Caring Futures: Developing Care Ethics for Technology-Mediated Care Practices

The research project Caring Futures: Developing Care Ethics for Technology-Mediated Care Practices will further develop care ethics in an increasingly technological health and welfare sector.

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Facts
Project manager

Professor Ellen Ramvi

Project period

2020 - 2025

Funding

The Research Council of Norway

Budget

NOK 20 million

Researchers will ensure the quality of care in a future with increasing use of technology-mediated care practices.

The world’s population is ageing. Older persons are dramatically increasing in number, with a greater disease burden in society. Policymakers in public welfare are concerned with the emergence of a corresponding resource deficit.

Increased efficiency and innovation are often presented as solutions to these new demands. The development and use of new technology are central aspects of these solutions. Proper use of new technology should facilitate care delivery without compromising care ethics in the relationship between users and professionals. However, the evidence on the ethical implications of technological innovation in current technology-mediated care practices is scarce. 

Identification of knowledge gaps in current care ethics

We have identified a discrepancy between society’s drive for new technology that is care-ethically ignorant – and an absence of technology-awareness within care ethical theory. The research project addresses this knowledge-deficit to secure quality care in a future with increasingly technology-mediated caring practices.

The project revisits care ethics in practice- and experience-near contexts, at a time of changing health, care, and welfare policies, services, and practices. Our principal research question is: how can technology-mediated care practices become care-ethically sound – and, correspondingly, how can care ethics become more technology-aware? 

Ensure quality of care in caring futures

The project has been developed in collaboration between the research group Professional Relations in health and welfare and the Centre for Gender Studies at the University of Stavanger.

It benefits users in primary and specialist healthcare, welfare services, and society as a whole. The project safeguards that increasing the use of new technology in care corresponds with quality in care for users and professionals and its implications for practice, policy, and education. We will create a new care ethics paradigm to inform and ensure the quality of care in caring futures. The project consists of four work packages which you will find detailed below.

Implications of using digital technologies in child welfare work

Work package 1 will explore the implications of using digital technologies in Norwegian child welfare work.

Illustrasjonsfoto barnevernsarbeid
Photo: Shutterstock

While the pace of the digital development has been slower in child welfare services relative to other welfare services in Norway, there is currently a promise of a technological “revolution”. DigiBarnevern is an ongoing nationwide project managed by the state and municipalities, promising better and more efficient child welfare services through various digital technologies. There is however limited research on the implications of using digital technologies in Norwegian child welfare work.

This project will contribute to fill this gap by drawing on various data materials collected at different moments in the implementation process of DigiBarnevern:

  1. Pre-DigiBarnevern implementation phase (data collection: medio 2022-medio 2023): Focus group interviews with social workers in 5 municipal child welfare services in Norway. In the focus groups we explore social workers’ experiences of using digital technologies and expectations towards how DigiBarnevern will influence child welfare work.
  2. DigiBarnevern implementation phase (data collection: ultimo 2023): Individual interviews with 10 “super users” of DigiBarnevern. These participants have a special responsibility for training social workers in how to use the various digital technologies in DigiBarnevern. In the individual interviews we explore super users’ experiences of the implementation process.
  3. Pre-post DigiBarnevern: One of the technologies that are currently operational in DigiBarnevern is “the national portal for reports of concern”. The portal was launched in April 2020 and is now used by more than 200 municipalities. Reports of concern were previously received by the municipal child welfare services via various channels - tel., letter, electronic. To gain a better understanding of how the portal has impacted the practice of writing reports of concern, we will analyse reports of concern written in the portal (n=150) and compare these with reports of concern written before the portal came into force (n=150).

Methods:

The project relies on 3 methods:

  1. Focus group interviews with social workers in municipal child welfare services in Norway.
  2. Individual interviews with super users of DigiBarnevern.
  3. Comparative document study of reports of concerns pre- and post DigiBarnevern launch.

Work package leader: Ida Bruheim Jensen, Associate professor at the Department of Social Studies, University of Stavanger

Researchers:

Becoming a healthcare professional in technology-mediated care practices

Work Package 2 seeks to expand the knowledge base on the relationship between healthcare professionals’ self- understanding and their ideals in low- and high-tech care practices, and how this relates to their ethics of care and their motivation for adopting new technology.

Jordmor med mor og barn på barsel
Photo: Elisabeth Tønnessen

The introduction of new technology in healthcare can raise ethical dilemmas and affect professionals’ motivation to change their caring practices. Ideals and realities in care practice are informed by professionals’ self- understanding, in turn shaped by their life and work experiences, as well as their societal context. Caring professionals need to be reflexively in touch with their own responses, emotions and vulnerabilities in order to engage in effective therapeutic relationships with users. Ethical conduct demands sensitivity to unequal power distributions in caring relationships and to relational dilemmas. Caring professionals may worry that future technologies will challenge conditions for sustaining therapeutic relationships or even shift the rationale for professional relational care.

Despite such concerns, there is currently a policy-driven societal impetus toward rapid implementation of new technology to alleviate care work for vulnerable population groups, such as the elderly, as seen in the Dementia Plan from 2020. However, if professionals feel reluctant to use new technologies and their concerns are not addressed by policy makers and healthcare management, such implementations can result in irresponsible practice and compromised patient safety.

