Nursing leadership and artificial intelligence ethics: Safeguarding relationships and values

The integration of artificial intelligence (AI) into healthcare marks a paradigmatic shift, raising not only technical and organizational challenges but also profound ethical questions. This theoretical-reflective paper explores the ethical dimensions of AI from a nursing perspective, focusing on the role of nurse leaders as ethical agents in the digital transformation of care. Drawing on philosophical and ethical frameworks, such as Heidegger's notion of humans as "sensors of machines" and the concept of algorethics, the article argues that AI should not replace the relational, interpretive, and moral dimensions of care, but rather support them, provided its implementation is guided by ethical vigilance. The World Health Organization's principles-autonomy, beneficence, transparency, accountability, justice, and sustainability-serve as the ethical foundation for AI in healthcare, highlighting the need to preserve human dignity and prevent discrimination. Yet algorithmic opacity, automation bias, and data-driven inequities demand renewed attention to responsibility, explainability, and the preservation of human agency. Nurse leaders are called to act along three ethical pillars: fostering transparency in algorithmic processes, ensuring shared responsibility for AI-supported decisions, and sustaining human relationships as the core of care. By reclaiming relational time (kairos) and resisting the delegation of moral judgment to machines, nurses safeguard the human face of care. In doing so, they embody a leadership rooted in presence, justice, and ethical discernment. Ultimately, this paper calls for a proactive governance of AI that anticipates its impacts and ensures its alignment with the telos of nursing: to care for persons with competence, conscience, and compassion.