Featured image of post book 「 Dying in 2045 」 Digital Society

book 「 Dying in 2045 」 Digital Society

An outlook in year 2045, in which we live and die as digital society.

Abstract

“Dying in 2045: Digital Society” offers an insightful outlook into a future where technology and society have evolved together, profoundly affecting how we live and eventually die. The book explores the deep integration of digitalization in our daily lives, touching on its historical roots and potential trajectory towards 2045. It delves into the concept of true digitalization, distinguishing it from mere digital mimicry and underscoring its transformative impact across various domains, including healthcare, consumer trends, and end-of-life experiences.

Chapter’s Overview:

  • Introduction: Sets the stage by reflecting on digitalization’s historical roots and its profound influence on society. This chapter contemplates the profound changes digitalization has brought, starting from Morse code to AI-driven technologies.
  • Currently Existing Trends in Technology and Digitalization: Examines current technological trends and their implications. Focuses on the status quo of technology, particularly in healthcare and consumer products.
  • True Digitalization: Differentiates between superficial digital mimicry and genuine, transformative digitalization. Explores the evolution of digitalization from initial replication of physical entities to fully realized digital integration.
  • Consumer Trends: Discusses current trends in consumer technology, particularly health tracking and digital healthcare apps. Analyzes current consumer technologies like health tracking wearables and digital healthcare apps, highlighting their benefits and shortcomings.
  • Upcoming Trends: Predicts future developments in IT corporations, digital healthcare, AI in mental health, the metaverse, and blockchain in healthcare. Looks at future prospects, including IT giants entering healthcare, AI in mental health, metaverse development, and blockchain’s potential in healthcare.
  • End of Life: Explores how digital advancements might alter perceptions and experiences of death. Speculates on how technology might transform our experience of death, including digital avatars and virtual reality.

“Dying in 2045: Digital Society” paints a vivid picture of a future where digital technology is deeply woven into our social fabric. It predicts significant transformations in healthcare, consumer behavior, and even our understanding of life and death. The book encourages readers to consider how these advancements might shape not just technology but our very humanity.

Introduction

How many more times will you remember a certain afternoon of your childhood, some afternoon that’s so deeply a part of your being that you can’t even conceive of your life without it? Perhaps four or five times more. Perhaps not even that. How many more times will you watch the full moon rise? Perhaps twenty. And yet it all seems limitless.

Paul Bowles, The Sheltering Sky

The history of digitalization in Germany began long before the first computers. We could start describing it since Friedrich Clemens Gerke simplified Morse code in Hamburg back in the XIX century, but we won’t. More importantly, it’s how digital technology thrives (or not) in modern times and what we can expect from the near and relatively far future in 2045.

It is worth describing the epoch of the prognosis first, as no technology exists in isolation and strongly depends on what social, political, and climate environments are. One pandemic outbreak transformed industries, made people work from home massively, and increased the speed of adoption of contactless payments. Even the vaccine itself was created in such a short time thanks to the progress in AI (Park, 2021). In 25 years, we will most probably have many black swan type of events, which would probably make all predictions irrelevant, as that is exactly the nature of such events - they are so rare and improbable, that we tend to neglect the very possibility of their occurrence. Still, it is worth trying to make an educated guess and propose an assumption, as such an exercise can show the undesirable shifts (even without major largely unpredictable incidents) in a long-term perspective, which will bring us to the future we probably would like to avoid. So after such, we could try to reflect where we took a wrong turn or a shortcut, and try to get back on course to prosperity. Or at least survival.

The target for this prognosis is the year 2045. So, Vladimir Putin is probably still president of Russia (the name might be different, the spirit is the same), Berlin’s airport is still under construction, and America is trying to be great yet again. Politicians are still talking about embracing the new digital world, which is of course still a new land for all of us, and you might probably still need a fax machine from time to time to communicate with this governmental institution.

Seriously though, as we are trying to make predictions about seniority and the process of dying, it is important to understand what generation will be considered seniors in 2045. It is relatively safe to say that people will retire at a more advanced age than 67, as now. Now students tend to stay at the university considerably longer than at the beginning of the century and start working professionally even later, the fringe of retirement is going to move further and further. Considering the current declining birthrate, the government will be left with no other choice but to postpone the retirement edge. It can be proposed that “seniors of the future” will be people older than 70, maybe even 75.

