of use specifically related to In Basket activities. A descriptive study was conducted. Due to the diversity of specialties, the providers were grouped into medical and surgical based on previous similar studies. The participants were further subgrouped based on their self-reported clinical full-time equivalent (FTE ) measure. This resulted in 3 subgroups for analysis: medical FTE <0.5, medical FTE >0.5, and surgical (all of whom reported FTE >0.5). The analysis was limited to outpatient clinical interactions and explicitly excluded inpatient activities. A total of 72 participants from 19 different specialties enrolled in this study. The providers had, on average, 8.31 appointments per day during the reporting periods. The providers received, on average, 21.93 messages per day, and they spent 7.61 minutes on average in the time in In Basket per day metric and 1.84 minutes on average in the time in In Basket per appointment metric. The time for the providers to mark messages as done (turnaround time) was on average 11.45 days during the reporting period. Although the surgical group had, on average, approximately twice as many appointments per scheduled day, they spent considerably less connected time (based on almost all time metrics) than the medical group. However, the surgical group took much longer than the medical group to mark messages as done (turnaround time). We observed a range of patterns with no consistent direction. There does not seem to be evidence of a "learning curve," which would have shown a consistent reduction in time spent on the system over time due to familiarity and experience. While this study does not show how the included metrics could be used as predictors of providers' satisfaction or feelings of burnout, the use trends could be used to start discussions about future Canadian studies needed in this area.

Survival and growth of larval Pallid Sturgeon are improved by a live diet

AbstractObjectiveConservation propagation facilities in the upper basin of the Missouri River are currently experiencing inconsistent survival of first‐feeding larval Pallid Sturgeon Scaphirhynchus albus among genetic families (i.e., distinct male–female pairings). The inconsistent survival can have unintended negative consequences for genetic representation of Pallid Sturgeon that are returned to the Missouri and Yellowstone rivers. We conducted a laboratory study designed to determine whether a live diet improves survival and growth of first‐feeding larval Pallid Sturgeon.MethodsFirst‐feeding larval Pallid Sturgeon from three distinct genetic families were assigned to one of the following diets: live first instar brine shrimp (Artemia franciscana) nauplii, an Otohime dry diet, a 50–50% combination of Otohime and live first instar brine shrimp nauplii, or food restricted (no food). Mortality was evaluated at the end of each day and at the end of the trial (21 days after the onset of exogenous feeding), and individual weight (g) was measured at the end of the trial.ResultPallid Sturgeon larvae that received a live diet (either solely live first instar brine shrimp nauplii or the combined diet) experienced higher survival than larvae that were fed solely Otohime. Furthermore, there was statistical evidence that larvae receiving solely live first instar brine shrimp nauplii were heavier at 21 days postexogenous feeding than larvae that were fed either solely Otohime or the combined diet.ConclusionOur results suggest that a live diet can improve survival and growth of first‐feeding larval Pallid Sturgeon at conservation propagation facilities.

Urban flood risk management needs nature-based solutions: a coupled social-ecological system perspective

A growing number of Nature-based Solutions (NbS) has been advocated for urban flood risk management (FRM). However, whether NbS for FRM (NbS-FRM) achieves both social and ecological co-benefits remains largely unknown. We here propose and use a conceptual framework with a coupled social-ecological perspective to explore and identify such “win-win” potential in NbS-FRM. Through a scoping-review we find that ecological FRM measures are unevenly distributed around the world, and those solely targeting flood mitigation may have unintended negative consequences for society and ecosystems. In elaborating this framework with evidence from the reviewed studies, we find that NbS-FRM has the potential to provide both social and ecological co-benefits, with remaining gaps including a lack of resilience thinking, inadequate consideration of environmental changes, and limited collaborative efforts to manage trade-offs. The proposed framework shows how to move forward to leverage NbS for equitable and sustainable FRM with improved human well-being and ecosystem health.

