Posted: April 5th, 2023

Capstone Project: Four Quadrant Approach

Capstone Project: Four Quadrant Approach
Introduction
The four prima facie principles include justice, autonomy, beneficence, and nonMaleficence. This prima facie establishes medical practitioners' moral commitments and provides a less complicated, socially approved, and neutral approach to ethical issues in clinical practice. They do this by aiding healthcare practitioners in decision-making while reflecting on moral issues that arise within their practice. Additionally, Josen et al. in their Book Clinical Ethics: A Practical Approach To Ethical Decisions In Clinical Medicine provide a handy tool that allows practitioners to establish more ethical decision-making that goes a long way in helping patients achieve the best care. The four-quadrant approach comes in very handy to help practitioners make the right decision respecting the patient's rights as a clinical ethics resource. This paper explores applying the four quadrant approach from an ethical perspective and determines the complexity and ease associated with each one of them.
Analysis of the Four Quadrant Approach
Categorically, diseases could take temporal complexity and be more dynamic for any patient as their treatment continue. As such, decisions identified and made before mutations or the development of a disease could be rendered useless in the face of these developments. Above all, the four topics approach allows me to be honest about the alternative as a clinical ethic resource. At the same time, it allows me to address the patients with a realistic expectation of how certain developments in their treatment may render them. This becomes useful for the patients to make better-informed decisions on whether or not to proceed with specific treatments or non at all. Medical indications, for me, as a clinical ethics resource was the most straightforward box to apply. It applies the principles of beneficence and nonmaleficence, which involves creating a balance in establishing the benefits of treatment against risks and costs involved and avoiding the causation of harm to the patient, respectively.
Under medical indications, my final decision will be aided by the patient's medical problem, history of the disease, prognosis, and diagnosis. With the help and advice of other medical practitioners relative to the patient's care, I will establish whether the problem is acute, critical or emergent, or reversible. I will also establish the goal of the treatment based on past practices and empirically outline the probabilities for success if the particular treatment was to be applied. The method also compels me to apply the alternatives if the method fails and overall empirically outlines the potential harm to be incurred and avoided.
The hardest of the four would be the Preferences of Patients. It is important to note that the guiding principle in this option considers autonomy and compels the practitioner to respect the patient or surrogate's decision as final whether I would be in agreement with their decision or not. This is the hardest because it considers the patient's right to choose to be respected relative to the laws and regulations. It establishes competence incapacity, which considers both legal and clinical decision making, introducing complexities into decision making as it considers more than one social institution. The patient may not be willing to cooperate and may fail to adhere to the competent clinical advice, resulting in a more complicated outlook.
Conclusion
Jonsen Siegler and Winslade's four topic boxes provide a basis for establishing ethical and medical decision-making. They are not necessarily law but a great tool to help practitioners establish the best decision for their patients, considering their well-being and rights. The relevance of Preference of Patients is considered from both a medical and an ethical standpoint as opposed to medical indications that consider the majority of the decisions to be made from a medical standpoint, which is generally a more empirical standpoint. While his or her decisions or the surrogates' decisions need to be respected, it introduces a very complicated outlook on the patients' generahighly complexin most cases, the patient's perspective is considered over medical recommendations.

References
Jonsen, A. R., Siegler, M., & Winslade, W. J. (2020). Clinical ethics: A practical approach to ethical decisions in clinical medicine. McGraw Hill Professional.

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Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics. Oxford University Press.

Taddio, A., Shah, V., & McMurtry, C. M. (2021). Helping healthcare providers in decision-making: The four quadrant approach. Paediatrics & Child Health, 26(1), 9-11.

Faden, R. R., Beauchamp, T. L., & King, N. M. (2021). A history and theory of informed consent. Oxford University Press.

American Medical Association. (2020). Code of Medical Ethics of the American Medical Association: Current Opinions with Annotations. American Medical Association.

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