If we as humanity survive another 25 years, today’s 40-45-year-olds will become these “seniors of the future”. It is a generation of people who were born in the 80s.

They were born before the internet was a thing (the invention of the internet happened in 1983), they didn’t have smartphones in school, but they know why the “save the document” button has a floppy disk icon and what sound a dial-up modem made. This is a generation of the digital revolution, lived through the web 1.0, web 2.0, and now they have entered the era of web 3.0. For sure, these people know how to adapt, and they might be almost the last generation that had time to grow some skin to actually be resilient, maybe they are the last such species on this planet. They already experienced so much in their life and they probably will witness several more revolutions down the line.

What are the traits of the generation we are talking about? There are managers (and other white-collars) among them, they are the first generation who could become true IT specialists. As soon as the internet and remote workstyle became a thing, many of them chose the path of digital nomads. They are the first generation to become self-published writers aka bloggers. They already survived one pandemic and they probably will need to overstay more lockdowns in these 25 years. They survived several economic crises and at the time of writing are trying to survive yet another one. It is too soon to state if they will be the World War III survivors, as well as the global climate crisis survivors.

Considering the weight on the shoulders of only this generation, and taking into consideration that Gen Z didn’t have a relatively calm childhood - instead, they were just thrown into the whirlwind of social media, informational noise, fear of missing out, endless anxiety, cancel culture, cryptocurrency, and pixelated pictures of apes sold at the price of a mansion - we can be absolutely sure we will have at least one societal collapse in the future years. As so many generations right now have completely opposite views, and the digital sphere makes it easier than ever to clash based on any misalignments. At that point, it wouldn’t be much of a surprise, if we would also be visited by aliens and attacked by zombies in the next 25 years.

Based on the picture we just drew, the digitalization of dying is going to fit into a very complex scenery. So we will start with observing the current stand of technology and digitalization, then take a look at trends that can be identified, and only after that will try to connect this to healthcare, medicine, and finally - dying. So basically we will use a classical spotlight and the flare method (Simi, 2020) by first going wide, trying to see the bigger picture, and then going narrow, focusing on what the book is actually about.

Now when we describe the people we are targeting for the prognosis, it makes sense to picture the status quo of technology and digitalization. In other words, describe what our digital space looks like right now. In this section, we will first define what digitalization even means and how true digitalization opens new possibilities. Then we take a look at trends from different perspectives: from the point of view of a consumer, corporations, and healthcare providers.

True Digitalization

Digitalization can be roughly separated into two phases - the phase of mimicking the real object and true digitalization.

Digitalization always starts with copying the existing object or process and transferring it as-is to the digital space. Since the screen became capable of displaying more or less realistic pictures, the user interfaces tried to mimic real objects. Virtually every reading app used a wooden bookshelf background to help users make a clear connection between a real object and an action and a virtual analogy of them. So, the abstraction level at first is always low in order to ensure a higher adoption rate.

An example of such a mimicking phase of digitalization was the way newspapers tried to adapt to the new reality by keeping the classic newspaper format and spreading the magazines over PDF. While some journals and magazines managed to keep this way of spreading their issues, the majority of the press embraced the new format.

Unfortunately, too many apps ignore the usability and reading experience of their customers. In certain industries, this is more prominent than in others. For example, apps of the telecommunication and insurance providers often look like a proper app at first glance, but every attempt to go deeper in any of the subcategories reveals the true nature of such apps - those are just website wrappers, meaning that the content is not part of the app itself but is just accessed over the internet as every browser would do. That alone is a sufficient reason not to use these apps in the first place and just stick to a provider’s webpage, as it is unclear why bother downloading the app if there are no advantages to using such. Developers of such apps would argue that this approach saves costs, but what would save costs even more is not to do this app at all. Moreover, the absolute majority of the apps in the same industry will ask the user to download a PDF to see the contract details or the latest invoice. This is another shortcut and shows nothing but the laziness of developers and the indifference of executive and strategy managers about the service they provide.

