e3iVR: Conference on Ethics in Investigational and Interventional Uses of Immersive VR

Applications of virtual reality (VR) technologies as investigational and clinical tools are promising. Immersive VR provides the experience of being in any environment by wearing head-mounted devices or standing in special rooms called cave automatic virtual environments. Experiments conducted in VR may be superior to those conducted in natural spaces because VR increases the control of potentially confounding variables. It also provides a method for studying sensitive clinical areas and personal spaces and allows an opportunity to study behavioral responses in situations that would be either dangerous or irresponsible for studies involving human subjects. Despite the growing public acceptance and emergence of inexpensive VR platforms, there exists little guidance regarding safe and ethical conduct of investigational and interventional uses of these technologies.

The objective of the Ethics in Investigational and Interventional Uses of Immersive VR (e3iVR) conference was to produce a set of standard ethical guidelines to support the safe use of virtual reality technologies for research and clinical purposes. This conference was unique in that it brought together the communities who create the technology, use the technology, and experience the technology as patients or research subjects. This conference was led by the Living Environments Laboratory at the University of Wisconsin-Madison.

The specific aims of this project were as follows:

• Provide experts, scholars, and lay people with informative lectures to ensure a baseline understanding. 
• Engage an invited subset of these participants in a thoughtful discussion in which each stakeholder group provided space to articulate their ideas and consider varying viewpoints. 
• Achieve consensus amongst representatives from the healthcare information technology, VR research, and patient communities on a baseline set of formal guidelines for the investigational and interventional use of VR technologies in healthcare. 
• Disseminate the guidelines for debate, discussion, and adoption by the clinical care and scientific research communities. 

An advisory panel nominated individuals to participate in the conference workgroup, provided guidance on the framework for the workgroup discussions, and advised on the dissemination plan for the guidelines. Discussions focused on the applications of VR technologies for healthcare research and in clinical settings. A list of ethical guidelines for the investigational and interventional uses of immersive VR from a multidisciplinary perspective was drafted. The advisory panel and workgroup participants agreed that the overarching goal of the guidelines is to help individuals exercise their freedom to participate in novel scientific research and clinical interventions in an informed way. The project team will disseminate the final guidelines at a future date.