Problematising autonomy and advocacy in nursing

  title={Problematising autonomy and advocacy in nursing},
  author={Clare Cole and Sally J Wellard and Jane Mummery},
  journal={Nursing Ethics},
  pages={576 - 582}
Customarily patient advocacy is argued to be an essential part of nursing, and this is reinforced in contemporary nursing codes of conduct, as well as codes of ethics and competency standards governing practice. However, the role of the nurse as an advocate is not clearly understood. Autonomy is a key concept in understanding advocacy, but traditional views of individual autonomy can be argued as being outdated and misguided in nursing. Instead, the feminist perspective of relational autonomy… 

Patient advocacy by nurses – past, present and future

The gap between the ideal of patient advocacy and the realities of everyday nursing practice is highlighted, highlighting the responsibility for enacting advocacy sits with both individual practitioners and the organizations nurses work within.

Empowerment as an alternative to traditional patient advocacy roles

It is suggested that it is time to recognise that the work of advocacy is no longer representative of what nurses (can) do in practice, and to explicitly reorient conceptualisations of nurse practice around empowerment.

Professional Autonomy as Centrality in Best Practices in Nursing.

A retrospective look at the creation and evolution of nursing autonomy in its knowledge and care practices, it exposes the use of autonomy in nursing care and foster the participation of the user and his family as the center of Best Practices in nursing.

Care, Autonomy, and Gender in Nursing Practice: A Historical Study of Nurses' Experiences.

A historical study based on oral interviews of nursing professionals who currently worked at the Hospital of the Holy Spirit or had worked there between 1961 and 2010 finds that changes related to the autonomy of nursing are related to changes in the concept of care.

[Nursing beliefs and actions in exercising patient advocacy in a hospital context].

Analyzing beliefs and actions of nurses in exercising patient advocacy in a hospital context by applying Protective Nursing Advocacy Scale - Brazilian version finds nurses do not disagree nor agree that advocating for patients in their working environments can bring them negative consequences.

[Nursing Actions in practicing inpatient advocacy in a Burn Unit].

This study identified that the nurses investigated exercised patient advocacy and that the recognition of their actions is an advance for the profession, contributing to the autonomy of nurses and the effectiveness of patients' rights and social justice.

Perception and opinion of nursing faculties regarding advocacy role: A qualitative research.

It was emphasized that nurse academics regarded advocacy as an ethical obligation and saw it from a broad perspective including social justice, that changing health system has increased the importance of advocacy role in nursing, that the personality characteristics of prospective nurses are important, and that nursing education should be improved in terms of advocacy.


The actions of nurses when advocating for patients as reported by the international scientific literature published in the last ten years are identified, broadening understanding of patient advocacy as an ethical component of the nursing practice.

Nurses defending the autonomy of the elderly at the end of life.

To understand how nurses deal with the elderly's autonomy at the end of life, qualitative, exploratory study guided by the Grounded Theory is conducted in Rio de Janeiro/Brazil.

Crucial contextual attributes of nursing leadership towards a care ethics

Making the understanding about crucial attributes explicit, the nurse may receive confirmation and recognition of crucial attributes for ethical care in order to move toward an ethical care.



Advocacy in mental health nursing: an integrative review of the literature.

A critique of nursing advocacy models is offered, raising a number of mental health nursing issues and identifying some areas for further research.

Ethical advocacy based on caring: A model for neonatal and paediatric nurses

  • K. Spence
  • Medicine, Political Science
    Journal of paediatrics and child health
  • 2011
Advocacy has been identified as an ideal in nursing practice. National codes (Australian Nursing and Midwifery Council) and professional standards (Australian College of Neonatal Nurses) state that

An Exploration of the Relationship Between Patient Autonomy and Patient Advocacy: implications for nursing practice

Whether patient/client autonomy is always compatible with the nurse’s role of advocacy is examined to examine whether the traditionally paternalistic approach to health care provision truly respects the autonomous rights of each patient.

Enhancing patient well-being: advocacy or negotiation?

  • A. Bird
  • Medicine
    Journal of medical ethics
  • 1994
The author examines the case for and against the nurse being the best person to act as advocate, and critically evaluates the criteria of advocacy, and concludes that the health care professional's role is to help people to assert control over the factors which affect their lives, that is empowerment, rather than advocacy.

Advocacy in Nursing

This qualitative study explored the perceptions of eight learning disability nurses about their advocacy role, using semi-structured interviews, and found that nurses used the term `advocacy' to describe a variety of activities that are underpinned by the opposing ethical principles of autonomy and paternalism.

Advocacy in nursing--a review of the literature.

  • M. Mallik
  • Medicine
    Journal of advanced nursing
  • 1997
It is argued that support systems are inadequate except in low-risk situations and ultimately acts of advocacy remain a moral choice for the individual nurse.

Individual patient advocacy, collective responsibility and activism within professional nursing associations

It is argued that, through collective advocacy, professional nursing associations ought to extend the reach of individual nurses in order to address systemic problems in health care institutions and bureaucracies.

Ethics in Nursing Practice: A Guide to Ethical Decision Making

This third edition of Ethics in Nursing Practice takes into account recent changes in ICN position statements, WHO documents, as well as addressing current issues in healthcare, such as providing for the health and care needs of refugees and asylum seekers, bioethics and the enforcement of nursing codes.

The nature of advocacy vs. paternalism in nursing: clarifying the 'thin line'.

Truly 'knowing' patients, their life experiences, values, beliefs and wishes can help clarify the 'thin line' and gain a grasp of these difficult to distinguish theoretical concepts.

Developing a mid-range theory of patient advocacy through concept analysis.

A mid-range theory of patient advocacy emerges during the process of synthesizing and analysing the advocacy literature and may be useful in guiding advocacy practice in nursing and in guiding research in the advocacy area.