To this day, some magazines are spreading their issues via PDF. To me, that either means the issuer didn’t bother compiling a proper and readable version of the content on the website, doesn’t understand how to sell digital content effectively, or they are targeting a very niche target audience, who has certain needs (and they probably don’t have resources to support both PDF and HTML versions of the content). For the majority of people, content formatted in an adaptive way (which looks good on both bigger and smaller screens) is the most comfortable way of reading (about 59% of the traffic on the internet is associated with smartphones). Reading a PDF on mobile is a very special kind of pleasure, and not every user enjoys it, to say the least. Significantly fewer people prefer desktop (about 39% of traffic) - these users can bear reading PDFs because of larger screens. According to statistics, a marginally low amount of traffic on the internet is associated with tablets (less than 2%) - and tablets are probably the only type of devices which provides a decent reading experience for PDF reading. The last number can be a bit off though, as users on tablets might just as well use desktop versions of the websites and therefore be recognized as desktop users, which may shift statistics towards desktops. Desktop Vs Mobile Vs Tablet Market Share Worldwide, 2022

True digitalization means that the process passed this first mimicking phase, is detached from physical limitations, and utilizes the full potential of being virtual. True digitalization does not happen in isolation, meaning that the world surrounding the object or a process also should change. For newspapers and magazines, that means switching to a format suitable for devices users actually use, considering the screen types and matching the fonts and layouts, which look best on those certain screens.

The concept of writing has changed with the change in technology. Writing has always adapted to the tools currently in use - cuneiform was born not because of the aesthetics of the straight lines but because of the necessity to use sharp tools on a firm surface. Then there were scrolls - with the trait of being long and relatively compact, the limitation was that they weren’t really convenient to produce in masses. Another inconvenience was with the increase in the length of written materials - it is not particularly convenient to index endless pieces of paper and reference parts of it. Traditional boxy books appeared and tried to fix the indexing problem with pagination and chapters. The duplication of a handwritten book was so time-consuming that even a cumbersome printing press was a better solution. Portable consumer-level typewriters shrank the size of the most widespread paper to A4 or letter size, and that is what digital writing of today inherited and mostly uses to date. Only in the very recent years, when the paperless culture started to spread, did consumers start to use an endless canvas for typing. An endless canvas possesses several traits of a digital space - it allows the creation of documents in various forms, depending on what the user tries to showcase or emphasize. For example, the Prezi presentation tool uses scaling and scrolling instead of switching slides and therefore provides the ability to show the bigger picture without hacks and tricks.

Digitalization also solved the indexing problem with hyperlinks (and bidirectional links), which allow citing and pointing to any point in a document, and basically, hyperlinks are still the backbone of the internet. Funnily enough, initially created to make scientific publications more interactive and up-to-date, the hyperlinks and the internet itself were able to revolutionize almost everything but science. Papers are still submitted in a strict format - A4, often black and white, and the publications are also published and accessed in PDF (portable document format). That has obvious drawbacks, like the inability to create interactive plots or embed videos, which could help researchers visualize the idea in a significantly better way. One might argue that the current standard of publication makes those very standardized and therefore relatively easily readable - readers can expect a solid publication to have a scientific structure - but that is actually not an issue whatsoever, as it is absolutely possible to enforce the submission of structured documents without the limits of an A4 piece of paper. Many software solutions do a great job of limiting the usage of decorative tools and therefore providing a unified look to all documents produced by the tool. A combination of LaTeX with limitless canvas and interactive tables or plots would make the whole difference in the way humanity publishes the results of scientific research.

One of the current trends in document production and note-taking are bidirectional links and block quotes (or synchronized blocks), which allow the creation of a network of interconnected pieces of content, and do that without duplication of paragraphs. Editing one synchronized block updates information in the linked block in all places of occurrence, creating a coherent knowledge database. Connections between such pieces of information can be represented as such a network reminiscent of neurons and can be legitimately called a second brain. By using such tools, humans can outsource long-term information storage to an external system.

Obsidian.md’s graph view represents interconnected notes, which can be used to cluster and explore topics in personal and professional knowledge databases.

With digitalization in healthcare, the process of becoming truly digital varies significantly. Some data is captured in a very digital-friendly, granular form, which is what the FHIR (Fast Healthcare Interoperability Resources) HL7 (Health Level Seven International) standard tries to roll out globally. This standard fundamentally enables interoperability by structuring data, so that every supported system can interpret and allocate the incoming data stream correctly. For example, one field with the patient’s name should always be labeled in an unambiguous way, vastly reducing the chance of machine error. However, not every medical system and medical device supports this standard, leaving some data very isolated.