Am I a good puppet? A review essay of Escaping Paternalism: Rationality, Behavioral Economics, and Public Policy

AbstractWhat would it truly mean to treat individuals “as real people” when designing public policies? This paper addresses this question by critically assessing the arguments put forth by Mario Rizzo and Glen Whitman’s Escaping Paternalism: Rationality, Behavioral Economics, and Public Policy (2019). Rizzo and Whitman argue that the endeavor of Behavioral Economics to reintroduce psychology into economics and to critique the narrow concept of homo economicus used by neoclassical economics was commendable. However, Behavioral Economics failed to deliver the theoretical breakaway from Neoclassical Economics that it promised. They argue that while Behavioral Economics rejects neoclassical rationality descriptively, it still adheres to it normatively, a move the authors find unjustified. The authors critique libertarian paternalism, a normative branch of Behavioral Economics, for its narrow concept of rationality, emphasizing the ambiguity in determining decision failures and true preferences. Moreover, even when it is apparent that agents are behaving erroneously, implementing policy measures to rectify the situation would be an almost impossible task or, in a worst-case scenario, could have unintended negative consequences. Overall, the book excels in scrutinizing the methodological foundations of libertarian paternalism. Building on their critique, in the final chapter of the book, the authors endeavor to outline their vision for the future of behavioral public policy. They advocate for treating humans as intricate beings rather than mere marionettes.

Leveraging healthcare standards-based improvement initiatives to support learning and continuous improvement: lessons from implementing the Ideal Clinic programme in Cape Town, South Africa

Abstract Background This paper draws on the experiences of a group of health system leaders and researchers in leading and supporting, respectively, the implementation of the Ideal Clinic Realisation and Maintenance Framework (ICRMF) in Cape Town, South Africa. The ICRMF is a national standards-based quality improvement initiative that seeks to improve the quality of care in public primary healthcare (PHC) facilities. We share lessons learned on how efforts to improve healthcare standards can be leveraged for learning and meaningful system change. Methods A three-pronged approach to improving the implementation of the ICRMF was used in 15 PHC facilities across two sub-districts. The approach included (i) nurturing trust, (ii) changing the ICRMF assessment strategy, and (iii) promoting a collaborative and collective sense-making approach to understanding performance and addressing gaps. Routine ICRMF quantitative data and qualitative feedback from both the ICRMF assessment process and routine management meetings were used to reflect on the experience of using this approach and to draw lessons. The results and conclusions were further confirmed through member-checking. Results We found that using the three-pronged approach, the ICRMF assessments were able to facilitate deep and reflexive conversations about everyday health system challenges facing healthcare delivery in the sub-districts, while encouraging collective sensemaking and collaboration. The ICRMF was often perceived as a compliance-driven exercise with limited value on the actual quality of care. The three-pronged approach helped shift some of these perceptions and improved the experiences of facility managers in implementing the programme. Conclusion When supported by trusting relationships, reflexive processes and multidisciplinary ownership and collaboration, healthcare standards programmes such as the ICRMF can provide powerful avenues for learning and meaningful change. Our limited dataset could not demonstrate if our approach addresses the challenge of maintaining standards or not (which is linked to continuous improvement).

The European energy crisis, the Dutch TTF, and the market correction mechanism: a financial markets perspective

Abstract In September 2022, the Title Transfer Facility (TTF) prices spiked at unprecedented levels. For various reasons, including the Russian invasion of Ukraine, Europe was facing an energy crisis: gas supply was significantly reduced while demand remained unchanged. Policymakers responded with a variety of measures, including regulatory interventions on the TTF market. While seeking to improve the situation in the ‘real world economy’, these measures have an important financial regulatory angle. This article investigates the potential impact of these interventions, in particular of the Market Correction Mechanism, on the wholesale gas market from a financial markets perspective. Considering, amongst others, observations from the EU Agency for the Cooperation of Energy Regulators, the European Securities and Markets Authority, and the European Central Bank, it appears that these interventions may have unintended negative consequences in light of the functioning and attractiveness of the Capital Markets Union and achieving strategic autonomy.

