Howard Rose has been working in medical VR for over 20 years now, and he’s the co-founder and CEO of Firsthand Technology. He reached out to me after listening to the XR for Change panel on Ethics in order to talk about some of the specific ethical considerations of experiential design that he’s learned from working on medical and educational VR experiences for over two decades.

We talk about some of the larger political, medical, and economic contexts as well as the importance of diversity and inclusion, but there’s also some specific insights that Rose shares from working on everything to PTSD therapy applications to oral health education aimed towards underrepresented minorities.

Rose also highlights these three points in terms of what he’s observed happen when people are in VR:

  1. People often think they had control and agency than was actually programmed into the experience.
  2. Our memory is a reconstruction process where sometimes people will extrapolate and create memories that never actually happened in the virtual world.
  3. People have a hard time differentiating between what happened in reality and what happened within virtual experiences.

Rose highlighted these points in the context for how these vulnerabilities could potentially be exploited to in order to maliciously manipulate people. While these vulnerabilities exist in other contexts and media, then our media literacy skills for being able to deconstruct how immersive experiences impact our beliefs is still at a very nascent stage of development. So he was also bringing up larger questions around whose stories are told, and which stories are not being told given this asymmetry of knowledge about the power of XR experiences.

There’s also a number of other ethical issues raised in an Frontiers of Virtual Reality article titled “The Ethics of Realism in Virtual and Augmented Reality” authored by Mel Slater and 13 other co-authors.

There is a lot of the specific information about the psychological and physiological impacts of immersive experiences that comes from the medical applications of XR, and so Rose wanted to share some of his insights and concerns about the ethics of experiential design with the broader XR community as he’s in the process of writing a book about this topic as well.


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Music: Fatality

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