Theorizing digital-relational harm in nursing.

Relational Ontology in a Digital World: Integrating African Personhood and Platformized Nursing.

The discipline of nursing has entered a historical moment in which two profound forces converge: the global rise of digital platform labour and the resurgence of relational, communitarian ontologies rooted in African philosophy. Yet these forces are rarely theorised together, despite shaping the same discipline. This paper integrates African philosophical thoughts which conceptualise personhood as a dynamic, communal, and relational achievement, with ideas around platformized nursing, which explains how digital platforms restructure nursing labour, relationships, and professional identity through algorithmic governance and datafication. Through a digital-relational synthesis, the paper argues that platformization disrupts the communal and relational foundations of personhood and care, while simultaneously creating new socio-technical spaces in which relationality must be renegotiated. An integrated model, the Digital-Relational Nursing Framework is presented which offers a multilevel lens for understanding how nurses and patients become persons within increasingly digitalised health systems. This synthesis provides conceptual grounding for empirical research, ethical analysis, workforce policy, and curriculum reform aimed at safeguarding relational accountability and communal wellbeing in the digital era.

[The Paradox and Integration of Digital Therapeutics: The Perspectives of Nursing Care and Care Ethics].

A comprehensive four-stage nursing engagement framework is proposed that spans the entire DTx lifecycle of design, implementation, evaluation, and ethical governance, highlighting the indispensable role of nurses in the clinical deployment of DTx.

When Civility Harms: Relational and Reputational Bullying in Mental Health Nursing.

Workplace bullying in nursing is commonly understood as overt interpersonal conflict, including incivility, aggression, or intimidation. While important, such framings risk obscuring subtler mechanisms through which harm is enacted and sustained in healthcare and academic settings. Drawing on mental health nursing scholarship, organisational theory, and critical perspectives, this paper adopts a conceptual and discursive approach to examine relational and reputational forms of bullying in mental health nursing practice and academia. It argues that under managerialism, commodification, and performance metrics, reputation functions as organisational currency. In these contexts, bullying operates through impression management and moral framing, where tactics such as flattery and strategic alignment confer protection and influence. Conversely, critically reflective and highly competent practitioners and academics whose work depends on ethical reflexivity and relational engagement, may be disproportionately marginalised. These dynamics challenge dominant assumptions about bullying, civility, and professionalism, showing how harm persists while remaining formally unrecognised. A conceptual model illustrates the structural, cultural, relational, and individual processes through which such bullying is produced and normalised. The paper concludes by considering implications for workplace culture, leadership, professional standards, and research, calling for greater attention to organisational conditions influencing whose voices are heard and whose are cancelled.

Digital Justice in Social Work: An Argument for a New Ethical Principle

When Care Does Not Count: Epistemic Injustice and the Organisational Recognition of Nursing Knowledge

ABSTRACT This discussion paper examines how care‐based nursing judgement becomes recognised, narrowed or excluded as professional knowledge within healthcare organisations. Nursing care is often described as relational, ethical, practical or compassionate, yet these descriptions may obscure its epistemic content: trained perception, contextual interpretation, anticipatory reasoning, moral judgement, continuity work and practical synthesis under uncertainty. Drawing on epistemic injustice, nursing knowledge development, care ethics and organisational governance, the paper argues that injustice in nursing knowledge is not only interpersonal but organisational. It identifies three mechanisms through which care‐based nursing knowledge may be downgraded: credibility distortion, interpretive narrowing and restricted epistemic uptake. The paper further develops the idea of reductive recognition: care may become visible in organisational systems only after being translated into categories that diminish its nursing rationality. Five organisational conditions are proposed for recognising care as knowledge: credible reception, hermeneutic infrastructure, shared knowledge governance, educational preparation and balanced standardisation. The central contribution is to shift the question from whether nurses possess knowledge to how healthcare organisations decide which forms of nursing knowledge are allowed to count.

A Multilevel Framework for the Safe and Ethical Use of AI in Mental Health Practice.

BACKGROUND Incorporating Artificial Intelligence (AI) into mental health practice represents a profound transformation of psychological care, enabling novel forms of assessment, intervention, and support. However, this shift also introduces substantial ethical and psychological risks, including erosion of autonomy, algorithmic bias, threats to digital rights, and strain on clinical judgment and therapeutic relationships. This article proposes PRISM, a multilevel framework designed to guide the ethical integration of AI in mental health across individual, technological, and institutional dimensions. METHOD An integrative conceptual review was conducted drawing on Self-Determination Theory, information ethics, data justice, and international guidelines from the APA, WHO, EU, and UNESCO. The framework introduces the concept of psychological regulation of AI, extending ethical oversight to the subjective and relational impacts of algorithmic mediation. RESULTS PRISM articulates four operational principles (digital autonomy, affective transparency, algorithmic justice, and relational care) along with practical tools, including psychological impact indicators and a Psychological Model Card, to support ethical auditing and clinical digital wellbeing. CONCLUSIONS A psychology-based regulatory approach is essential to ensure dignity, autonomy, and ethical sustainability in digital mental health. PRISM provides an operational bridge between technological governance and psychological practice, supporting responsible, person-centred AI use in clinical contexts.