Nurses' awareness of ethical issues relating to medical and caregiving robots

BackgroundJapan has been promoting the use of medical and long-term care robots to reduce the workload of healthcare professionals. In home-visit nursing, where the number of older adults and patients with dementia is increasing, robots may provide benefits, such as supporting infection control and physically demanding care. However, implementing these technologies may also generate new ethical challenges.ObjectiveTo clarify home-visiting nurses' perceptions and the ethical issues regarding the introduction of medical and caregiving robots into home-visiting nursing field in Japan.MethodsA mixed-methods design was employed. A questionnaire survey was distributed to one nurse from each of 1012 home-visit nursing stations in Prefecture A. Descriptive statistics were used for quantitative analysis. To gain deeper insights, interviews were conducted with eight nurses who consented to participate.Ethical considerationsThis study was approved by the institutional review board (Approval No.: 2022N-026). Participation was voluntary, and informed consent was obtained. Data were anonymized to ensure confidentiality.Results and discussionThe questionnaire response rate was 17%. Simple tabulation showed that visiting nurses had positive expectations regarding the introduction of medical care robots but lacked confidence in their specific usefulness and safety. Only "disinfection of equipment" was identified as a task that could be fully shifted to robots. Twenty-six tasks, including "rehabilitation," "massage," "bathing and shower care," and "relaxation," were considered shareable between nurses and robots. Fifteen tasks-such as "suctioning," "enema and fecal disimpaction," "postmortem care," and "explanations and communication with family"-were regarded as nurse-exclusive. Interview findings suggest that medical and nursing care robots may help reduce workload and supplement care for individuals living alone or requiring intensive support. However, key challenges include device safety and reliability, user and family acceptance, privacy protection, and implementation costs. Ethical consideration and clinical effectiveness must be carefully evaluated after clarifying target users, purpose, and scope of intervention.