Ethical Issues in the Application of Virtual Reality to the Treatment of Mental Disorders

Abstract A second computer revolution is under way. Smaller, more powerful and, possibly, less expensive computing systems will become available for use in medicine. An important advantage of proposed systems is that a part of their computing power can be set aside to make them easier to use. Should patients be allowed directly to interface with advanced computers? Specifically, should the mentally ill be offered assessment and treatment within the context of ‘virtual reality’ as simulated by computer? These questions are placed in historical context. ‘Pseudo-scientific’ therapies in psychiatry are briefly discussed as are the electrical treatments of depression and behaviour disorders. The ‘punitive’ component of some treatments is emphasized and the role of social expectations of the causes and treatment of mental disorders is examined. Ethical issues are considered under the general headings of (a) current principles in the ethical conduct of research on persons with mental incapacity, (b) the application of virtual reality to the assessment and treatment of fears, phobias and stress, and (c) the prosthetic use of advanced computer interfaces in the care of patients with brain injury. It is concluded that discussion of ethical issues in this exciting and potentially rewarding application would be timely and that the means of professional self-regulation should soon be introduced to ensure continuing surveillance of clinical practices.