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autonomy, discourse, ethics, nursing, patient advocacy, professionalism



  1. Shirley, Jamie L. PhD, RN


This article critiques the dominance of the discourse of autonomy in nursing ethical conversations, and the ways in which it is linked with nursing's commitment to patient advocacy. In its current discursive form, autonomy is too often used to reinforce the position of those already privileged and exacerbates the challenges faced by those with social vulnerabilities. Nursing's historical identity provides both challenges and resources for developing alternate ethical values. We have allowed narrow understandings of autonomy and advocacy to dominate our ethical discourse and have relied too exclusively on them to resolve conflicts and guide practice.