Good intentions meet complex realities: CITES listing of diverse frankincense (Boswellia species) might do more harm than good

Frankincense gum resin is a globally traded forest product, likely generating more than $1 billion USD in value annually for its use in perfumery, medicines, and incense. It supports thousands of rural livelihoods in Somalia, Sudan, Ethiopia, India, and several other countries, where it is harvested from Boswellia trees. Recent research indicates unsustainable practices and population declines in both heavily and minimally traded species, prompting a review by the CITES Secretariat and consideration of potential listing of the genus (or species therein) in Appendix II. We argue that each of the 24 Boswellia species faces different circumstances and challenges with respect to trade and must be treated as an individual entity rather than being lumped together as part of a homogenous multi-species entity. The trade-conservation relationship for Boswellia species is not straightforward, with both positive and negative impacts of trade apparent, and interventions must account for this. CITES as a mechanism relies heavily on the infrastructure of exporting states, some of which suffer from limited resources, severe corruption, and existing trade suspensions. These limitations make CITES listing inappropriate as a conservation and regulatory tool. Tougher standards are needed, but without aiming for simple answers, we suggest that these are better implemented through importing country regulation driving private supply chain improvements rather than through exporting country-based CITES regulations. This can avoid foreseeable unintended negative consequences for both the conservation of different Boswellia species, populations, and the livelihoods of local communities frankincense tapping has supported for thousands of years.

To stay or not to stay at home? The unintended consequences of public health advice for older adults in the context of Covid-19 and urban heat

Stay-at-home advice is one of the most widespread public health solutions to various health risks, including Covid-19 and heat stress. Authorities often direct this recommendation to adults above 65 years old, a group particularly vulnerable to multiple risks. While this advice aims to save lives, when prolonged it also comes with various negative unintended consequences. It increases older adults’ isolation and loneliness, which negatively affects their mental and physical health, as well as their wellbeing and quality of life.This article builds on the findings from two European projects that studied, respectively, Covid-19 responses and adaptation to urban heat. First, we analyze the data from semi-structured interviews about Covid-19 responses and their consequences conducted with local experts in Vienna, Austria, in 2021–22. Second, we analyze the data from focus groups on experiencing and adapting to urban heat conducted with older adults in Warsaw, Poland, in 2021.This article demonstrates why stay-at-home advice might be problematic for older adults who live alone and how it leads to their increased isolation and loneliness when it stops being a short-term measure and becomes a prolonged experience. We examine differences and similarities between the two cases to discuss the shortcomings in care for older and frail people. We argue that public health recommendations should consider the issues of temporality, sociality and inequality when re-implementing the stay-at-home advice in the future. We also demonstrate that measures focusing on community wellbeing, instead of thinking only in terms of individual health and responsibility, might be a way to address those issues.

Small-scale land-use change effects on breeding success in a desert-living social bird

Abstract Human villages in deserts can provide resources in an otherwise stark environment, potentially buffering against extreme environmental conditions. It is thus expected that breeding within these villages would result in higher fitness. However, choosing to raise offspring in these resource-rich environments may have unintended negative consequences. Here, we studied the breeding success of a cooperative breeding bird nesting in habitats with different levels of human disturbance—the Arabian babbler (Argya squamiceps), in the Negev desert of Israel. We recorded 42 breeding attempts from 15 groups between March and July 2022. We examined overall breeding success, brood size, and causes of nest failure. When nestlings were 6 days old, we also calculated daily change in body mass and adult provisioning rate. We found that despite higher resource abundance in villages, proximity to villages did not affect provisioning rate, and nestlings gained less mass at higher temperatures for all nests. Currently, there is no evidence that human villages are providing oases of resources for nesting babblers. Further, various conservation interventions (e.g., encouraging residents to keep cats indoors) could improve babblers’ overall fitness. Ultimately, we highlight how, for some desert specialists, additional resources provided by humans may not do enough to counter potential negative effects.

