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Health Care Anal. 2010 Dec;18(4):374-88. doi: 10.1007/s10728-009-0140-1.

The heart of the matter. About good nursing and telecare.

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Department of General Practice, Section of Medical Ethics, Academic Medical Centre (AMC) Amsterdam, Postbox 22700, 1100 DE, Amsterdam, The Netherlands.


Nurses and ethicists worry that the implementation of care at a distance or telecare will impoverish patient care by taking out 'the heart' of the clinical work. This means that telecare is feared to induce the neglect of patients, and to possibly hinder the development of a personal relation between nurse and patient. This study aims to analyse whether these worries are warranted by analysing Dutch care practices using telemonitoring in care for chronic patients in the Netherlands. How do clinical practices of nursing change when telecare devices are introduced and what this means for notions and norms of good nursing? The paper concludes that at this point the practices studied do not warrant the fear of negligence and compromised relations. Quite the contrary; in the practices studied, telecare lead to more frequent and more specialised contacts between nurses and patients. The paper concludes by reflecting on the ethical implications of these changes.

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