There are many health care decisions or choices to be made. Nurses can empower clients by providing them with an environment that encourages them to participate in care decisions, to learn, and to have a sense of self-determination or a feeling of control. At times though, nurses must act directly for others who are unable to act for themselves. This action is not always confined to a single individual, it can extend to families, the workplace, a community, and even society. When acting for others, nurses must be aware of ethical principles and other guidelines or influences that affect advocacy, such as laws.
Autonomy is a critical ethical principle, as autonomy is based on the right to self-determination.
People can and do make their own decisions, even decisions which nurses would not make. Sometimes decisions are made by default, as when nothing is done or no deliberate decision is made. Not all clients want to be involved in making their own decisions. The most difficult part of empowerment or autonomy is supporting someone even when it is thought that they are not making the best choices. Health care providers cannot assume they know best.