title: Technologically-mediated nursing care: the impact on moral agency.
abstract: Technology is pervasive and overwhelming in the intensive care setting. It has the power to inform and direct the nursing care of critically ill patients. Technology changes the moral and social dynamics within nurse-patient encounters. Nurses use technology as the main reference point to interpret and evaluate clinical patient outcomes. This shapes nurses' understanding and the kind of care provided. Technology inserts itself between patients and nurses, thus distancing nurses from patients. This situates nurses into positions of power, granting them epistemic authority, which constrains them as moral agents. Technology serves to categorize and marginalize patients' illness experience. In this article, moral agency is examined within the technologically-mediated context of the intensive care unit. Uncritical use of technology has a negative impact on patient care and nurses' view of patients, thus limiting moral agency. Through examination of technology as it frames cardiac patients, it is demonstrated how technology changes the way nurses understand and conceptualize moral agency. This article offers a new perspective on the ethical discussion of technology and its impact on nurses' moral agency. Employing reflective analysis using the technique of embodied reflection may help to ensure that patients remain at the centre of nurses' moral practice. Embodied reflection invites nurses critically to examine how technology has reshaped conceptualization, understanding, and the underlying motivation governing nurses' moral agency.
authors.affiliation: Faculty of Nursing, University of Toronto, Toronto, ON, Canada. s.okeefe.mccarthy@utoronto.ca
authors.forename: Sheila
authors.initials: S
authors.lastname: O'Keefe-McCarthy
mesh_terms: D006331:Heart Diseases / Q000451:nursing; D006801:Humans; D007362:Intensive Care Units; D013677:Medical Laboratory Science; D009014:Morals; D009723:Nurse-Patient Relations; D009732:Nursing Care