Public Reporting of Heart Transplant Center Performance: Promoting Clarity or Causing Confusion?

Transplant center report cards are publicly available and used by regulators, insurance payers, and importantly patients and families. In this study, the authors sought to evaluate the variability in reported public performance ratings of pediatric and adult heart transplant centers. Program-specific reports from the Scientific Registry of Transplant Recipients from 2017-2021 were used to evaluate stability, volatility, and reliability of 3 publicly reported ratings: waitlist survival (WS), getting to a faster transplant (FT), and post-transplantation graft failure (GF). There were 112 adult and 55 pediatric centers. Over the study period, nearly all centers (98%) had at least 1 change in rating in at least 1 of the tiers. The average time to the first rating change of any magnitude was 12-18months for all tiers and centers. For adult centers, the most volatile rating was WS (SD: 0.77), followed by GF (SD: 0.76) and then FT (SD: 0.57). For pediatric centers, the most volatile rating was WS (SD: 0.79), followed by both GF (SD: 0.66) and FT (SD: 0.68), which were equally volatile. All tiers except adult FT had an estimated Fleiss's kappa<0.20, indicating poor agreement/consistency across the study period. In addition, the intraclass correlation coefficient for all tiers was<0.50, indicating poor reliability. The current 5-tier reporting of transplant center performance is highly volatile and has poor reliability and consistency. Given the unintended and significant negative consequences these reports can have, critical revision of these ratings is warranted.

Addressing Non-Communicable Diseases: Unveiling “Collateral Damage” and Pursuing Solutions at the Grassroots

Public health professionals are crucial in developing strategies to prevent and manage diseases while promoting overall population health. Despite some successes in controlling diseases like smallpox and polio, the 21st century has seen a shift in disease dynamics, with non-communicable diseases (NCDs) disproportionately affecting low- and middle-income countries. These nations bear over three-quarters of global NCD-related deaths annually, posing a significant challenge to healthcare administrators. It's essential to view NCDs as unintended consequences of lifestyle decisions, allowing policymakers to reformulate policies accordingly. “collateral damage”, whether in military contexts or medicine, refers to unintended harm or negative consequences. Adverse effects like antibiotic resistance or antibiotic-associated diarrhoea illustrate this concept in healthcare. Furthermore, NCDs often result from factors outside the healthcare sector, such as poverty-driven dietary choices or inadequate urban planning, leading to sedentary lifestyles. Globalisation exacerbates NCDs by promoting unhealthy Western lifestyles, including the consumption of fast foods with inferior quality in low-income countries. Uncontrolled urbanisation further compounds the issue by fostering unhealthy behaviours. Aging populations also contribute, with elderly individuals adopting sedentary lifestyles that increase their risk of NCDs. Health promotion offers a proactive approach to address “collateral damage”, emphasising action through advocacy, policy formulation, and health education. Effective control of NCDs requires primary prevention measures like healthy diets and physical exercise, alongside public health legislation and collaborative efforts among various sectors. Preventing NCDs necessitates auditing decisions across industries to assess potential “collateral damage”s, involving the Ministry of Health and Family Welfare(MOHFW) in authorising new ventures like liquor shops or fast-food centres. While the battle against NCDs has yet to begin, concerted efforts are required to implement strategies and actions effectively and efficiently. This paper discusses innovative grassroots strategies and intersectoral collaborations that have shown promise in combating NCDs, aiming to inspire actionable solutions.

Social Media, Stereotypes, and the Acknowledgement of War Crimes

ABSTRACT Human rights activists increasingly employ social media to promote post-conflict justice and reconciliation. This study asks what role social media play in facilitating the acknowledgement of war crimes committed by members of one’s ethnicity and what the implications of mediated visibility are. It finds that people are less willing to acknowledge ingroup responsibility for war crimes on social media because they fear being negatively stereotyped by foreign audiences and reputationally undermined. The study sheds light on the unintended negative consequences of mediated visibility of war crimes and counters presumptions of digital universalism showing that implications of visibility are context dependent.

