A critical review of the arguments debating the role of the nurse advocate.

AIMS OF THE PAPER: 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.
CONCLUSION: 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.