J Med Ethics 34:513-516 doi:10.1136/jme.2007.021212
  • Clinical ethics

The “four quadrants” approach to clinical ethics case analysis; an application and review

  1. D K Sokol
  1. Dr D K Sokol, Centre for Medical and Healthcare Education, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK; daniel.sokol{at}
  • Received 29 March 2007
  • Revised 25 May 2007
  • Accepted 18 June 2007


In 1982, Jonsen, Siegler and Winslade published Clinical Ethics, in which they described the “four quadrants” approach, a new method of analysing clinical ethics cases. Although the book is now in its 6th edition, a literature search has revealed only one academic paper demonstrating the method at work. This paper is an attempt to start filling this gap. As a way of describing and testing the approach, I apply the four quadrants method to a detailed clinical ethics case. The analysis is interspersed with reflections on the method itself. It is hoped that this experiment will encourage ethicists and clinicians to devote more attention to this neglected approach.


  • Competing interests: None.