Objectives

  1. to expand knowledge of how healthcare professionals’ self-understanding and ideals in high- and low technology-mediated care influence their motivation for taking new technology into use and their care ethics, and
  2. to support reflective practice in midwifery care.

Work package 2 consists of four sub-studies:

  • Study 1a) is a research project based on life-history interviews with healthcare professionals, run by postdoctoral candidate Sissel Merete Finholt-Pedersen.
  • Study 1b) is a researcher project based on six focus groups (n=35) to cover variations in professionals’ ideals in high-tech and low-tech care healthcare sectors, and their attitudes to technology-mediated care. The study is conducted by Professors Ellen Ramvi.
  • Study 1c) is a research project on relational ethics in technology-mediated GP practice, relying on semi-structured interviews for data collection. The study is run by Postdoctoral candidate/MD Damoun Nassehi.
  • Study 2) is an educational project will identify whether a new educational model contributes to midwives’ reflective practice and care ethics in light of increasingly technology-mediated professional practice. The study is led by Marta Høyland Lavik.

Work package leader: Ellen Ramvi, Professor at the Faculty of Health Sciences, University of Stavanger

Researchers:

  • Marta Høyland Lavik, Professor II, University of Stavanger
  • Sissel Merete Finholt-Pedersen, Postdoctoral candidate, University of Stavanger
  • Damoun Nassehi, Postdoctoral candidate, University of Stavanger
  • Wendy Hollway, Emeritus Professor, The Open University
  • Henning Salling Olesen, Emeritus Professor, Roskilde University
  • Signe Egenberg, Ph.D,  Midwife, Stavanger University Hospital

The impact of robots and other caregiving techno-bodies on agency and quality of care

Work package 3 is concerned with how new technologies impact on questions of agency and quality of care.

Photo: Stutterstock

We are particularly interested in technology that imitates animals or humans, or technology that is attached to or integrated into the human body. What does it mean to live with technology that enables quality of life? What kind of care ethial dilemmas arise from our increasing interactions with technologies and robots?

The project consists of three parts.

Part 1 is a PhD project reading science fiction stories of care robots against Immanuel Levinas' ethics. The project is led by Ilghar Azarmanesh.

Part 2 is a researcher project exploring how cultural imaginaries impact on our understanding of health and welfare technologies, particularly the care robot. This study has an innovative design, using Visual Matrix Methodology, a  qualitative method facilitating group associations and imaginaries on topics that are difficult to put into words (Gripsrud et al. 2018; Ramvi et al. 2019).

Part 3 is a study with conducted by Ingrid Leiknes. Parkinson’s patients living at home with an implanted Duodopa medicine pump are interviewed about their life-world narratives on living with on-the-body medical technology.

Work package leader: Ingvil Hellstrand, Associate professor at the Faculty of Health Sciences, University of Stavanger

Researchers:

Implementation of welfare technologies in municipal healthcare services

Work Package 4 aims to offer new insights into municipal managers’ and suppliers’ considerations when implementing welfare technologies in municipal healthcare services.

Photo: Shutterstock

The state authorities and suppliers promote welfare technologies as a solution to a situation characterised by scarce resources - a situation municipal personnel are aware of. However, it is possible that they consider welfare technologies as a threat to service quality. The work package explores tensions between care ethics and the use of technologies that claim to improve quality and efficiency in healthcare delivery. How, and in which contexts do such tensions appear, and how do municipalities and suppliers deal with them? Theories claiming that user needs are embedded in the technology are part of the theoretical framework, and this work package also explores how suppliers understand users’ needs.

Method

The data consists of interviews with suppliers and municipal managers in middle and lower level management. The lower level managers have been selected since we expect them to have to balance municipal demands of efficiency on the one hand and users’ need for service quality on the other. Relevant policy and plan documents have been collated. The analysis will be inductive-deductive.

Work package leader: Brita Gjerstad, Associate Professor at the Department of Social Studies, University of Stavanger

Researchers:

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Work package leaders and researchers at the University of Stavanger

Professor
51834179
Faculty of Health Sciences
Department of Caring and Ethics
Associate Professor
51831690
Faculty of Social Sciences
Department of Social Studies
Associate Professor
51831543
Faculty of Health Sciences
Department of Caring and Ethics
Associate Professor
51832799
Faculty of Social Sciences
Department of Social Studies
Ekstern tilknyttet UiS
Faculty of Health Sciences
Department of Caring and Ethics
Ekstern tilknyttet UiS
51831338
Faculty of Health Sciences
Department of Caring and Ethics
Ekstern tilknyttet UiS
Faculty of Health Sciences
Department of Caring and Ethics
Professor
Faculty of Health Sciences
Department of Caring and Ethics
Associate Professor
51831521
Faculty of Social Sciences
Department of Social Studies
Professor
51834237
Faculty of Social Sciences
PhD Candidate
51831605
Faculty of Social Sciences

Scientific Advisory Board

Lynn Froggett
Professor
University of Central Lancashire
Tove Pettersen
Professor
University of Oslo
Jeannette Pols
Professor
University of Amsterdam