The impact of welfare technology on care ethics: a qualitative analysis of healthcare professionals and managers’ experiences with welfare technologies

Abstract Background Providing healthcare for the elderly population is challenging due to a shortage of staff. The challenge is addressed by increased use of technology. The article explores the impact of welfare technology on healthcare personnel’s care ethical considerations in Norway’s primary healthcare sector. Through a qualitative study of how healthcare professionals, managers, and technology suppliers understand and perceive welfare technology in healthcare, we examine whether instrumental values displace care-ethical values in primary healthcare practices. Methods The study is based on a qualitative analysis of interviews with healthcare workers, healthcare managers and technology suppliers in primary healthcare in Norway. Semi-structured interviews were conducted with managers and quality developers at the municipal administrative level and healthcare managers and staff in healthcare units. Interviews with suppliers/manufacturers of welfare technology (GPS, pill dispensers and robotics) were also conducted. We combined an inductive approach with theoretical exploration as we alternated between the empirical data, a thematic approach, and theories of technology and care ethics. Results In the analysis of the empirical material, we identified two overarching themes that were related to our research question: 1) demands and solutions and 2) two sides of autonomy. The informants generally highlighted the benefits of welfare technology, but the informants were also ambiguous about the use of welfare technology. Autonomy was seen as an important value but was attached with ambivalence. Conclusion Care ethical considerations are significantly present within healthcare professionals’ understandings of technology even though managers and technology suppliers were advocating for welfare technology in a more instrumental sense. Despite extensive acclaim for user autonomy, healthcare personnel make decisions about care and technology use independently of the resource situation. They hold onto a professional room of freedom in between the patient’s needs, available resources, and suitable technology. They are sceptical about applying technological solutions if they suspect it will lead to potentially adverse consequences, such as loneliness or increased insecurity due to technological illiteracy. By engaging a relational autonomy approach in their care practices, healthcare professionals control technology rather than submit to technology and we see that rather than being displaced by technical-economic reasoning, care ethical reasoning also accommodates technology.