Provision 7

The practice of nursing requires the integration of technology. New technologies enter, proliferate, and change healthcare at a rapid pace and the scale ranges from the molecular (e.g., genomics) to the infinite (e.g., machine learning [ML] and augmented intelligence or artificial intelligence [AI]). Nurses contribute to decisions involving the development and adoption of technologies in the provision of nursing care and conduct of research through multiple routes including engagement with ethics committees. In addition to weighing the viability and efficacy of technologies’ end products and deliverables, nurses also consider the ways in which technologies are developed and their impact on knowledge production and nursing practice. Developing and adopting cutting-edge technologies may stratify care in ways that exclude those who are unable to afford potential options. Conscientious use of informatics and healthcare technologies requires consideration of health equity principles and an emphasis on transparency in development tactics and application processes.

Although it is impossible to account for every nuance of every technological development and predict how technology will be used in healthcare in the future, nurses should appreciate that ML, augmented intelligence, and AI are already deeply embedded in healthcare. Common examples include algorithms designed to support clinical decision-making and diagnostic programs used in radiology and pathology. Nurses need to grasp the broader implications of their input on downstream data, clinical decision-making, clinical decision support rules and alerts, and electronically transmitted information into subsequent records. Nurses recognize the potential for ML, augmented intelligence, and AI to expand nursing capacity but ought to also acknowledge that technologies may cause harm. The ability to reverse data permissions or delete data must be considered throughout the development of these technologies. For example, it is not always clear when ML, augmented intelligence, and AI are being used to collect or use data, making opting-out difficult for both nurses and patients. Considerations for reversibility, or the ability to withdraw permissions to access data or to remove data entirely, must continually be explored before, during, and after the development of data-collecting technologies. Augmented intelligence or AI also may result in wage inequalities and amplify inequities inherent in big data. Balancing the risks and benefits of technologies requires that nurses stay informed about developments, acknowledge the potential benefits and harms, maintain the dignity of the recipient of care, complement the relational nature of nursing, and ensure the voice of nursing is present when decisions are made in healthcare systems.

Advancements in genetics and genomics research and their technologies, such as whole genome and exome sequencing, raise similar concerns (e.g., informed consent, risk-benefit ratio, privacy, and confidentiality) as well as unique ethical concerns. Ethical questions that nurses should continue to consider and reflect on include who has access to these technologies, how will they be used and by whom, how will genetic information affect historically- and currently-oppressed or resource-poor communities, what approaches can be used to minimize harm to families, and when is there a duty to return results or disclose incidental findings.

Nurses ought to ensure the ethical and responsible use of evolving technologies by critically questioning the underlying assumptions of technologies and the implications of their use in research. Nurses who are educators ought to emphasize the centrality of technology in the provision of nursing care as they educate the next generation of nurses, considering the benefits and challenges of technologies in supporting patient care. By critically questioning the underlying assumptions of these innovations, nurses may affirm that they reflect the values, principles, and goals of the profession.