Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Ethical tensions of virtual reality treatment in vulnerable patients

Nature Medicine volume 25, pages 1185–1188 (2019)Cite this article

Subjects

Emerging virtual reality systems offer intriguing therapeutic possibilities, but their development and use should be guided by ethical priorities that account for the specific vulnerabilities of patients.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1

References

  1. Dascal, J. et al. Virtual reality and medical inpatients: a systematic review of randomized, controlled trials. Innov. Clin. Neurosci. 14, 14–21 (2017).

    PubMed  PubMed Central  Google Scholar 

  2. Howard, M. C. A meta-analysis and systematic literature review of virtual reality rehabilitation programs. Comput. Hum. Behav. 70, 317–327 (2017).

    Article  Google Scholar 

  3. Freeman, D. et al. Automated psychological therapy using immersive virtual reality for treatment of fear of heights: a single-blind, parallel-group, randomised controlled trial. Lancet Psychiatry 5, 625–632 (2018).

    Article  Google Scholar 

  4. Pot-Kolder, R. M. C. A. et al. Virtual-reality-based cognitive behavioural therapy versus waiting list control for paranoid ideation and social avoidance in patients with psychotic disorders: a single-blind randomised controlled trial. Lancet Psychiatry 5, 217–226 (2018).

    Article  Google Scholar 

  5. Klein Tuente, S., Bogaerts, S., van IJzendoorn, S. & Veling, W. Effect of virtual reality aggression prevention training for forensic psychiatric patients (VRAPT): study protocol of a multi-center RCT. BMC Psychiatry 18, 251 (2018).

    Article  Google Scholar 

  6. Kellmeyer, P. Neurophilosophical and ethical aspects of virtual reality therapy in neurology and psychiatry. Camb. Q. Healthc. Ethics 27, 610–627 (2018).

    Article  Google Scholar 

  7. Mackenzie, C., Rogers, W. & Dodds, S. Vulnerability: New Essays in Ethics and Feminist Philosophy (Oxford University Press, 2013).

  8. Ganguli-Mitra, A. & Biller-Andorno, N. Vulnerability in healthcare and research ethics. in The SAGE Handbook of Health Care Ethics (eds. Chadwick, R., ten Have, H. & Meslin, E. M.) 239–250 (SAGE, 2011).

  9. Hurst, S. A. Vulnerability in research and health care; describing the elephant in the room? Bioethics 22, 191–202 (2008).

    Article  Google Scholar 

  10. Orji, R. & Moffatt, K. Persuasive technology for health and wellness: State-of-the-art and emerging trends. Health Inform. J. 24, 66–91 (2018).

    Article  Google Scholar 

  11. Timmer, J., Kool, L. & van Est, R. Ethical challenges in emerging applications of persuasive technology. in Persuasive Technology (eds. MacTavish, T. & Basapur, S.) 196–201 (Springer International, 2015).

  12. Beauchamp, T. L. & Childress, J. F. Principles of Biomedical Ethics (Oxford University Press, 2001).

  13. Morozov, E. To Save Everything, Click Here: The Folly of Technological Solutionism (PublicAffairs, 2014).

  14. Fogg, B. J. Persuasive Technology: Using Computers to Change what We Think and Do (Morgan Kaufmann, 2003).

Download references

Acknowledgements

This work was partly supported by the German Ministry of Education and Research (BMBF) grant no. 13GW0053D to the University of Freiburg - Medical Center; and by the German Research Foundation (DFG) grant no. EXC1086 (BrainLinks-BrainTools) to the University of Freiburg. Author P.K. wishes to thank his friend Dr. med. Lorenz Lehmann (University of Heidelberg - Medical Center) for valuable inspiration in designing the figure.

Author information

Authors and Affiliations

  1. Neuromedical Artificial Intelligence Lab, Department of Neurosurgery, University of Freiburg–Medical Center, Freiburg, Germany

    Philipp Kellmeyer

  2. Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany

    Philipp Kellmeyer

  3. Cluster of Excellence BrainLinks-BrainTools, University of Freiburg, Freiburg, Germany

    Philipp Kellmeyer

  4. Institute for Biomedical Ethics and History of Medicine, University of Zurich, Zurich, Switzerland

    Philipp Kellmeyer & Nikola Biller-Andorno

  5. Faculty of Humanities, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

    Gerben Meynen

  6. Willem Pompe Institute for Criminal Law and Criminology & Utrecht Centre for Accountability and Liability Law (UCALL), Utrecht University, Utrecht, the Netherlands

    Gerben Meynen

Authors
  1. Philipp Kellmeyer
    View author publications

    Search author on:PubMed Google Scholar

  2. Nikola Biller-Andorno
    View author publications

    Search author on:PubMed Google Scholar

  3. Gerben Meynen
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to Philipp Kellmeyer.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kellmeyer, P., Biller-Andorno, N. & Meynen, G. Ethical tensions of virtual reality treatment in vulnerable patients. Nat Med 25, 1185–1188 (2019). https://doi.org/10.1038/s41591-019-0543-y

Download citation

  • Published:

  • Version of record:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41591-019-0543-y

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing