Religious belief, medicine and new technologies: a paradigm shift?

A cura di Livia Saporito

 

1. The new frontiers of medical science: religion and health behaviors

Where one wonders whether religion, including both established faiths and individual beliefs, ought to have a voice in the face of the scientific and social shifts brought about by digital technology[1], there seems to be a growing opposition maintaining that the religious perspective is unnecessary in the formation of the digital future. This simplified view of religion seems strengthened if we explore its role in the current dimension of medical science whose practice has evolved significantly over time, from a more holistic approach – in which each organism is seen in its entirety, and not just as composed of individual parts – to a mechanistic approach, based, instead, on a strictly biometric and specialized vision of human physiology and diseases.

Through the ages, religion has influenced lifestyle choices, guiding human health-related behaviors^[2].In all cultures we find religious prescriptions relating to body care and conduct that can be harmful. For example, the sacred texts of the main religions – including the Bible, Torah and Quran – prohibit premarital and extramarital sex or denounce the pork as impure and unsuitable for consumption and give advise against the use of alcohol and tobacco; some others suggest dietary[3].

The connection between religion and physical health[4] has favored the development of research about the use of screening spiritual histories and educational interventions for physicians to consider patient religious beliefs and values in care, particularly in faith-based health care systems. For instance, scholars have linked religion to multiple physiological processes, including cardiovascular and neuro endocrine functions. Higher levels of religion have been associated with better lipid profiles (i.e., lower low-density lipoprotein and higher high-density lipoprotein cholesterol) and religious practices (e.g., meditation, spiritual relaxation) have been associated with lower cholesterol and stress hormone (e.g., cortisol) levels[5]. Similarly, the religious factor seems to have positive effects also on the immune system.

Since religion shapes social values ​​and beliefs, rules governing health care delivery, family planning, contraception, prevention services often reflect the religious beliefs of its members. Religious beliefcan encourage prevention of cervical cancer through vaccination against the human papillomavirus (HPV) or cancer screening behaviors, such as mammograms, Pap tests, and colonoscopy. In addition, religion can promote best practices such as lower cigarette smoking, lower substance abuse[6], and less high-risk sexual behaviors.

It is true that some of these conducts are likely a consequence of the social sanctions imposed by some religious institutions against “bad conducts”, but it is also true that the same institutions often provide access to health-related activities and resources especially for the more marginalized sections of the population, (among which there is a higher level of religiosity). On the other hand, religiosity can negatively influence participation in clinical trials. For example, the belief that God determines who lives or dies from cancer may deter African Americans from participating in cancer clinical trials[7]. Furthermore, the uncertainty surrounding genetic studies may discourage participation in studies requiring biological samples.

Medical science is rapidly evolving along at least three lines: restorative/integrative medicine, regenerative medicine and precision medicine, whose lowest common denominator lies in the possibilities offered by the information technology revolution and by artificial intelligence. The term Medicine 4.0 hints at the idea of a fourth season of Medicine, the last in chronological order after Medicine 1.0, i.e., traditional medicine that for hundreds of years relied on the skills of physicians who had little more than the five senses to diagnose diseases and a small number of drugs, mostly derived from natural substances, and a limited choice of surgeries to cure their patients; Medicine 2. 0., that is, twentieth-century technological medicine, whose main innovations were the introduction of X-rays in the diagnostic field and of antibiotics in the therapeutic field; Medicine 3.0, characterized by miniaturization (microsystems) and electronics (computer-assisted surgery, image recognition, robotics).

With the expression Medicine 4.0 we intend to refer to the integration of Information and Communication Technology, electronics and microstructure technology for new forms of therapy such as personalized chemotherapy and therapeutic telemedicine.  Medicine 4.0 is the counterpart, in medical science and practice, of the Fourth Industrial Revolution, the latter of which is characterized by the fusion of physical, digital and biological technologies capable of impacting all economic and industrial disciplines. Similarly, in Medicine 4.0 the fusion of different technologies is the essential element of a process that challenges both the traits of healthcare professions and the very concept of “human”. The enormous potential of AI and new technologies in diagnostics and treatment raise a number of legal[8] and ethical[9] issues that need to be addressed. As William Gibson, a science fiction writer, said: «Technologies are morally neutral until we apply them»[10].

Precision medicine is one of the keywords (together with personalization, prediction, and prevention) of quantitative medicine. This latter represents a paradigm shift in the practice of medicine that emphasizes the use of big data and mathematical models to understand and treat disease. This approach is based on the idea that the human body can be studied as a complex system, with many interconnected parts that can be modeled and simulated using mathematical and computational tools.

Although the terms are used as synonyms, there is a fundamental difference between precision medicine and personalized medicine. Precision medicine represents the next stage in the evolution of patient care and refers to the use of molecular and genetic information to guide the development of targeted treatments for individual patients[11]. In contrast to one-size-fits-all approach, it takes into account the individual characteristics to tailor medical treatments[12]. Precision medicine identifies subgroups of patients who are at risk for developing specific diseases and who may respond differently to treatments. It aims at identifying the mechanisms underlying the disease and at modulating therapies to the specific cause of the disease. 

Personalized medicine[13] builds on the principles of precision medicine, but takes a broader view of the patient, considering not only the genetic characteristics, but also other factors such as his/her medical history, lifestyle, habits, environment and the social context in which he or she lives (socioecological context). This approach recognizes that patients may have different needs and preferences, emphasizing the importance of individual treatment plans. More precisely, the former studies the specific mechanisms that are responsible for the onset of a disease; the latter integrates the genetic characteristics of the patient with further informations which can exert an influence on the origin of disease, its effects, and response to treatment. Both are based on a deterministic understanding of disease using tools such as diagnosis of causal factors, ability to treat the root causes of disease, genomic and post-genomic biological databases, “omics,” cellular analysis and bioinformatics. Their main weapons are immunotherapy and nanomedicine.

And both are expressions of the so called patient-centered care model[14], whose goal seems to be more easily achievable by virtue of the use of new technologies and artificial intelligence, as in the cases of telemedicine and digital twins.

 

2. The medical Internet of things: telemedicine and digital twins

As known, telemedicine is the distribution of clinical services, via electronic information and telecommunication technologies. When lack of transport, lack of mobility, epidemics or pandemics, lack of financial support, or other contingencies restrict the access to care, telemedicine may bridge the gap. It is no coincidence that it has considerable grown during the Covid-19 pandemic, providing remote healthcare diagnosis and monitoring medical conditions such as hypertension and depression.

Digital Twins are a virtual entity that digitally recreate a physical entity, reshaping the physical world into a virtual digital space, with the help of historical data, real-time data and algorithm models[15]. Such replicas of the physical world and its contents (people and things) are called digital twins. They could be a car, a medical equipment or even a human.

Digital Twin provide technical support for constructing the Metaverse, commonly defined as fully immersive, parallel digital space offering replicas of the physical world^[16]. Although both the Metaverse and Digital Twins focus on the connection and interaction between the real and virtual worlds, the essential difference between the two is that the Metaverse is mostly oriented towards people, whereas Digital Twins are oriented towards things and are more concerned with the synchronization of data. They are adaptable to various fields and present numerous forms of expression. It is plausible to believe that – in a not too distant future – the use of Digital Twins will revolutionize healthcare[17], improving organizational system and medical research and implementing personalization of care.

Indeed, Digital Twins find application in the mapping of physiological characteristics and lifestyle of an individual in his environmental context, allowing the development of personalized treatments and providing support for precision medicine. There have already been attempts to use immersive experiences to revitalise healthcare services and delivery. For instance, in the video game Second Life, launched in 2003, there was a platform where various health initiatives were tested, including the Cystic F(A)ibrosis University, a Diabetes headquarters, a patient support networks for families of disabled children. The project “Living Heart” has been one of the first realistic virtual models of a human organ (the heart). The evolution of this model has led to the creation of digital twins of other organs.

The goal of digitizing the human body and creating replicas completely functioning of its internal systems has undoubted advantages such as the early discovery of diseases, the testing of treatments and the improvement of preparedness for surgery.

Today, despite the interest and increasing amount of progress in the field of personalized medicine, there are very few Digital Twin applications with real patients. One of the specialized centers is Linköping University in Sweden, which has mapped the RNA of mice in a digital twin to predict the effects of certain drugs.

Nevertheless, the use of both telemedicine and digital twins requires a careful reflection due to their legal and ethical implications^[18]. Promoting digital health can significantly enhance healthcare delivery and improve the population’s overall health. Several technologies, including artificial intelligence, can aid in optimizing patient care and management while ensuring cost-effectiveness. However, it raises ethical concerns such as the breach of personal privacy, the risk of misdiagnosis to a larger population, and potential bias to certain populations. Despite the many positive effects that technological advances will bring to human life in terms of health, economic and social benefits, there are also disadvantages: loss of job[19], loss of privacy, increasing social disequality.

In the case of telemedicine the risk of a dehumanization of the doctor-patient relationship is high.From one hand, patient has become a “digital” patient, more engaged in consulting specialized sites and reluctant to “negotiate” a therapeutic pact. On the other hand,
physical distance could deeply undermine the fiduciary relationship between the parties, affecting the role of consent.

Although the unstoppable aging of populations, the increase in chronic diseases, the difficulties in accessing care, and the need of ensuring cost-effectiveness suggest the implementation of telemedicine, its success depends on the disease indication and may not be suitable for all patients. Telemedicine is no doubt a resource, but if we think of hospitals located in disadvantaged areas, the prospect of building a meta-version of them sends us a digitally multiplied chaos and leaves the patients, especially the terminal ones, far from both virtual and real cures[20].

Similarly, digital twin application development has to deal with the quality and use of big data. Artificial intelligence using neural networks learns from biomedical data products collected basically through private companies that implement Digital Twins, consequently the quality and standards of the data are often poor homogeneous and badly structured. Moreover, personal data, such as biological, genetic and physical information, could be used for different purposes, for example by insurance companies to carry out profiling. Above all, digital twin technology understimates the role ofsocioecological factors (individual behaviours, race, education, status, religiosity etc.) in advancing personalised medicine efforts.

3. Transforming health through the metaverse. Is there a place for religion?

Patients often perceive that their spiritual needs are only partially met by health care providers. Likewise, the faith of the health care providers should be more considered in patient treatment. It is ingenuous to assume that people are religious only when they are in a church, mosque or temple, and that, in practicing healthcare, they adopt a non-religious perspective. Consequently, taking into account religious beliefs of both patients and health care providers might facilitate a greater degree of personalised medicine and provide more efficacious treatment, particularly in the areas of end-of-life care, organ donation and mental health.

At the end of life, for many people spiritual matters come to the fore and can be a great comfort[21]. It has long been acknowledged that pain is not always only physical and can encompass psychological, social and spiritual dimensions. Accordingly, to ensure truly holistic and person-centered care at end of life, professionals and providers should ensure that any spiritual needs of the individuals they care for are addressed. A person’s spiritual belief may lend itself to particular practice and rituals at the end of life, particularly when associated with an established faith[22]. Every individual’s spiritual needs and wishes are different. They may be affiliated to a faith or belief system, or may ascribe to an interpretation of a faith or belief system particular to their own culture and lifestyle. Faith traditions have rituals and beliefs that influence healthcare choices, bring comfort and meaning, and can facilitate attaining peace at the time of death.