Patients often receive results of lab analyses on paper or in PDF, and the same goes for prescriptions. Digital patient records are barely used. This means that when patients visit another doctor, the data must either be requested from the lab or entered manually. The ePA (Elektronische Patientenakte) should address this issue by giving patients access to their results and allowing them to grant access to such data to certain doctors or clinics. As long as the adoption of the ePA remains marginally low (“Elektronische Patientenakte: Einführung Läuft Schleppend, 2022”), the situation won’t change.

Granular, true digital patient data exchange should drastically reduce the amount of mistreatment by seamlessly sharing data with all involved parties, enabling the analysis of prescriptions for mutual incompatibilities, and simplifying patients’ understanding of their own conditions. This simplification should work in the same way as an online calculator with visualization simplifies understanding of bureaucratic processes such as taxation or insurance, which otherwise can only be fully understood by reading large amounts of fine text.

To predict future trends, it’s sensible to grasp a feeling of what is trending now - what is the bleeding edge of digital technology. The consideration of each trend is represented as answers to five questions:

  • What is the trend about?
  • What are typical actuators of the trend?
  • What are the advantages for consumers?
  • What are the disadvantages for consumers?

Health Tracking

Wearable devices have shown steady growth over the last few years. In 2016, only 325 million devices were in use; by 2022, the number of wearables had almost tripled to 1.1 billion. Consumers count steps, heartbeats, blood oxygen saturation percentages, and minutes spent in certain sleep phases. Recently, the most advanced devices have started to provide (somewhat limited) ECG measurements.

Thanks to movement and fitness analysis, consumers can now see significantly more insights about body quality. For example, deviations in walking steadiness, double support time, and walking symmetry might indicate certain conditions - all this information and much more is now available in the form of graphics and quantitative analysis at any time. The accuracy of the measurement itself is definitely not on par with professional fitness evaluation, but the fact of continuous data collection makes it possible to build individualized trends, which is more important than the absolute deviation from average values.

However, health tracking goes beyond wearables. For example, there are smart scales that can automatically calculate body mass index and approximate body composition (not particularly accurately) and send the data to a smartphone, making it easier to track the progress of losing or gaining weight.

In general, health tracking capabilities are mostly prominent on mobile devices. Both Android and iOS provide solid apps. The user experience for iOS users is, traditionally, more guided and polished - the Apple Health app is part of the standard package and comes preinstalled. On Android, each smartphone manufacturer has their own implementation, which can be downloaded on almost any device. However, the user interface, quality of the app, and security standards vary a lot.

Some health apps make the attempt of sharing data with your physician easier than others, but acceptance of user-collected data is not widespread for now. This is a shame actually, as this data is true-digital, as collected and can be transferred in digital format (which might not be compatible with FHIR HL7), simplifying telemedical diagnosis and observation. Without any doubt, each manufacturer and developer also uses the collected data for their own purposes. The difference is only whether this usage is clearly announced and declared or not. It might be great news for researchers who can partner with smartphone and fitness tracker producers and get whopping amounts of data in a data-science suitable format, which they otherwise would never be able to collect in any reasonable time. This is obviously interesting for manufacturers themselves, allowing them to improve quality, innovate, and hire great employees to work on their products. It can’t be excluded that some manufacturers might use data for marketing purposes, although most of them claim that they don’t. Especially shady might be smaller and less-known manufacturers, which produce smartphones, fitness trackers, and develop apps for them - and they do all this for the price of a dinner for two in a good restaurant. Saying, “If the goods are free or too cheap - the real good here is you”.

Fitness trackers’ data is extremely valuable not only for advertisers but also for health insurance companies. Now, some insurances already offer mild discounts for people who own fitness trackers or even send such trackers to their clients. It is foreseeable that we might end up in a situation where if you are not obeying every single healthy lifestyle trend, your health insurance will be more expensive for you.

Despite all these fitness trackers being sold and advertised, humanity still has a massive problem with a lack of activity, and the obesity problem in society continues to grow. It might have something to do with pandemics, but probably also due to the trend towards normalization of obesity. So apparently, wearables are losing the battle to motivate people to go for a walk or cut this tasty hamburger in half and share it with a friend or partner. Considering that tech corporations often almost blindly follow such social trends, we can’t exclude that in the future the BMIs or similar metrics also in apps will be rethought, which would revert the effect of trackers and provide even more justification for an unhealthy lifestyle.

On another side of the spectrum, there are hypochondriac people, who will be even more worried about every mild change in health, which might lead to doctors being overrun by people who “searched this change of trend on the internet and it is for sure a severe sign of X-syndrome”.

