Irreplaceable human moral agency in the age of artificial intelligence

PHILADELPHIA (March 10, 2026) – From predicting patient outcomes to deploying humanoid “robot nurses,” artificial intelligence (AI) is rapidly being integrated into clinical practice. Hastings Center Report The moral agency at the heart of nursing cautions that it must remain a human-driven responsibility.

The article “What does moral agency mean for nurses in the age of artificial intelligence?” explores the growing tension between advanced algorithmic capabilities and the ethical obligations of the world’s most trusted profession.

Although AI systems can now simulate empathy and generate situationally aware responses, Penn State College of Nursing’s Connie M. Ulrich, Ph.D., RN, FAAN, Lillian S. Brunner Professor of Medical and Surgical Nursing, Professor of Nursing, and Professor of Medical Ethics and Health Policy, and her coauthors argue that AI lacks sentience, intentionality, and accountability. The authors define a moral agent as someone who can distinguish between right and wrong and who can take responsibility for his or her actions.

The main findings from the article are:

• AI as a “moral zombie”: The authors point out that algorithms lack the sensitivity necessary for true moral responsibility.
• relationship value: Nursing is characterized by a “therapeutic presence” and an intuitive exchange of common humanity that cannot be replicated by algorithms, especially in sensitive areas such as end-of-life care.
• growing industry: The global robot nurse industry is expected to reach more than $2.7 billion by 2031, highlighting the urgent need to establish ethical guardrails.

Recommendations for health systems

This article emphasizes that nurses must be active leaders in technology design and implementation, rather than passive users of technology. To maintain public trust, the authors offer several important recommendations.

• Participation in design: Nurses should be part of the AI ​​design team to ensure tools align with clinical values ​​and preferences.
• Transparency as default: Facilities must explicitly disclose when AI is used to generate summaries and treatment recommendations so that patients and clinicians understand the source of the information.
• The boundaries of AI adoption: AI should not be used to make hiring decisions for nurses because algorithms cannot identify human traits such as empathy and critical reasoning.
• maintain accountability: AI should be treated as a resource that supports human moral deliberation, rather than replacing it.

“Patients come to healthcare to be heard, seen, and evaluated by trained professionals, not to seek care from a machine,” the authors state. “AI may simulate compassion, but it cannot be ‘compassionate’ in the moral sense.”

Penn Nursing co-authors include George Demiris, Ph.D. Dr. Patricia Brennan. Ongyi Oh, MSN; and Sun Bin Yu, MSN.

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About the University of Pennsylvania School of Nursing

of University of Pennsylvania School of Nursing (Penn Nursing) is a world leader in nursing education, research, and practice and is the nation’s top nursing research institution, funded by the National Institutes of Health (NIH). Ranked the No. 1 nursing school in the nation by QS University for the past decade, Penn Nursing consistently earns the nation’s top rankings for BSN and graduate programs by U.S. News & World Report. By integrating innovation, interdisciplinary collaboration, and evidence-based practice, Penn Nursing prepares nurse scientists, clinicians, and leaders to address the complex health needs of our global society. Follow Penn Nursing: facebook | linkedin | YouTube | Instagram.