title: \Defining Patient Advocacy for the Context of Clinical Ethics Consultation: A Review of the Literature and Recommendations for Consultants.
abstract: The idea of patient advocacy as a function of clinical ethics consultation (CEC) has been debated in the bioethics literature. In particular, opinion is divided as to whether patient advocacy inherently is in conflict with the other duties of the ethics consultant, especially that of impartial mediator. The debate is complicated, however, because patient advocacy is not uniformly conceptualized. This article examines two literatures that are crucial to understanding patient advocacy in the context of bioethical deliberations: the CEC literature and the literature on advocacy in the social work profession. A review of this literature identifies four distinct approaches to patient advocacy that are relevant to CEC: (1) the best interest approach, (2) the patient rights approach, (3) the representational approach, and (4) the empowerment approach. After providing a clearer understanding of the varied meanings of patient advocacy in the context of CEC, we assert that patient advocacy is not inherently inconsistent with the function of the ethics consultant and the CEC process. Finally, we provide a framework to help consultants determine if they should adopt an advocacy role.
authors.affiliation: Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington USA. tbrazg@uw.edu.
authors.forename: Tracy
authors.initials: T
authors.lastname: Brazg
authors.affiliation: University of Washington School of Social Work, Seattle, Washington USA. tarynlin@uw.edu.
authors.forename: Taryn
authors.initials: T
authors.lastname: Lindhorst
authors.affiliation: University of Washington Department of Bioethics and Humanities, Seattle, Washington USA. dudzin@uw.edu.
authors.forename: Denise
authors.initials: D
authors.lastname: Dudzinski
authors.affiliation: Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington USA. benjamin.wilfond@seattlechildrens.org.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Wilfond
mesh_terms: D016265:Conflict of Interest; D026822:Ethicists / Q000592:standards; D033061:Ethics Consultation / Q000592:standards*; D026690:Ethics, Clinical; D006801:Humans; D017008:Negotiating; D010344:Patient Advocacy; D028701:Patient Rights; D024382:Professional Role