Physicians and advocacy

It is evident that providing responsible advocacy for patients, individually and collectively, is an obligation for Canadian physicians, as was discussed in a CMAJ editorial1 earlier this year. The College of Family Physicians of Canada has distributed a Declaration of Commitment, dated Nov. 25, 2004, that states “we are a resource to our practice populations -—promoting health to prevent illness, providing and explaining health information, collaborating with and facilitating access to other caregivers, and advocating for patients throughout the health care system.” The Educating Future Physicians for Ontario project identified “advocate” as one of the roles patients expect from their physician. Similarly, the Royal College of Physicians and Surgeons of Canada's CanMEDs roles include the role of “advocate.”

Even if such advocacy makes administrators uncomfortable, physicians must judge what is in the best interests of their patients and behave accordingly. We must strive for communication within institutions that ensures that medical staff can make good judgments about how best to exercise their responsibility for advocacy, but we must never stifle their voices. There are too many historical examples of suppression of information when patients would have benefited from prompt disclosure.