The ethical principle which requires "respect for the law and a responsibility to seek change when existing law may be contrary to the best interests of the patient" supports responsible advocacy on the part of physicians. Drawing the public's attention to complex health care issues involves decisions regarding what tactics will be the most effective means of communication. As frustrations rise from the lack of response to traditional actions—letter writing campaigns, telephone calls to legislators, use of lobbyists, etc.—calls for more radical approaches may become more prevalent.
In the area of health care, calls for work stoppages create conflicts of interest. One interest—"patient advocacy"—the presumed underlying reason for legislative changes—conflicts with another interest—continuity of patient care. Engaging in advocacy such that needed care is still provided may raise important issues in a constructive way without neglecting physician obligations. For example, elective or screening procedures may be briefly postponed without patient harm or abandonment. Due diligence in ensuring continuity of care and emergent care for patients must be carefully balanced with the aims of advocacy.