When bioethics meets gaming: Exploring how immersive digital experiences are transforming our understanding of moral decision-making
What if the video games young people play could unlock deeper understandings of their ethical perspectives? Imagine researchers swapping traditional surveys for immersive digital games to explore complex moral dilemmas. This isn't science fiction—it's the cutting edge of design bioethics, an innovative approach that's transforming how we study ethical decision-making.
Immersive experiences that simulate real-life ethical dilemmas in engaging digital environments.
Standard research tools that present ethical questions in abstract, decontextualized formats.
At the University of Oxford, Professor Ilina Singh and her interdisciplinary team are pioneering this fusion of gaming and bioethics research. Their work addresses a critical challenge: how to better engage young people in conversations about ethically complex topics like mental health technologies. Traditional surveys often fail to capture the nuanced, contextual nature of moral decision-making. But what if a game could simulate real-life dilemmas more effectively?
In a landmark study, the team put these questions to the test, creating a digital game called Tracing Tomorrow to compare it directly against conventional research methods. Their findings, published in AJOB Empirical Bioethics, suggest we might be on the cusp of a research revolution—one where young people don't just answer ethical questions but live them through digital experiences 1 3 .
For decades, bioethics has trailed behind other fields in methodological innovation. While neuroscience, psychology, and social sciences have developed increasingly sophisticated research tools, bioethics has largely remained tied to three traditional methods: surveys, interviews, and research papers 1 3 .
This limitation persists despite what scholars call the empirical turn in bioethics—the growing recognition that ethical understanding benefits from studying real-world attitudes and behaviors. The problem with traditional methods is that they often struggle to capture the contextual, social, and relational aspects of moral decision-making 3 .
A standard survey question about whether you'd share mental health information with parents feels very different from actually making that choice within an unfolding narrative where characters react to your decisions 3 .
This methodological gap becomes particularly significant when researching young people's perspectives on emerging technologies. If we want to understand how adolescents really think about issues like digital phenotyping—using their digital footprints to predict mental health risks—we need methods that engage them authentically.
Enter design bioethics—an innovative approach that creates purpose-built tools specifically for bioethics investigation. Think of it as engineering custom research instruments rather than always borrowing standard ones from other fields 1 3 .
This methodology draws inspiration from John Dewey's idea that knowledge emerges through experience and engagement with practical challenges.
A state of deep involvement where participants lose track of time and become fully immersed in the activity—a key goal of design bioethics.
Especially for young participants
Real-life situational embedding
Reaching non-traditional participants
Tapping into conscious and intuitive responses
Professor Singh's team hypothesized that a well-designed bioethics game could achieve greater cognitive absorption—a state of deep involvement where participants lose track of time and become fully immersed in the activity 3 .
The research team decided to directly test their design bioethics approach through a carefully controlled comparison study. They created a digital game called "Tracing Tomorrow" and compared it against a traditional vignette survey that covered identical ethical content 1 3 .
An online game that explores the implications of digital phenotyping for mental health. Players navigate a story filled with ethically charged dilemmas and decisions about mental health tracking technologies.
Presented descriptively equivalent questions and multiple-choice responses but lacked the narrative continuity, interactivity, and personalization of the game.
301 UK adolescents aged 16-18 years
Participants randomly assigned to either play the digital game or complete the vignette survey
Young people involved in development through NeurOX Young People's Advisory Group (YPAG)
All participants completed measures assessing various dimensions of engagement and experience
The findings revealed significant differences between the two methods across multiple dimensions of engagement. Participants who played the game reported substantially richer experiences in several key areas compared to those who completed the traditional survey.
Felt more like real life
Harder choices because I cared about the characters
Remember specific story moments weeks later
Typical survey questions
Straightforward, just picked an answer
Couldn't remember most questions afterward
The results demonstrated that the game format produced deeper emotional involvement, greater absorption in the activity, and stronger feelings of being present in the scenario. Perhaps most importantly, participants gained greater insight into mental health ethics through the game format 1 3 .
Notably, both methods performed equally well in terms of perceived authenticity and sparking curiosity about the topic. This suggests that the game enhanced engagement without sacrificing the credibility or motivational impact of the research experience 3 .
Design bioethics research requires specialized "reagents"—the tools and components needed to conduct innovative studies. Here are the key elements from the Tracing Tomorrow study:
| Research Component | Function in Study | Example from Tracing Tomorrow |
|---|---|---|
| Digital Game Platform | Creates immersive narrative environment for ethical decision-making | Tracing Tomorrow game (www.tracingtomorrow.org) |
| Equivalent Vignette Survey | Provides traditional methodological comparison | Online survey with identical ethical dilemmas |
| Youth Advisory Group | Ensures age-appropriate design and relevance | NeurOX Young People's Advisory Group (YPAG) |
| Engagement Metrics | Measures cognitive and emotional involvement | Presence, cognitive absorption, emotional engagement scales |
| Ethical Approval Framework | Ensures participant protection and research integrity | University of Oxford Medical Sciences Interdivisional Research Ethics Committee |
Custom-built game environment for ethical exploration
Direct involvement of young people in research design
Multi-dimensional measurement of engagement and insight
The Tracing Tomorrow study demonstrates that methodological innovation in bioethics can yield significant benefits. The enhanced engagement and insight provided by purpose-built digital games suggests they may be particularly valuable for exploring complex, emotionally-charged topics with young populations 1 3 .
Professor Singh's team emphasizes that these tools aren't meant to replace all traditional methods, but rather to expand the bioethics toolkit. Different research questions may call for different methodologies.
The potential applications extend beyond academic research to education, clinical settings, and public policy for gathering authentic input on ethically complex technologies.
Looking forward, the integration of even more advanced technologies—artificial intelligence, virtual reality, and neurotechnologies—promises to further transform bioethics research 8 . As these tools develop, the principles of design bioethics ensure that methodological innovation remains grounded in rigorous research and ethical reflection.
The Tracing Tomorrow study represents more than just an academic comparison—it points toward a future where ethical research becomes more engaging, inclusive, and insightful. By meeting young people in the digital environments where they're already comfortable, researchers can access richer understandings of their moral perspectives.
As Professor Singh's team concludes, "The results of this study highlight the importance of purpose-built methodology for empirical bioethics research" 1 . The "empirical turn" in bioethics began by incorporating data from other fields. The next evolution might be bioethics developing its own innovative methods tailored to the unique challenges of understanding moral experience.
In an age of rapidly advancing technologies—from digital phenotyping to portable neuroimaging 6 —we need more sophisticated tools to understand their ethical implications. Design bioethics offers a promising path forward, one where we don't just ask questions about ethics, but create experiences that illuminate how we navigate moral complexity in an increasingly technological world.
The game controller may seem an unlikely research instrument, but it might just help us better understand what it means to be ethical in the digital age.