The rapid move toward a posthuman care environment calls for careful philosophical reflection. As we approach a ‘tipping point’ at which non-biological entities, ranging from predictive algorithms to autonomous robotic interfaces, meaningfully shape the delivery of care, we can no longer view technology as merely a neutral tool or assistant. Historically, nursing has treated technology through an instrumentalist lens: a means to an end, a way to increase efficiency or monitor vitals. However, the current digital transformation suggests that technology is no longer ‘outside’ the care relationship; it is becoming the medium through which the relationship is negotiated (Pepito et al. 2026). As care expands with telehealth, electronic health records and AI-supported diagnostic platforms, the traditional boundaries of the ‘caring occasion’ are being redefined. We need an integrated way of thinking about care in which the ‘caring occasion’ (Watson 2008) is genuinely co-created by humans and machines. This is not a surrender of nursing values to automation, but rather a realisation that the nurse–patient–technology triad is now the fundamental unit of care. This shift raises difficult questions. In a posthumanised care system, what becomes of ‘touch’? For over a century, the physical hand has been the primary signifier of nursing care. If a robotic arm replaces the human hand, or a screen replaces bedside presence, how do we understand the ‘justice of touch’—the ethical obligation to provide embodied, dignifying care to all humans, regardless of their condition? In a digital environment, there is a risk that touch becomes ‘sanitised’, reduced to data points and mechanical interactions. To move forward, we need to redefine ‘Digital Touch’. This should not be reduced to mechanical contact. Rather, it should be understood as a new sensory channel through which the nurse's caring intentions are conveyed. When a nurse uses a digital interface to sense a patient's distress across a distance, that interface becomes an extension of the nurse's own skin. In this sense, digital touch resonates with Locsin's idea that technological competency is itself a form of caring (Locsin 2005). The machine is not an outsider; it becomes an expression of the nurse's understanding and ‘knowing’ of the person as a whole. The future of fundamental care depends on our ability to prevent a gradual ‘ontological thinning’ of the nursing profession. Many institutional frameworks currently relegate nurses to ‘data custodians’, individuals responsible for feeding information into the machine. This labour is often invisible and undervalued, leading to burnout and moral distress, as highlighted in recent studies on the intersection of nursing labour and digital systems (Jackson et al. 2026). When the nurse is viewed primarily as a data-entry point, their epistemic agency, the authority to know and interpret the patient's reality, is severely diminished. As care systems become increasingly non-biological, we must insist on models of practice in which expert nurses work to their full scope, not merely as users of technology, but as moral architects of the digital systems that shape care. A moral architect does not simply accept an algorithm's output; they interrogate the ethics of the algorithm itself. Kikuchi (1992) argues that nursing must engage philosophical rather than merely scientific modes of inquiry, and this imperative extends beyond clinical questions to the ethical architecture of the algorithms that increasingly govern care decisions. They ask: Whose values are encoded here? Does this system protect the dignity of the marginalised? If nurses do not take this role, we risk a ‘black box’ care model in which decisions are made by non-biological logic that lacks the caritas essential to healing. We must also ask whether ‘Digital Empathy’ can be more than an artificial simulation of human feeling. Large Language Models (LLMs) and emotive AI can now mimic empathetic language with startling accuracy, yet they lack the ontological grounding of a human heart. For this to mark a true evolution in nursing practice, digital empathy must be rooted in the nurse's own caritas. In this framework, the algorithm functions as an expanded ‘nervous system’. Just as a nurse uses their biological senses to detect subtle shifts in a patient's mood, they can use AI to sense and respond to patient vulnerability across virtual and face-to-face settings (Pepito et al. 2026). The algorithm becomes a magnifying tool, allowing the nurse to ‘see’ needs that were previously invisible. However, the nurse remains the source of caring intention. This aligns with the view of nursing as a distinct philosophical discipline (Kikuchi 1992); our body of knowledge is not just about what to do but about how to be in relationship with the vulnerable (Bishop and Scudder 1990). As nurse scholars, our position should be one of integrative evolution. We cannot simply reject technology in a Luddite fashion, nor should we accept a split in which machines do the so-called ‘dirty work’ while nurses are relegated to monitoring screens. This dichotomy is a trap that leads to deskilling the profession and a fragmented professional identity. Instead, we should advocate for a cyborgian nursing praxis in which human presence and technology form a unified whole (Watson 2018). In this model, technology does not replace the nurse; it extends the nurse's presence. A ‘cyborgian’ nurse integrates the precision of digital health with the depth of human caritas. Looking ahead to 2026 and beyond, our aim should not be merely to use technology efficiently or to meet performance metrics such as ‘bed turnaround time’ or ‘click counts’. Our deeper obligation is to ensure that ‘Touch’ in technology remains a conscious, ethical decision, rooted in the foundational belief that technological competency is an expression of care (Locsin 2005). We must be honest about the risks of this transition. While we advocate an integrated ontology, we must also recognise that digital systems can be sites of exclusion and systemic bias. Algorithms often inherit the racial, gendered and classed biases of their creators. Jackson et al. (2026) demonstrate how healthcare systems routinely render the experiences of marginalised groups invisible through structural and discursive forces. This dynamic is not only reproduced but potentially amplified when algorithmic logic replaces human judgement. If nursing fails to act as a moral architect, these digital tools will become engines of inequity, further alienating the very populations we are sworn to protect. Furthermore, we must address the ‘digital isolation’ many nurses feel. When technology is poorly designed, it becomes a barrier between the nurse and the patient. The nurse spends more time looking at the patient's ‘digital twin’ than at the physical human in the bed. This phenomenon complicates the ‘justice of touch’, as the focus shifts from the embodied person to the digitised data point. Our proposed Techno-Caritas framework seeks to dismantle this wall by designing interfaces that facilitate, rather than hinder, the caring occasion. This is a critical intervention for nurse well-being; when a nurse feels that technology enables them to care more deeply, their sense of professional fulfilment is restored. Ultimately, as our care structures are increasingly mediated by technology, the core of nursing must remain firmly grounded in the holistic protection of human dignity. The challenge before us is not merely a technical one; it is a creative and political one. We must design and use digital tools in ways that deepen, rather than dilute, what it means to care. As Watson (2018) emphasised, the survival of the nursing profession in a posthuman era depends on our ability to maintain the ‘unitary’ connection between the nurse, the patient and the universe. This connection must now extend through the digital ether. To achieve this, nursing inquiry must pivot toward the design stage of technology. We can no longer wait for systems to be built and then try to ‘fix’ them with a nursing perspective. We must be in the rooms where the code is written, ensuring that the ontology of caritas is embedded in the very architecture of the posthuman care environment. By doing so, we safeguard the future of fundamental care and ensure that nursing remains a vibrant, essential and deeply human presence in an increasingly non-biological world. This is the ultimate ‘solution’ to the challenges of the modern workforce: a nursing practice that is technologically sophisticated yet ontologically grounded (Locsin 2005). The author declares no conflicts of interest. The author used Grammarly (including its AI-assisted writing features) to improve the language, grammar and readability of this manuscript. The author reviewed and edited all AI-suggested changes and takes full responsibility for the final content.
Joko Gunawan (Tue,) studied this question.