Ethical issues in the application of virtual reality to medicine

Abstract

Virtual reality (VR) will be increasingly used as a research tool in medicine. Examples include the computer modelling of complex pathological regulatory systems in disease; the integration of massive data bases derived from structural imaging of diseased organs and simultaneous functional mapping of the same organ; the development of neural prosthetic devices in sensory and/or mental impairment and the assessment or modification of major behavioural abnormalities in selected individuals. In time, advances in VR will lead to increasing pressure to introduce patients to a virtual reality environment and it is here that ethical problems will most frequently be encountered. Early examples would include the monitoring of anaesthesia and intensive care procedures but may extend to the support and enrichment of life of those patients who suffer chronic disabilities. In the setting of virtual reality, they may be able to experience much improved educational, recreational or pleasurable pursuits. Whilst the ultimate goal of improvement of the human condition will be cited to justify any human costs encountered in the development, testing and introduction of VR machines to patient care, pertinent ethical problems must simultaneously be addressed. These include the possibility that some researchers place their own advancement above the interests of a particular patient. Some other researchers may be unduly paternalistic especially when making decisions about patients who because of mental impairment or illness are unable to give their informed consent. Potentially, VR machines may be prone to errors such that they introduce into the mental life of susceptible individuals specific distortions that serve to exacerbate the symptoms of mental illness or induce such symptoms when none were previously present. It is argued in this article that information scientists, those who develop VR machines and professional regulatory organizations should promote debate on these and other related topics and reach a consensus on optimum ethical standards that should govern the introduction of patients to VR machines for the purposes of research, assessment or care.