Ethical, Legal, and Social Issues in Metaverse-Enabled Healthcare

Metaverse is heralded by some as the next iteration of the internet. It offers three-dimensional, immersive virtual spaces, where users, represented as avatars, can synchronously work, play, interact, and transact. Initially developed within the realm of massive multiplayer online role-playing games, the metaverse now extends into sectors such as music, entertainment, retail, real estate, and, more recently, healthcare. Users engage in the metaverse using augmented reality or virtual reality (AR/VR) headsets that interoperate with other sensory devices to integrate biofeedback and multimodal data streams.¹ In this article, the authors offer a conceptual synthesis and anticipatory policy analysis grounded in a narrative review of current trends reported in public-facing news reports as well as interdisciplinary sources from bioethics, law, digital-health policy, and science-and-technology studies. There are seven key ethical, legal, and social issue areas for consideration in the delivery of metaverse-enabled healthcare. We additionally issue a call to action to explore the metaverse through a bioethics lens. The authors begin by providing a primer on the metaverse, including the various forces shaping its development. Next, the authors describe what distinguishes the metaverse from other digital-health technologies and illustrate emerging use cases for the metaverse. We then outline what we consider the most pressing ethical issues raised as the metaverse matures in parallel with (or in advance of) policy guidance and regulation. Finally, we conclude with a research agenda that treats the metaverse as a serious topic of normative and empirical inquiry and argue for sustained engagement from diverse user communities to support its ethical design and development.