Although health tracking trends for sure pose some threats, the advantages for consumers still outweigh the cons. Multiple studies have shown that fitness trackers can boost health and improve lifestyle by providing gamification of [routine tasks like exercising](https://www.webmd.com/fitness-exercise/news/20220726/more-evidence-fitness-trackers-can-boost-your-health#1, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407266/). Motivation to be more physically active is hard to overestimate in our age of sitting jobs, but also paying attention to symptoms, which people tend to ignore, easy tracking of alcohol or nicotine consumption can contribute to the cultivation of healthy habits.

The trend also forces physicians to pay attention to early signs and encourage early diagnostics. It is especially easy as the data in well-designed health tracking apps is visualized in an understandable way.

Self-tests and Back-tracking of Sick People

One special case of health trackers are reporting tools, which became prominent during the Covid-19 pandemic. These apps can capture the fact of being sick and report this to a centralized data center to back-track the chain of infection spread and warn people who were near the sick person. This process is known as exposure tracking and notification.

Exposure tracking works based on handshakes of randomly created and frequently updated identifiers for each user, which use the physical proximity of the devices in an anonymous and non-location-related way. The identifiers are then sent to the data center, which processes them. If one of the users submits a positive test result, all identifiers that were in contact with this user receive an exposure notification on their smartphone.

The Covid pandemic induced change and accelerated development in many areas, from cash-free payments and grocery delivery services to almost global infection spread tracking systems. One remarkable outcome was that Google and Apple could agree on data collection standards, allowing national governments to adopt the standard in their app implementations. In Germany, the app is called Corona-Warn and is developed as an open-source project by German Telekom AG in collaboration with SAP AG. The app is a so-called superapp, meaning it combines many functions. Users can use one or several functions without the necessity to register, provide personal data, or turn on exposure tracking.

Functions of the app include:

  • Informational support about official statistics.
  • Current rules of wearing masks and vaccination.
  • Users can also declare themselves sick, thereby initiating the notification sent out to people they previously met (based on proximity data).
  • One can upload a vaccination certificate and show it as needed as a QR code.
  • Users can scan an event QR or even create one, which would notify all visitors if one of the event’s visitors tested positive and reported it afterward.

Apple and Google claim that they do not receive data collected by these apps, and so far, no evidence implies the opposite. The Corona-Warn implementation of the exposure tracking technology is also open-sourced, which allows the community to check that the statement is actually true and even contribute to the solution by proposing improvements in code. This shows socially responsible behavior from corporations, and their interest might be in attempting to score some trust from the population. For developers (companies that built solutions based on exposure tracking technology), creating such apps represents the possibility to participate in governmental grants.

The app is a great and very well-made official source of information about Covid-19, both nationally and locally. It is a properly made app, with updating numbers and dashboards, which makes the user experience smooth and pleasant. No embedded websites (some links indeed lead to external websites, but those are mostly there to “read more”), no PDFs to download; everything is displayed and scaled properly for mobile screens.

Also, the ability to create a true-digital version of your vaccination certificate is a great plus. Being able to show a valid certificate via QR code so that it also can be checked, is amazing and frees you from carrying around an original yellow vaccination passport.

Although the idea of back-tracking makes total sense, the implementation gives you relatively little confidence regarding whether you are at risk or not. Reporting over the app in Germany is not mandatory, so each person decides for themselves whether to opt in or not. Numbers say that more than 200 million tests (positive and negative) were captured and sent over the app during the pandemic [Corona-Warn-App: Anzahl übermittelter Testergebnisse in Deutschland 2022 | Statista]. These numbers should not be confused with official confirmed cases, as negative tests can also be submitted. Currently, only about 5% of confirmed cases were reported via the app [Datenschutz versus Effizienz: Sollte die Corona-Warn-App überarbeitet werden?].

Also, bureaucracy is (always) in the way. Theoretically, those who receive the red notice (“you contacted a person who filed a report of being positively tested for covid”) are eligible to receive a free PCR test. In reality, it is up to medical practice to decide, and as reports say, apparently not every Hausarzt has the capacity to perform these tests.

As a result of all that, the Corona-Warn app in its current state of non-mandatory opt-in reporting is great as an official source of information and certificate-wallet/scanner, but unreliable for exposure risk estimation. If the usage of the app were mandatory, as in, for example, South Korea, one could speak of any efficiency of the back-tracking, as the measurements would be on a different qualitative level. As it is often the case with half-measures, the problem can’t be fully solved without being bold.