Nearly all religious groups support organ and tissue donation and transplantation as long as it does not impede the life or hasten the death of the donor[23]. In Catholicism, donation is encouraged as an act of charity and love that saves or enhances life and is considered a demonstration of faith and love. In Judaism organ donations after death represent not only an act of kindness, but a also a “commanded obligation” which saves human lives. Organ donation is permitted in the Islamic faith as long as shar’i guidelines are met and that measures are in place to protect human dignity. Living donation is permitted in order to keep the recipient alive, or an essential function of their body intact. In the case of deceased donation, permission must be given by the deceased before their death or by their heirs after death. In 2019, the Fiqh Council of North America (FCNA) announced that organ donation and transplantation is permissible within the Islamic faith and among American Muslims. In Hinduismorgan donation is not prohibited by religious law, rather it is considered an individual’s decision. There are many references that support organ donation in Hindu scriptures. Daan is the original word in Sanskrit for donation meaning selfless giving. It is also third in the list of the ten Niyamas (virtuous acts). Life after death is a strong belief of Hindus and is an ongoing process of rebirth.

For around 84 percent of the world’s population, religion impacts important psychological constructs such as motivation, values, self-concepts, morality[24]. Investigating the relationship between religions and social variables, a substantial body of literature[25] has concluded that religion plays a critical role in emotional wellbeing, resilience, and mental health[26], reducing the impact of stressful events or generating hope and optimism. Religion is an essential aspect of social identity and a cornerstone of psychological wellbeing. The social support that the individual can receive from the religious congregation to which he or she belongs is also significant for the purposes of reducing stress. Scholars have also shown a remarkable association between religion and psychiatric outcomes[27], creating practice guidelines for psychiatrists to integrate patient religious beliefs with a personalized treatment plan. Surprisingly, the influence of religiosity on man’s choices and behavior in matters of health is underestimated. It is worth questioning whether the new technologies applied to medical sciences can recover the centrality of the religious factor in healthcare. Maybe Medicine 4.0 could fill this gap, allowing patients to take on the role of their own digital twin. Just as the Internet has transformed health, the “Proteus effect” could be a way of changing health attitudes in the future. To this aim, it is essential to recover the original vision of Meta (formerly Facebook) as a tool to get people even closer than they would be in the real world, expanding this into the religious realm[28]. Indeed, the social implications of the Metaverse are mostly centered on secular activities such as video game production, leisure, entertainment, retail, entertainment, tourism, and give little attention to religion and religious practices. All this, in spite of the fact that the sense of being together with other people is a characteristic attribute of the world’s major religious traditions. Moreover, people who share the same belief feel bound by moral rules that, although not having the universal value of the laws, are based on personal emotions. For example, what constitutes a “mortal sin” in each religion is felt as a rule that someway constraint faithfuls.  In this vein, some scholars[29] figure out that using digital twins of religious belief in future research could better reflect the changes in individual human emotions and thoughts in the Metaverse.

After all, there is no shortage of enthusiasm for creating a medical Internet of Things (MIoT): the “Expert Consensus on the Metaverse in Medicine”^[30] think that interaction between virtual and real cloud experts and doctors «will be able to carry out medical education, science popularization, consultation, graded diagnosis and treatment, clinical research, and even comprehensive healthcare in the metaverse».

 

4. Towards a systemic approach: integrating religion into Medicine 4.0

As stated previously, the abandonment of a holistic approach in favor of a reductionist approach has deeply impacted the practice of medicine and the conception of medicine itself. Since the Renaissance, reductionism is rooted in the assumption that complex problems are solvable by dividing them into smaller, simpler, units. The Cartesian dualism with the body and mind being separate entities is the philosophical perspective underlying this approach[31].

Reductionism came into its own in the mid-20th century and was based on the belief that the understanding of the human body requires the study of its individual parts and of the correlations between them. More recently, the development of new technologies like genomics and proteomics has allowed researchers to study the complex interactions between genes, proteins, and other biological molecules, and to develop more personalized and targeted treatments, fueling the rise of quantitative data and of mathematical models.

