Page 106 - 《社会》2026年第4期

人机共存的生成机制：以安宁疗护社会工作实践为例

work，yet bringing techno logy into care does not necessarily mean that it becomes
part of care. Existing studies have largely followed two lines of inquiry. One
highlights the potential of AI to improve efficiency，prediction，and service delivery，
while the other focuses on ethical concerns such as surveillance，algorithmic bias，
and dehumanization. More recent work in Science and Technology Studies（STS）
has moved beyond this opposition by treating AI as a socio鄄technical actor involved
in human鄄technology relations. Even so，relatively little attention has been paid to
how AI becomes embedded in everyday care practice and how human鄄AI
coexistence is gradually produced through interaction，negotiation，and organizational
adaptation，particularly in emotionally demanding and ethically sensitive settings
such as palliative care.
This article examines these questions through an AI鄄enabled palliative care
social work intervention undertaken in a tertiary hospital in China. Rather than
evaluating whether AI improves care outcomes，the study focuses on the practical
processes through which AI is incorporated into care relationships. Qualitative
inquiry was embedded within the intervention evaluation and drew on interviews with
patients，family caregivers，social workers，healthcare professionals，and AI developers，
together with participant observation，system interaction records，and field notes.
This research design made it possible to follow AI as it moved through everyday
practice and to examine how its role was continuously shaped by different actors.
The findings suggest that AI does not enter care as a stable or
predetermined technological actor. Instead，its place within palliative care is
progressively established through ongoing adjustments to local contexts，emotional
exchanges，and ethical deliberation. As AI is adapted to existing routines，
communication styles，and professional practices，it gradually shifts from a digital
tool to a participant in care relationships. At the same time，emotional support
becomes reorganized rather than automated. AI helps sustain communication，
encourages emotional expression，and extends opportunities for interaction，while
social workers remain responsible for interpretation，relationship building，and
professional judgement. Ethical responsibility also emerges as a negotiated
accomplishment. Decisions about risk，intervention，and accountability continue to
rely on professional deliberation，with AI functioning as a source of support rather
than an autonomous decision鄄maker.
Based on these empirical observations，the article develops a framework of
adaptation—senti鄄modulation—co鄄governance framework to explain the making of
human鄄AI coexistence in palliative care social work. The framework argues that
coexistence should not be understood simply as collaboration between humans and

· 99·