Digital Healthcare Apps

Digital healthcare apps have been available since October 2020. These are apps that can officially be prescribed by a physician, with their usage costs covered by insurance. The scope of these apps is diverse, but they often focus on the self-treatment of mental or physical conditions. Apps may provide information on how to deal with psychiatric disorders, pain, trauma, and may include tools for journaling psychological conditions, tracking progress in physical exercises, or symptoms. Currently, around 33 apps are registered as digital healthcare apps.

The idea is promising, but a reality check reveals that some aspects might not have been thoroughly considered.

First, it’s important to understand why these apps are needed, who is developing them, and who is using them. Therapy apps are in demand due to the catastrophic deficit of healthcare specialists across the entire healthcare industry. Excluding deficits in highly specialized stationary professionals (who likely won’t be replaced by apps in the near or distant future), there are too few mental health professionals, rehabilitation physicians, and special care specialists. This shortage means that patients either have to wait in long queues for treatment they need immediately or use an app as a substitute. App usage is also more cost-effective (despite relatively high bills charged by developers for single patients - approximately 200 to 700 Euros per quarter per patient) than the valuable time of medical personnel.

This demand and the relatively high margins have led various companies (including those with no prior experience in software development) to jump on this bandwagon before regulation becomes stricter. Surprisingly, especially in Germany, the efficacy of these apps can be declared by the developers themselves, and these claims are rarely checked by the regulator BFAM. This means that an unknown number of non-evidence-based apps are being used by actual patients. These apps don’t have any sort of “beta”, early access, or similar labels, nor do they have an experimental status, because otherwise, they wouldn’t be applicable to patients. Considering how overregulated the medical sphere generally is, particularly in Germany, this situation appears to be the complete opposite, resembling the wild west during the gold rush.

Not only is the efficacy unproven, but the security and privacy aspects are also questionable. With a lack of regulatory employees who understand digital systems, there’s no way to thoroughly check these apps for potential security vulnerabilities. Despite the small number of apps on the market (less than 50), it seems feasible to examine them all. Regulators seem to blindly trust that developers will handle security themselves, but this approach is flawed. As shown by voluntary and reputable German IT researchers, a significant number of these apps completely ignore basic security standards, leading to the loss of a substantial amount (estimated at at least 20,000 accounts) of highly sensitive medical records of real patients.

Furthermore, these apps function as a replacement, not an addition, to professional medical treatment. This means there is no synergy between the physician and the patient; no one reviews the data or reacts if it indicates the patient is at risk. Essentially, these apps are another isolated data island, not integrated into the healthcare system. Given the security issues, some of these apps may require complete redevelopment.

While the concept of digital healthcare apps is innovative, its execution is poor and incompetent. A significant amount of insurance payers’ money is flowing into the hands of developers who apparently are not delivering quality work. This situation demonstrates that decision-makers’ treatment of digitalization is based on assumptions and superficial knowledge, leading to poor performance of the initiative and undermining public trust in the concept.

IT Corporations Entering Conservative Industries

The healthcare industry, dominated by a handful of corporations established decades ago, is witnessing a new player: IT corporations. These companies, often younger, hungrier, and bolder, have amassed fortunes in a fraction of the time compared to healthcare giants. They frequently rejuvenate themselves by acquiring disruptive startups. Now, they are eyeing an industry that sometimes seems so bureaucratized and overregulated that it might be easier to rebuild it from scratch.

IT corporations have already made inroads into healthcare with health hubs that collect user data in true digital format. They have partnered with universities and researchers to innovate wearable technology. In recent years, wearable tech has advanced to the point where some devices can be considered medical devices for special cases. We are now starting to see tech giants acquiring entire networks of clinics, such as Amazon’s acquisition of One Medical, to ensure an uninterrupted flow of data between customer devices, diagnostics, and therapy – a milestone traditional healthcare has failed to achieve despite significant investment.

Why are IT corporations interested in healthcare? Primarily, healthcare is lucrative. Financial interests will always be paramount for virtually all players in any industry. Secondly, employee wellbeing is a factor. If traditional healthcare can’t provide affordable, effective preventive medicine, or deal with user-collected healthcare data, corporations will acquire their own clinics and set their own rules, based on what internet users are accustomed to – continuous data flow and big data analysis.