Despite these advances, there are still many challenges and limitations to the reductionist approach to medicine^[32]. Some critics argue that it focuses on treating individual symptoms, rather than addressing the underlying causes, and ignores the complexity and interconnections of the human body.Others observe that it can be dehumanizing, reducing patients to a collection of data symptoms and diagnoses, losing sight of the patient as a unique, a whole. The practice of medicine involves much more than simply identifying and targeting isolated biological processes. At its core, medicine is a humanistic endeavour that involves treating patients as unique individuals with complex physical, emotional, and social needs. Medicine is not anymore a knowhow, a therapeutic gesture; it is a “knowledge,”, a systemic framework for explaining and interpreting the “cases” of its “object-subject,” namely the human being. This latter need to be understood as an unique individual with complex physical, emotional, and social needs, as a network of body and mind from which derives an approach to the patient that must take into account his complexity, his interaction with the environment and with all other living beings, his needs and preferences. An alternative model in the medical interpretation of health and disease is the systems perspective, whose founding principle can be summarized as follows: the forest cannot be explained by studying the trees individually. Thus, rather than dividing a complex problem into its component parts, the systems perspective appreciates the comprehensive and composite characteristics of a problem.

In this vein, and as the examples provided demonstrate, integrating the religious belief into personalised medicine is urgently needed. Religion still maintain relevancy in the face of a new scientific and technocentric consciousness that seemingly contradicts traditional religious sensibility[33]. Although not always playing a direct creative role, religions can certainly utilize their inherent reflective capability to discern the possible impact of certain scientific and to preserve human dignity against the risks of depersonalization and dehumanization in the digital sphere[34].  In order to avoid the danger of a personalised medicine without the person, it is worth considering in future medical research also a Digital Twins of religious beliefs able to reflect the changes in individual human emotions and thoughts in the Metaverse. Religious belief must a have a place in the discussion of medicine and new technologies, because «whether you are an atheist, an agnostic, or a believer, religion still matters on some level—whether as a belief system, an ethical framework, or a cultural touchstone—to much of the world’s human population»^[35].

We must avoid the risk of a “digital catechism[36]” arising from technological idolatry. Religion can still maintain relevancy in a technocentric social and economic construct, in which it seems more plausible for Silicon Valley to be seen as the new Jerusalem, Google and Facebook as the new megachurches of the 21st century and, quoting the co-founder of Google Sergey Brin, the perfect search engine as “the Mind of God”^[37].

 

*This draft was presented at the 7^th International Conference of EUARE (European Academy of Religion) University of Palermo. The paper was evaluated by the board of the Conference.

[1] R. Santoro, F. Gravino, Internet, culture e religioni.  Spunti di riflessione per un web interculturale, in Stato, Chiese e pluralismo confessionale, 2020, n. 20.

[2] H.G. Koenig, D.E. King, V.B. Carson, Handbook of Religion and Health, 2nd ed, New York, NY: Oxford University Press, 2012.

[3] See L. Decimo, A. Fuccillo, F. Sorvillo, Diritto e religioni nelle scelte alimentari, in Stato, Chiese e pluralismo confessionale, 2016, n. 18, p. 3.; A. Fuccillo, Il cibo degli dei. Diritto, religioni, mercati alimentari, Torino, 2015; L Saporito, I consumatori del ghetto: cibo religiosamente orientato e mercati alimentari, in Comparazione e diritto civile, 2021, n. 1, p. 8.

[4] S. Coakly, Religion and the Body, Cambridge: Cambridge University Press, 1997.

[5] J. Tartaro, L.J. Luecken, H.E. Gunn, Exploring heart and soul: Effects of religiosity/spirituality and gender on blood pressure and cortisol stress responses, in Journ. Health Psychol., 2005,10(6), p. 753 ss.

[6] A. Moscati, B. Mezuk, Losing Faith and Finding Religion: Religiosity over the life course and substance use and abuse, in Drug Alcohol Depend, 2014,1. p. 127 ss.

