Enhancing Surgical Vision: Augmented Reality in Otolaryngology-Head and Neck Surgery.

The “metaverse” has risen and fallen in the hype cycle, but its core components continue to evolve and, whatever we ultimately call them, will transform the way we interface with health and medicine. Immersive technologies are central to this vision, promising direct experiential access to the digital future of medicine wherein persistent, multiuser, digital environments host clinical interactions, medical treatment provision, and access to health resources. For example, imagine your future avatar leaving the digital workplace to visit a physician in a virtual clinic space, followed by immersive, AI-guided physical therapy, followed later in the evening by an immersive virtual support group. In each of these settings, trust in providers and medical systems is critical for effective care, and preservation of patient privacy is both a key facet of trustworthiness and its own social good. While the “medical metaverse” (MM) does not yet exist, it is critical to consider potential points of tension between the need for trust and privacy on one hand, and established norms and capabilities of the digital platforms on which health care is expected to increasingly run. This can enable more thoughtful design of MM systems as they begin to emerge in earnest. This is especially important as elements of the MM have been projected to increase access to underserved and vulnerable populations where trust is already low and privacy violations may be of higher consequence. Through examination of longstanding human psychological and social tendencies and projection of how these tendencies will interface with emerging metaverse technologies with their own norms and practice, we can identify several points of tension to consider. As humans transition from the physical world to 2D web and mobile technologies, to immersive, social, and 3D ones, we bring with us preexisting habits, heuristics, beliefs, norms, and expectations molded through evolutionarily-influenced predispositions and real-world experiences that may operate suboptimally in the MM. The (see for definition of italicized terms) notes that while most technology users report highly valuing data privacy and fear the risks of unintended disclosure, they seldom take strong measures to protect their digital privacy. This constellation of ideas suggests that humans are very attuned to potential privacy invasion by other individuals as has been the primary privacy concern though human social history, however, humans tend to be less sensitive to privacy threats in modern digital ecosystems. Here, personal data are collected by faceless digital platforms and intermediates (e.g., tech companies), sometimes retained indefinitely. This paradox exemplifies the nature of conflicts between human psychology and the likely realities of trust and privacy in facets of the MM.