Patient advocacy: a role for nurses?

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Abstract
There is much controversy surrounding the issue of nurses in the role of patient advocate. Cancer patients are vulnerable due to their diagnoses, the anxiety that it generates, the nature of the disease and subsequent treatment and may have diminished autonomy as a result. It is questionable whether the nurse is able to promote the best interests of the patient in this situation. Models of advocacy and the nurse‐patient relationship are discussed. The main arguments for taking on the role of patient advocate include: reference to long periods of time spent with the patient and the chance to build a relationship; the duty to care and the duty to do no harm. Criticisms of the appropriateness of the advocacy role for nurses include: inability for the patient to choose his or her nurse; promotion of self interests; charges of paternalism; challenges from other health care professionals and multiple and/or conflicting obligations. It is concluded that perhaps the most ethical way of caring is by empowering patients and promoting selfadvocacy. This concept needs to be further explored.