[7] V.L. Shavers‐Hornaday, C.F. Lynch, L.F. Burmeister, J.C. Torner, Why are African Americans under‐represented in medical research studies? Impediments to participation, in Ethnicity & Health, 1997, 2, p. 31 ss.

[8]  See C. Perlingieri, Gli enigmi della medicina predittiva’ nell’era dell’Intelligenza artificiale, Draft presented at the Conference “Ruolo del Notaio: “baricentro” di una funzione promozionale nell’attuale esperienza giuridica. Rileggendo Carmine Donisi”, Sorrento, 2024.

[9] Comitato nazionale per la bioetica, Riflessioni bioetiche sulla medicina di precisione e sviluppi diagnostico-terapeutici, 19 novembre 2020

[10][10] William Gibson Interview, http://josefsson.net/gibson/

[11] K.H.K. Yeary, K.I. Alcaraz, K.T. Ashing, C. Chiu, S.M. Christy, K.F. Felsted, C.I. Lu Q, Lumpkins, K.S. Masters, R.L. Newton, C.L. Park, M.J. Shen, V.J. Silfee, B. Yanez, J. Yi, Considering religion and spirituality in precision medicine, in Transl. Behav. Med., 2020, 10, p. 195.

[12]  F.S. Collins, H.A. Varmus, A new initiative on precision medicine, in  N. Engl. Journ. Med., 2015, 372, p. 793 ss.

[13] AA.VV., Persona e Medicina. Sinergie sistemiche per la medicina personalizzata, a cura di F. Anelli, A. Cesario, M. D’Oria, C. Giuliodori, G. Scambia, 2021, Milano, S. Giardina, E.  Giardina, La medicina personalizzata: dalle radici storiche al futuro postgenomico, in Tendenze nuove, 2013, 4, p. 359 ss.

[14]  Consiglio di Europa, Conclusioni del Consiglio su una medicina personalizzata per i pazienti (2015/C 421/03).

[15] A. El Saddik, Digital Twins: The Convergence of Multimedia Technologies, IEEE MultiMedia, 2018, 25(2), p. 87 ss.

[16] Definitions for the metaverse vary and there is still much uncertainty in its eventual future manifestation. It is perhaps best defined as a fully immersive, parallel digital reality where users will be able to interact at a scale previously unimagined. (see, S. Mystakidis, Metaverse,  in Encyclopedia, 2022, 2, p. 486 ss.

[17] K. Bruynseels, F. Santoni de Sio, J. van den Hoven, Digital twins in health care: ethical implications of an emerging engineering paradigm, in Frontiers in Genetics, 2018, p. 9.

[18] See E. Popa, M. van Hilten, E. Oosterkamp, M.J. Bogaardt,  The use of digital twins in healthcare: socio-ethical benefits and socio-ethical risks, in  Life Sciences, Society and Policy, 2021, vol. 17; A. M. Tagoranao Gamon, Ethics of Digital Health from an Islamic Perspective, in J. Science and Technology, 2023, vol. 28, 1.

[19] C. B. Frey, M.A. Osborne, The future of employment: How susceptible are jobs to computerisation?, in Technological Forecasting and Social Change, 2017, p. 254 ss.

[20] M. Leone, Metavolti, volti a metà e volti-meta: Il destino del viso nella realtà immersiva, in Academia.edu., 12 maggio 2022, p. 8.

[21] Public Health England, Faith at end of life. A resource for professionals, providers and commissioners working in communities, London, 2016; G. Galanti, Caring for Patients from Different Cultures, 2008, Philadelphia.

[22]  T. Balboni, M. Balboni, ME Paulk, et al., Support of cancer patients’ spiritual needs and associations with medical care costs at the end of life, in Cancer, 2011, 117(23), p. 5383 ss.

