The Relational Care-AI Alignment Framework: An Ethical Model for Artificial Intelligence Involvement in...

Area of Science:

• Nursing Ethics
• Artificial Intelligence in Healthcare
• Person-Centred Care Theory

Background:

• The increasing integration of artificial intelligence (AI) in healthcare necessitates ethical frameworks for its application in fundamental care.
• Existing ethical guidelines may not adequately address the nuances of AI involvement in person-centred care, particularly concerning relational aspects.

Purpose of the Study:

• To propose the Relational Care-Artificial Intelligence Alignment (RCAA) framework for ethical decision-making regarding AI in person-centred fundamental care.
• To ground the framework in established theories like the Fundamentals of Care Framework and Caring Life Course Theory.

Main Methods:

• A discursive paper synthesizing scholarship from care ethics, person-centred care theory, technology ethics, and health informatics.
• A comprehensive literature review of peer-reviewed articles (2006-2026) and relevant policy documents from major health organizations.

Main Results:

• The RCAA framework categorizes AI involvement into three zones based on relational dependency: background support (Zone 1), collaborative partnership (Zone 2), and autonomous operation under oversight (Zone 3).
• Five ethical principles—relational autonomy, non-maleficence of depersonalisation, universal access, transparency, and proportionality—guide AI placement within these zones.
• The framework emphasizes the nurse-patient relationship and patient preferences at its core.

Conclusions:

• The RCAA framework provides a structured approach to integrating AI into fundamental care while safeguarding the relational essence of nursing.
• It serves as a heuristic tool to foster discussion and guide actions in clinical, educational, and policy contexts.
• The framework can inform AI adoption policies, nursing curricula, and regulatory standards for technology in care.