This project provides an analysis of the concept 'advocacy'. It uncovers assumptions regarding the meanings of advocacy as this concept has been utilized in health care settings to describe professional actions of various sorts. The primary objective of the undertaking is to facilitate the goals of medicine, nursing, and other health care professions in regard to the population of their concern. To the extent the goals of medicine and nursing are focused on promoting the well-being of persons and society the (...) pursuit of such goals is a moral endeavor. The analysis provides for consistency of communication among the professions with regard to advocacy and exposes the scope of professional obligation for health care professionals. ;Chapter One outlines problems surrounding uses of the term 'advocacy.' It offers an explication of other concepts which prove important for the analysis such as 'profession', 'physician-patient relationship', 'nurse-patient relationship', and 'clinical ethics'. Chapter Two makes some distinctions regarding advocacy and considers the context in which professions provide service to society. Additionally, the 'ideal' of lawyers as exemplars of professional advocacy is explored since it is from this setting notions of 'advocacy' for health care professions have been borrowed. ;In Chapter Three an investigation of the nature and foundations of professional obligations is undertaken. Codes of ethics are discovered to be important sources of a profession's own view of its obligations; these allow assessment of a professional's moral accountability. As the investigation develops, professional advocacy is seen to be complex role-responsibility. The focus of Chapter Four is discussion of the proposal that professional advocacy is a broader concept for health care professionals than it is for legal advocates because it involves both attention to individual needs and attention to the needs of society. Thus the source of some interdisciplinary confusions is located. ;Finally, Chapter Five elucidates the implications of the newly clarified concept 'Professional Advocacy' when this is applied to health care situations as an account of health care professional obligation to both individuals and society. (shrink)

Bishop is a professor of nursing; Scudder is a professor of philosophy.

Advocacy is an important concept in nursing practice; it is frequently used to describe th nurse-client relationship. The term advocacy, however, is subject to ambiguity of interpretation. Such ambiguity was evidenced recently in criticisms levelled at the nursing profession by hospital ethicist Ellen Bernal. She reproached nursing for using 'patient rights advocate' as a viable role for nurses. We maintain that, for nursing, patient advocacy may encompass, but is not limited to, patient rights advocacy. Patient advocacy is not merely the (...) defence of infringements of patient rights. Advocacy for nursing stems from a philosophy of nursing in which nursing practice is the support of an individual to promote his or her own well-being, as understood by that individual. It is an ethic of practice. La défense des malades joue un grand rôle dans la pratique des infirmiers/ères. Le terme est souvent utilisé pour définir les rapports entre malades et soignants. Le mot 'defénse' pourtant, peut être mal compris. Une ambiguïté était évidente récemment dans la critique de la profession infirmière faite par la philosophe éthique Ellen Bernal. Elle reproche à la profession d'utiliser le terme 'avocat des droits des malades' pour désigner le rôle primordial des infirmiers/ères. Nous croyons que pour les soignants, la défense des malades peut comprendre le rôle 'd'avocat des droits des malades' mais elle ne s'y borne pas. La défense n'est pas limitée à la défense des infractions des droits des malades. La défense dans la profession infirmière est basée sur une philosophie où la pratique infirmière est le soutien des malades dans leur quête de promouvoir leur propre bien-être. Die Fürsprache spielt eine wichtige Rolle in der Krankenpflege. Sie wird oft als kennzeichnend für die Beziehung zwischen Patient und Pflegepersonal beschrieben. Der Ausdruck 'Fürsprache' kann aber auch mehrdeutig interpretiert werden. Das wurde letzthin in der Kritik der Ethikerin Ellen Bernal an der Krankenpflege sichtbar. Sie machte den Pflegenden den Vorwurf, dass sie sich die Rolle des 'Rechts-Advokat des Patienten' aneignen. Wir sind der Meinung, dass es die Aufgabe des Pflegepersonals ist, auch die Rechte der Patienten zu vertreten, aber dass das nur ein Teil der Fürsprache ist. Sie ist nicht nur Verteidignung von verletzten Patientenrechten. Die Fürsprache in der Krankenpflege stammt von einer Philosophie, deren Ausübung die Unterstützung der Patienten für ihr Wohlergehen zum Ziel hat, so wie die Patienten selbst ihr Wohlergehen verstehen. Sie ist eine Ethik der Tat. (shrink)

It is often assumed that the chief responsibility medical professionals bear is patient care and advocacy. The meeting of other duties, such as ensuring a more just distribution of medical resources and promoting the public good, is not considered a legitimate basis for curtailing or slackening beneficial patient services. It is argued that this assumption is often made without sufficient attention to foundational principles of professional ethics; that once core principles are laid bare this assumption is revealed as largely unwarranted; (...) and, finally, that these observations at the level of moral theory should be reflected, in various ways, in medical practice. Specifically, this essay clarifies a tension that exists between different kinds of moral principles and explores the possibility of dissipating that tension by shoring up foundational principles. The paper begins by setting out three alternative models of how best to balance patient advocacy responsibilities with broader social responsibilities. It then turns to critically assess these models and argue that one has several advantages over the others. (shrink)

Medical ethics involve more than a prohibition against advertising or solicitation of patients, or a limit on the height of the letters on a doctor's office door. The true ethics of health care are the fundamental values that guide-or should guide-physicians in every aspect of their interaction with patients, their families, and society at large. Professional ethics is a complex and controversial issue, but one that must be dealt with in an era of increasing skepticism about the practice of medicine. (...) Medical Stewardship is a carefully reasoned historical and philosophical inquiry into the origins of our notions of medical ethics, and the ways in which a true sense of the doctor's proper role can be restored. Tracing the development of medical ethics from ancient times to the modern era, Dr. Kepler consides them in relation to the medical profession of today. He considers several areas seldom discussed in works on medical ethics: the exploitation of the patient, preventive versus disease treatment, ethical problems in medical education, drug abuse by physicians, the ethics of organized medicine, and some important but under-utilized roles of the physician. (shrink)

A discussion of Christian ethics focuses on the physician's image as a parent, warrior against death, expert, and teacher, and the oath that guides his or her practice.

Description: Why Be Moral? is designed as a textbook for beginners. It is also intended for all concerned with understanding ethics. It emphasizes fundamental questions about the nature of: 1. Good and bad, right and wrong, rights and duties. 2. Oughtness, intention, responsibility, conscience. 3. Self, self-as-social, self-interest, extensions of self. 4. Groups, conflicts of interests, reciprocity, justice. It examines persisting issues: 1. Individual vs. social ethics. 2. Selfishness vs. altruism. 3. Intentions vs. consequences. 4. Codes vs. principles. 5. Freedom (...) vs. determinism. 6. Capitalism vs. socialism. Insights into problems in individual and in social ethics are enriched by comparative parallel treatment by chapters. (shrink)

The central thesis of this paper is that cost-containment challenges to an Ideal Advocate model of the physician-patient relationship can be met under proper circumstances. More specifically, it is possible for physicians to constrain costs while still making clinical decisions that are free from considerations of the physician's own interests and are uninfluenced by judgements about the patient's worth. But what is required is a closed distributive system, in which savings of resources at one point are applied to others' care (...) of higher priority and a just system, that is, a system whose distributive priorities are consistent with relevant principles of justice under moderate scarcity. The historical context of the argument and a stopgap, palliative, step are also developed. (shrink)