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- 03 - Four Quadrant Approach: A Method for Analysing Cases in Research Ethics and Research Integrity + (In a collaborative effort, three clinical … In a collaborative effort, three clinical ethicists, a philosopher, Jonsen, a physician, Siegler, and a lawyer, Winslade, developed the ‘four quadrant approach’ (‘4QA’) for dealing with difficult cases in clinical settings.[[#%20ftn1|<sup><sup>[1]</sup></sup>]] The process can be viewed as an “ethics workup,” similar to the “History and Physical” skills that all medical students come to use when learning how to “workup” a patient’s primary complaints. </br></br>The full procedure of the 4QA involves three stages and a list of distinctive steps:</br></br>#The first stage identifies and describes our initial perception of the case;</br>#The second involves the four quadrants (medical indications, patient preferences, quality of life, contextual features) and the identification of information relevant to a given quadrant;</br>#The third involves the application of case-based reasoning to identify and justify the best course of action.</br></br>----[[#%20ftnref1|<sup>[1]</sup>]] Jonsen A, Siegler M, Winslade W. Clinical ethics: a practical approach to ethical decisions in clinical medicine. Mc-Graw Hill, 6th edition, 2010.</br></br>[[#%20ftnref2|<sup>[2]</sup>]] http://depts.washington.edu/bioethx/tools/cesumm.htmlgt;[2]</sup>]] http://depts.washington.edu/bioethx/tools/cesumm.html)
