Customarily patient advocacy is argued to be an essential part of nursing, and this is reinforced in contemporary nursing codes of conduct, as well as codes of ethics and competency standards governing practice. However, the role of the nurse as an advocate is not clearly understood. Autonomy is a key concept in understanding advocacy, but traditional views of individual autonomy can be argued as being outdated and misguided in nursing. Instead, the feminist perspective of relational autonomy is arguably more relevant within the context of advocacy and nurses’ work in clinical healthcare settings. This article serves to highlight and problematise some of the assumptions and influences around the perceived role of the nurse as an advocate for patients in contemporary Western healthcare systems by focusing on key assumptions concerning autonomy inherent in the role of the advocate.