Gender considerations in One Health: a framework for researchers.

One Health research and intervention outcomes are strongly influenced by gender dynamics. Women, men, girls, and boys can be negatively affected by gender-based disadvantage in any of the three One Health domains (animal, human, and environmental health), and where this occurs in more than one domain the result may be a compounding of inequity. Evidence worldwide shows that women and girls are more likely to suffer from such gender-based disadvantage. A thoughtfully implemented One Health intervention that prioritizes gender equity is more likely to be adopted, has fewer unintended negative consequences, and can support progress toward gender equality, however there is limited evidence and discussion to guide using a gender lens in One Health activities. We propose a framework to identify key gender considerations in One Health research for development - with a focus on Low-and Middle-Income Countries. The framework encourages developing two types of research questions at multiple stages of the research process: those with a bioscience entry-point and those with a gender entry-point. Gender considerations at each stage of research, institutional support required, and intervention approaches is described in the framework. We also give an applied example of the framework as it might be used in One Health research. Incorporation of gender questions in One Health research supports progress toward more equitable, sustainable, and effective One Health interventions. We hope that this framework will be implemented and optimized for use across many One Health challenge areas with the goal of mainstreaming gender into One Health research.

Digital economy structuring for sustainable development: the role of blockchain and artificial intelligence in improving supply chain and reducing negative environmental impacts

In the current global context of environmental degradation and resource constraints, the pursuit of sustainable development has become an imperative. One avenue that holds promise for achieving this objective is the application of digital technologies, which have the potential to decouple economic growth from its carbon footprint. However, it is crucial to ensure that these technologies are designed and governed in a prudent manner, with a strong alignment to environmental priorities. This study focuses on exploring the potential roles of blockchain and artificial intelligence (AI) in supply chain coordination and impact mitigation. Furthermore, they have the capacity to incentivize recycling and circular business models, as well as facilitate carbon accounting and offsetting. To fully realize these benefits, it is essential to deploy these technologies within inclusive collaborative frameworks that take into consideration social and ecological considerations. The study also offers policy recommendations that highlight key leverage points for digital innovation, enabling countries to embark on smart and green industrial transformation pathways. By harnessing the potential of blockchain and AI in supply chains, governments can promote transparency, traceability, and accountability, thereby fostering sustainable practices and reducing environmental impacts. Incorporating blockchain and AI technologies into supply chain approaches leads to a substantial improvement in efficiency, as demonstrated by a numerical analysis. In conclusion, the integration of innovative digital technologies offers significant opportunities to optimize production systems and economic activity while prioritizing sustainability objectives for the betterment of society and the environment. These technologies have the potential to mitigate environmental externalities by addressing information imbalances within global supply chains. However, it is essential to prioritize inclusive governance that emphasizes democratic participation to mitigate any unintended negative consequences, especially for vulnerable communities. By ensuring inclusive decision-making processes, we can maximize the positive impact of these technologies while minimizing potential harm.

Dorm-preneurship as Entrepreneurial Living and Learning: An Educational Design Ethnography

Entrepreneurship residence halls/dorms have been appearing on more and more campuses, especially in the United States and Canada. However, there is a very thin knowledge base on which to construct and design these expensive campus facilities/programs. Sometimes called “dormcubators,” these facilities/programs are linked to both the university business incubation (UBI) and living-learning communities (LLC) movements. As a result, the design and delivery of these hybrid spaces/programs can be oriented toward achieving economic (i.e., starting companies), social (i.e., building communities), and/or educational (i.e., entrepreneurial learning) outcomes. Prior research on other kinds of post-secondary LLCs suggests that the intended outcomes are also likely accompanied by unintended negative consequences for students and faculty. To understand how various dorm-preneurship program designs have worked in practice, this paper applies an ‘educational design ethnography’ approach to four different residential entrepreneurship programs at the University of Waterloo, Canada. The key finding is that problems arise when dorm-preneurship programs lack any link to educational/curricular outcomes and focus only on economic objectives or social ones. Four design principles are developed to guide research and development of similar programs in other contexts.