We also see how devices are starting to serve as emergency aids. In 2022, Apple announced satellite support for emergency calls in areas without cell coverage and crash detection support. For several years, wearable devices have been able to call an ambulance if the user falls and doesn’t respond to the prompt “Are you ok?”

What can we expect next? Which healthcare-related spheres still untouched by true digitalization might technology infiltrate next? Health insurance and first responders come to mind. Imagine a future where health insurance is designed to save customers by any means, where first responders have clear prioritization of targets based on the insurance tier of the client. Combined with privately controlled clinics, those who can afford it will receive treatment akin to space tourism: incredibly individualized, exorbitantly expensive, and largely unattainable for most of the planet.

Another emerging area is military technology. SpaceX, the first private space exploration company, also provides satellite internet. During the Russian-Ukrainian conflict in 2022, SpaceX supplied satellite internet to the Ukrainian army, considered humanitarian assistance. However, considering global tensions and the fact that today’s technology is heavily software and digital circuit reliant – areas where IT corporations excel – it’s conceivable that a major corporation could create a military department.

This leads to a dystopian scenario: a corporation that dominates IT, healthcare, and military technology, controls access to insurance and first responders, and caters to clients willing to pay substantial sums for security and safety, regardless of location or time. We can envision touristic tours to battlefields, where super-rich VIP clients are accompanied by private military campaign troops, and top-tier emergency responders are poised to override any obstacle to protect the client. This is a future we are potentially heading towards, as our world becomes increasingly volatile, uncertain, complex, and ambiguous.

Digital Healthcare Apps

Digital healthcare apps have been around since October 2020. These apps can officially be prescribed by a physician, with their usage costs covered by insurance. They often focus on the self-treatment of mental or physical conditions, offering information on managing psychiatric disorders, pain, trauma, and tools for journaling psychological conditions or tracking physical exercise and symptoms. Currently, about 33 apps are registered as digital healthcare apps.

While the concept is promising, a closer look reveals some oversights.

These apps emerged due to a significant shortage of healthcare specialists, not just in niche areas, but across the entire healthcare industry, including mental health professionals, rehabilitation physicians, and special care specialists. This scarcity means patients often face long waits for needed treatment or turn to apps as an alternative. Despite being more cost-effective (despite charges of approximately 200 to 700 Euros per quarter per patient), these apps raise several concerns.

The demand and profit potential have attracted a variety of companies, including those inexperienced in software development, to enter this market before potential tightening of regulations. In Germany, developers can declare the efficacy of their apps, a claim rarely scrutinized by the regulator BFAM. This leads to the use of possibly ineffective, non-evidence-based apps by patients.

Moreover, the security and privacy of these apps are questionable. With a lack of regulatory expertise in digital systems, the apps’ security vulnerabilities remain unchecked. Although the market is small, with less than 50 apps, regulators seem to rely on developers to ensure security. However, as shown by German IT researchers, many apps fail even basic security standards, resulting in the loss of sensitive medical records of potentially over 20,000 accounts.

Furthermore, these apps tend to replace rather than supplement professional medical treatment. There’s no synergy between physicians and patients; no one monitors the data to respond if a patient is at risk. Effectively, these apps create isolated data islands, disconnected from the broader healthcare system. Given their security issues, some may require a complete overhaul.

While digital healthcare apps are a brilliant idea, their execution has been flawed and incompetent. A significant amount of insurance payers’ money is being directed to developers who may not be delivering effective or secure products. This situation suggests that decision-makers are handling digitalization based on assumptions and superficial understanding, leading to the initiative’s poor performance and eroding public trust.

AI-powered Robots in Mental Health

With burnout becoming increasingly common, impacting businesses and individuals alike, employers are actively seeking ways to identify candidates with stress resilience and monitor stress levels across departments. Digitalization in various industries allows employees’ performance and potential mental health issues, including burnout risk, to be assessed through their digital footprints in tools like Slack, Microsoft Teams, emails, and calendar entries. AI tools are being developed to analyze this data and estimate stress levels.

While attempts to reduce stress are generally positive, especially since some employees might not recognize early burnout signs, there are ethical considerations regarding such AI analytics. Not everyone may welcome the diagnosis of a potential mental health issue, as awareness can sometimes create a negative feedback loop, exacerbating the individual’s condition.

