Black, white or green: ‘race’, gender and avatars within the therapeutic space

Abstract

Personal identity is critical to provider--patient interactions. Patients and doctors tend to self-select, ideally forming therapeutic units that maximise the patients' benefit. Recently, however, 'reality' has changed. The internet and virtual worlds such as Second Life (http://www.secondlife.com/) allow models of identity and provider--patient interactions that go beyond the limits of mainstream personal identity. In this paper some of the ethical implications of virtual patient--provider interactions, especially those that have to do with personal identity, are explored.

Vol 9 No 2 (2019)

“…I found a discursive struggle over health professionalism between two notions: a notion of freedom of choice and a notion of diversity (e.g., Andersson, 2010). The former promoted the users choosing the avatar motivated by making the user feel safe and more inclined to participate in health-enhancing activities, while the latter was concerned with the risk of patients choosing what they feel safe with, possibly based on prejudices regarding gender and ethnicity (e.g., Graber & Graber, 2011). Mol (2008) argues that the "logic of choice" is part of a global tendency of person-centred health care focused on patient choice (see also West & Lundgren, 2015).…”

“…The former links human avatars with professional-like credibility in the sense of representing human physiotherapists, while the latter links non-human avatars with credible professional-likeness, focusing on the outcome of the patient's health (cf. Graber & Graber, 2011). The human avatars also engendered concerns and some informants raised the question of (in)authenticity, due to linking being professional with being human.…”

“…Secondly, Carl tried to handle this conflict by differentiating a virtual nurse from a human nurse: to choose an avatar based on the patient's preferences is not necessarily a threat towards values of diversity for the health professionals because the VHP is not a human health professional (cf. Graber & Graber, 2011). Previously, I mentioned how a variety of avatar options for the VHP, based on gender and ethnicity, was motivated to avoid the reproduction of stereotypical embodiments.…”

Therapy in Virtual Environments—Clinical and Ethical Issues

“…[42][43][44] However, preliminary ethical guidelines for mental health treatment in VEs, where the patient and therapist are represented by avatars, have yet to be fully established. Practice guidelines have been established for the provision of mental health treatment through other electronic platforms such as online therapy and telemedicine.…”

“…45,46 Guidelines regarding informed consent, patient confidentiality, patient wellbeing, clinician competence, therapeutic environment and process, and emergencies have been established in these fields. 22,44,[47][48][49] Similar ethical concerns (i.e., privacy, competency, standard of care, etc.) for clinical applications of VEs have been discussed 42 but have yet to be fully developed.…”