Citation

Teven CM, Gottlieb LJ. AMA J. Ethics 2018; 20(1): 595-601.

Affiliation

A professor of surgery, the director of the Burn and Complex Wound Center, a faculty member at the MacLean Center for Clinical Medical Ethics, and a senior faculty scholar at the Bucksbaum Institute at the University of Chicago Medicine.

Copyright

(Copyright © 2018, American Medical Association)

DOI

10.1001/journalofethics.2018.20.6.vwpt1-1806

PMID

29905139

Abstract

Burn injuries raise questions about decision-making capacity, informed consent, medical decision making, patient autonomy, the patient-physician relationship, and medical futility that must be acutely addressed. A commonly used approach to managing ethical challenges focuses on moral principles including respect for patient autonomy, beneficence, nonmaleficence, and justice. Another paradigm for ethical analysis is the "four-quadrant" approach, which poses questions for a given case regarding medical indications, patient preferences, quality of life, and contextual features. We have found this approach to be very effective in the clinical setting. This article will highlight the use of the four-quadrant approach in the management of ethical challenges that arise in the care of the severely burned patient.

© 2018 American Medical Association. All Rights Reserved.

Language: en