A critical review of the arguments debating the role of the nurse advocate.
OBJECTIVE
This paper critically reviews the arguments for and against undertaking the role of nurse advocate.


BACKGROUND
Advocacy has become a popular concept in nursing literature over the past two decades. By addressing issues of power and accountability, conclusions are drawn about the risks facing nurses who would practice patient advocacy.


METHODS
Review and analysis of theoretical debate.


RESULTS
Empirical evidence is sparse and philosophical arguments predominate in the field of patient advocacy. Humanistic arguments that promote advocacy as a moral imperative are compelling. However, in reality nurses appear to lack the power base to comply except by covert means. Informed consent with a knowledge of the consequences of undertaking such an intervention is as relevant to the nurse as it is to the patient.


CONCLUSIONS
Nurses need to be empowered first, if they are to empower their patients. There may however, be more suitable candidates for the role of patient advocate and nurses should recognize that they do not have a monopoly on ethical decision making.
Hewitt
Jeanette
J
School of Health Science, University of Wales, Singleton Park, Swansea, UK. j.l.hewitt@swan.ac.uk
D003220:Conflict, Psychological; D003657:Decision Making; D004993:Ethics, Nursing; D006808:Humanism; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D007400:Interprofessional Relations; D007587:Job Description; D019359:Knowledge; D016365:Liability, Legal; D016294:Models, Nursing; D024802:Nurse's Role; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D010687:Philosophy, Nursing; D011209:Power, Psychological; D017009:Professional Autonomy; D012309:Risk-Taking; D006113:United Kingdom