It is a question that arrives late and should arrive early: do you need consent to put a virtual reality headset on a patient?
Whoever asks usually already has the equipment on the table and a clinical governance meeting in the calendar. It is worth arriving with the answer ready.
This is not legal advice. The decision on the form of consent belongs to the clinical leadership and the institution's own framework. What follows is what experience shows teams weigh up.
Start by classifying what you are doing
The question that precedes consent is: what is this, within your protocol?
If the session is understood as a comfort and occupation activity (like putting on music, reading aloud, or watching a film with someone) it is in one category. If it is understood as part of an intervention plan with defined objectives, it is in another. The form of consent follows that classification, not the other way round.
Many institutions resolve this by placing sessions inside an existing general care consent. Others prefer a specific record. Both are defensible positions; what is not defensible is never having decided.
What makes this different from putting on a film
One thing, and it is concrete: the headset occupies the field of view. The person stops seeing the room.
That is the difference that justifies explaining beforehand, even where the institution concludes no signature is needed. Someone who did not understand what was about to happen and suddenly cannot see the room is having a different experience from the intended one.
In practice, three sentences do it: what you will see, how long it lasts, and that you can stop whenever you want.
The right to stop matters more than the signature
More than a signature, what protects is the power to interrupt.
- Does the person know they can say "take this off me" and that it happens immediately?
- Is there someone in the room to hear it?
- Can the team stop it remotely if the person cannot ask?
With RVer the session is always accompanied and the Companion app has a remote emergency stop. That does not replace the explanation beforehand: it backs it up.
When the person cannot consent
This is the most frequent case in care homes and in advanced dementia, and it is where teams hesitate most.
The usual framing combines three things: authorisation from whoever has legitimacy to decide, the assent of the person in the moment (meaning accepting, not resisting, not showing discomfort) and continuous reading of signs by whoever is running the session.
Refusal does not have to be verbal. Removing the headset, turning the head away, becoming agitated: all of that is refusal, and is treated as such. A session that continues against signs like these has no consent at all, whatever has been signed.
The contraindication check comes first
It is not consent, but it belongs to the same conversation and happens first. Caution or prior clinical assessment is advised for anyone with a history of severe motion sickness or vestibular disorders, uncontrolled epilepsy or photosensitive seizure disorders, or who cannot follow safety instructions. The list is on the FAQ page and in the manual.
What about consent for data?
This part is simpler than feared, because no personal patient data leaves the headset.
What is sent is per-device usage statistics (which content played, on which headset, when) which identify nobody. Assigning a patient to a headset happens on the local network and never reaches a server. The institution is the data controller for its patients' data.
Whoever writes the consent text will be grateful for that paragraph: there is no need to seek authorisation to transfer clinical data that is not transferred.
A workflow that tends to work
- Before: check contraindications.
- Before: explain in three sentences: what you will see, how long, you can stop.
- During: someone in the room, watching for signs.
- After: record that the session happened, like any other activity.
- Once, at the start: decide which category this falls into in your protocol, and write it down.
The fifth point is the only one that needs a meeting. The other four are routine.
On who can run the sessions, we wrote in who can run a session. On safety and contraindications, in is virtual reality bad for you?.
Frequently asked questions
Is informed consent required for a virtual reality session?
It depends on how the institution classifies the session in its protocol: a comfort and occupation activity, or part of an intervention plan. Many institutions fold it into an existing general care consent; others prefer a specific record. Both are defensible. The decision belongs to clinical leadership, and what is not defensible is never having decided.
What should you explain to the person beforehand?
Three sentences are enough: what you will see, how long it lasts, and that you can stop whenever you want. What distinguishes this from putting on a film is that the headset occupies the field of view and the person stops seeing the room: that difference justifies explaining beforehand even where no signature is required.
What if the person cannot consent, for example in advanced dementia?
The usual framing combines authorisation from whoever has legitimacy to decide, the assent of the person in the moment (accepting, not resisting, not showing discomfort) and continuous reading of signs by whoever is running the session. Refusal does not have to be verbal: removing the headset, turning away or becoming agitated is refusal and is treated as such.
Is consent needed for data in virtual reality?
The data part is simpler than feared, because no personal or clinical patient data leaves the headset. What is sent is per-device usage statistics, which identify nobody. Assigning a patient to a headset happens on the local network and never reaches a server.