[23] S.E. Morgan, Many facets of reluctance: African Americans and the decision (not) to donate organs, in J Natl Med Assoc, 2006;98(5), p. 695 ss.; Y.W. Yew, S.M. Saw, J.C. Pan, et al., Knowledge and beliefs on corneal donation in Singapore adults, in Br.J. Ophthalmol., 2005, 89(7), p. 835  ss.

[24] Pew Research Center, The Global Religious Landscape: A Report on the Size and Distribution of the World’s Major Religious Groups as of 2010, Washington, 2012.

[25] L. Miller, P. Wickramaratne, M.J. Gameroff, M. Sage, C.E. Tenke, M.M. Weissman, Religiosity and major depression in adults at high risk: A ten-year prospective study, in Am J Psychiatry, 2012, 169, p. 89 ss.

[26] People’s cognitive and behavioral responses to stressful life events are frequently informed by their faith traditions: see K.I. Pargament, The Psychology of Religion and Coping, New York, 1997.

[27] T.B. Smith, J. Poll, M.E. McCullough, Religiousness and depression: Evidence for a main effect and the moderating influence of stressful life events, in Psychol Bull., 2003, 29(4), p. 614 ss.

[28] «Religion, belief, and prayer have a place in the discussion of AI and ethics, because whether you are an atheist, an agnostic, or a believer, religion still matters on some level-whether as a belief system, an ethical framework, or a cultural touchstone-to much of the world’s human population» (F. Coleman, A Human Algorithm: How Artificial Intelligence Is Redefining Who We Are, Berkeley, 2019, p. 224).

[29] L.V. Zhihan, X. Shuxuan, L. Yuxi, M.S. Hossain, A. El Saddik, Building the metaverse using digital twins at all scales, states, and relations, in Virtual Reality & Intelligent Hardware, 2022, vol. 4., 6, p. 466.

[30] Yang, D., Zhou, J., Chen, R C., Song, Y.L., Song, Z.J., Zhang, X.J., Wang, Q., Zhou, C.Z., Sun, J.Y., Zhang, L.C., Bai, L., Wang, Y.H., Wang, X., Lu, Y.T., Xin, H.Y., Powell, C.A., Thüemmler,C., Chavannes, N.H., Chen, W., Wu, L., Bai, C.X. (2022). Expert consensus on the metaverse in medicine, in Clinical eHealth, 2022, vol. 5, pp. 1-9. The expert group has discussed the definition of the metaverse in the medical context, and its concept and application scenarios, as well as its clinical importance. See also M. Massetti, G.A. Chiariello, The metaverse in medicine, in European Heart Journal Supplements, Volume 25, Issue Supplement_B, April 2023-

[31] N. Mehta, Mind-body dualism: A critique from a health perspective, in Mens Sana Monogr., 2011, 9, p. 202.

[32] In this vein see L. Saba, S. Tagliagambe, Quantitative medicine: Tracing the transition from holistic to reductionist approaches. A new “quantitative holism” is possible?, in Journal of Public Health Research, 2023, vol. 12(2), p. 1 ss. The authors stress the need to balance reductionist and holistic approaches in order to achieve a comprehensive understanding of human health.

[33] Elaine Howard Ecklund, Why Science and Faith Need Each Other (Grand Rapids, MI: Brazos Press, 2020), 33.

[34]  See A. Fuccillo, Il paradiso digitale. Diritto e religioni nell’iperuranio del web, Napoli, 2023.

[35] F. Coleman, A Human Algorithm: How Artificial Intelligence Is Redefining Who We Are (Berkeley, CA: Counterpoint, 2019), 224-225.

[36] K. Healey, Robert H. Woods Jr., Ethics and Religion in the Age of Social Media: Digital Proverbs for Responsible Citizens (New York, NY: Routledge, 2019  Kindle version: the authors outline a set of five “proverbs” for living responsibly in the digital world: (1) information is not wisdom; (2) transparency is not authenticity; (3) convergence is not integrity; (4) processing is not judgment; and (5) storage is not memory.