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Four Quandrant Approach

Investigators: Heather Draper (PI), Lt Col Lizzy Bernthal (RCDM), Col Rob Russel (RCDM)
Funder: Royal Centre for Defence Medicine (Academia and Research)

The ‘four quadrant approach’ (4QA) was adopted by the UK military as a useful tool to aid ethical decision-making. We explored how and when medical personnel were using this tool in the kinetic environment of Field Hospital in Camp Bastion, Afghanistan September 2012 – January 2013. We also explored how useful they perceived to be, under what circumstances and why.


Bernthal, LMM, Russel, RJ, Draper H (corresponding author) A qualitative study of the four quadrant approach to assist ethical decision-making during deployment. Journal of the Royal Medical Army Corps, 2014; 160:196-202