In my future shoes: using VR decision support tools in moral and practical prenatal decisions for an enriched and less biased simulation of one’s future self (Preprint)

Abstract

BACKGROUND An expectant mother faces several decisions related to pregnancy that cannot be tackled with the rational choice method or by consulting medical evidence. These choices are moral and practical prenatal decisions, which involve respectively the prospective mother’s moral and practical identities. Current genetic counselling services do not support expectant mothers in such decisions, and the mental processes employed, such as mental simulation, are prone to decision-making biases that increase the likelihood of making sub-optimal decisions. OBJECTIVE We show how the quality of moral and practical prenatal decisions can be improved using virtual reality (VR) and provide practical recommendations for the design and development of an effective and ethically aligned VR tool for such prenatal decisions. METHODS This is a theoretical study on moral and practical decisions in pregnancy, which adopts the logical-conceptual method of philosophy. RESULTS VR technology is a suitable decision-support tool for making moral and practical prenatal decisions. Yet, to be effective and ethically aligned, VR should comply to a set of practical recommendations for its design and development that we provide. CONCLUSIONS VR allows the operationalization of biopsychosocial support in the clinical encounter, facilitates the individual’s reflection on her values and beliefs, supports the contextualization of available choices to an individual’s circumstance, presents complex information in more understandable forms, and enhances the ability of mental simulation. An effective VR tool facilitating decision-making in moral and practical prenatal decisions should consider the specific needs of its target audience and be built in consultation with the relevant stakeholders and experts in the field (e.g., social workers, therapists, clinicians). Moreover, VR scenarios that are part of this tool should be community specific, presented in an emotionally balanced manner, and based in reality. Finally, VR tools should be distributed as part of a public health program for reasons of fairness. This study provides the theoretical basis and framework for the development of a better consulting support in pregnancy and contributes to a more inclusive patient engagement in prenatal decision-making, which has been advocated for in contemporary medical practice. CLINICALTRIAL Not applicable