Stigma and public attitudes toward euthanasia or assisted suicide for psychiatric conditions: results from a general population survey in Germany.

With growing numbers of countries legalizing euthanasia or assisted suicide (EAS), there is a debate as to whether EAS should also be available to people with severe, treatment-resistant mental illness. Excluding mental illness as a legitimate reason to receive EAS has been framed as discriminating against people with mental illness. We examine whether approval or opposition to psychiatric EAS are related to stigma toward people with mental illness. We asked a representative sample of the general population in Germany (N = 1515) whether they would approve of EAS for someone with severe, treatment-resistant mental illness. Stigma was assessed with the Value-Based Stigma Inventory (VASI), addressing rejection of people with mental illness in relation to different personal values. A total of 19% of the German population approved of psychiatric EAS. Higher stigma scores were associated with greater approval of EAS (Spearman rank correlation coefficient, 0.28; P < 0.001). This association held true when controlling for sociodemographic variables. It was strongest for stigma related to perceived threats to one's security, reputation and meritocratic values. Our results highlight that, although opposing psychiatric EAS is sometimes framed as discriminatory, approval of psychiatric EAS might also carry hidden, stigmatising motives. To avoid any unintended negative consequences for people with severe, treatment-resistant mental illness, any legislation on psychiatric EAS needs to be crafted with particular caution.

How Competition for Funding Impacts Scientific Practice: Building Pre-fab Houses but no Cathedrals

In the research integrity literature, funding plays two different roles: it is thought to elevate questionable research practices (QRPs) due to perverse incentives, and it is a potential actor to incentivize research integrity standards. Recent studies, asking funders, have emphasized the importance of the latter. However, the perspective of active researchers on the impact of competitive research funding on science has not been explored yet. Here, I address this issue by conducting a series of group sessions with researchers in two different countries with different degrees of competition for funding, from three scientific fields (medical sciences, natural sciences, humanities), and in two different career stages (permanent versus temporary employment). Researchers across all groups experienced that competition for funding shapes science, with many unintended negative consequences. Intriguingly, these consequences had little to do with the type of QRPs typically being presented in the research integrity literature. Instead, the researchers pointed out that funding could result in predictable, fashionable, short-sighted, and overpromising science. This was seen as highly problematic: scientists experienced that the ‘projectification’ of science makes it more and more difficult to do any science of real importance: plunging into the unknown or addressing big issues that need a long-term horizon to mature. They also problematized unintended negative effects from collaboration and strategizing. I suggest it may be time to move away from a focus on QRPs in connection with funding, and rather address the real problems. Such a shift may then call for entirely different types of policy actions.

EXPRESS: So, Sue Me … If You Can! How Legal Changes Diminishing Managers’ Risk of Being Held Liable by Shareholders Affect Firms’ Likelihood to Recall Products

Research examining the antecedents instead of consequences of recalls is relatively sparse and has not considered whether firms’ likelihood to recall products is influenced by legal changes that could induce managerial opportunism, such as those reducing shareholder litigation risk. To examine this question, the authors exploit the staggered adoption of universal demand (UD) laws across different states in the U.S. as a quasi-natural experiment. UD laws aim to prevent frivolous litigation from disrupting a firm’s normal business operations by making it more difficult for shareholders to sue managers for neglecting their fiduciary duties and hold them personally liable. Although UD laws are well-intended, the reduced threat of shareholder litigation disciplining a firm’s managers could have unintended negative consequences. Indeed, using a difference-in-differences (DiD) analysis, the authors find that following the adoption of UD laws, affected firms become less likely to recall products. This effect is weaker in the presence of organizational mechanisms constraining managers’ self-interest-seeking behavior, such as a corporate culture focused on customer needs and interests or the exercise of normative control through monitoring by institutional investors. The authors do not find support for a potential alternative explanation of operational improvement and therefore higher product quality driving their findings.