There’s a growing concern about “surveillance-like care” becoming a mandatory part of employment contracts, where future employees might have to agree to these monitoring terms. However, feeling depressed or not always being cheerful isn’t necessarily a problem that needs fixing. It could be a character trait, and if it doesn’t affect job performance, it arguably shouldn’t concern the employer. Trying to ‘fix’ what isn’t broken could be detrimental to both employee and employer.

Despite these concerns, the increasing prevalence of mental health issues and the shortage of mental health professionals are driving the development of AI-based apps in the mental health field. These tools are emerging as potential solutions to bridge the gap created by the global shortage of healthcare professionals, particularly in mental health. As the trend of mindfulness transitions to reliance on AI for mental health support, these developments mark a significant shift in how mental health care is approached and delivered.

behavioral health workforce in US

The intersection of healthcare shortages and the escalating issue of loneliness presents a particularly challenging situation. The rapid advancement of AI technology offers potential solutions. For instance, the impressive development in generative art through AI platforms like Dall-E and MidJourney illustrates the leaps made in AI capabilities. These generative engines transform text into compositionally sensible images, a concept that was almost unimaginable just a few years ago.

Future chatbots, benefiting from decades of development, are likely to be far more advanced and nuanced than current versions. By training these chatbots on meta-analyses of psychiatric research papers and collaborating with professionals, their effectiveness could approach or even surpass human-like efficiency. Twenty-five years is a significant time frame for advancements in computer science and machine learning.

In the context of mental health, a future chatbot’s objective would be to understand the root of a person’s mental issues through text input (and possibly audio/visual cues) and provide responses based on extensive databases of cases. Although measuring the effectiveness of mental healthcare professionals is subjective, it seems feasible for AI to match or exceed the average mental health professional and outperform the average friend or family member, akin to how generative art engines now rival average digital artists.

Cost-effectiveness is a significant advantage of these bots. While personal psychotherapy sessions can cost between 60€ to 100€ per hour, a subscription to a mental health app might only be around 13€ per month (using the Headspace mindfulness app as a reference, as there are no well-established mental health apps on the market yet).

However, there are risks associated with this approach. For example, in 2018, BBC News reported incidents where chatbots failed to recognize instances of sexual abuse mentioned in conversations. While developers can address specific issues like these, edge cases will always present challenges, and there will inevitably be victims of these system errors. This highlights the need for continual improvement and oversight in the development and deployment of AI-powered mental health solutions.

user’s test request to the chatbot chatbot’s response

While humans can also be neglectful and make errors, it’s important that users don’t rely entirely on AI. In fact, it’s prudent advice not to rely completely on anything. As machines become increasingly proficient in tasks they are trained to perform, a virtual “being” designed to be understanding and attentive could be perceived by many as a better partner than a real one. Although this reliance on AI could potentially have a negative impact on human relationships, with people criticizing each other for not being as responsive as machines, there is also an opportunity to learn from these AI systems.

The capacity of AI to listen and respond without judgment or fatigue could serve as a model for improving human interactions. By observing how AI maintains patience, offers unbiased support, and handles repetitive inquiries without frustration, people might gain insights into enhancing their communication and empathy skills. However, it’s crucial to maintain a balance. Human connections offer depth, emotional nuances, and a level of understanding that AI cannot replicate. Personal relationships are integral to human experience and well-being, providing aspects of interaction that AI cannot fulfill.

Therefore, while AI can be a valuable tool in areas like mental health support, especially in the face of professional shortages and increasing loneliness, it should complement rather than replace human connections. Embracing the strengths of AI while acknowledging and preserving the unique value of human interactions will be essential as we navigate this evolving landscape.

Metaverse and Superposition of Digital and Real Worlds

The first historical mention of the metaverse dates back to Neal Stephenson’s novel “Snow Crash” (1992), which predicted many of the trends we currently enjoy as a civilization, like high-speed internet or VR headsets. However, this alone can be found in many science fiction novels. What was relatively novel is the concept of the metaverse - the inseparable combination of digital and real worlds, where one event from the digital world influences the real one. Some experts call the entanglement of these two worlds a superposition of worlds - as we are dealing with two (or more) systems, the state of which can only be described as a combination of attributes of both systems.

The mixture of digital and physical worlds we are living in can be called the metaverse for a long time already, but recently - namely since Mark Zuckerberg announced Facebook’s rebranding into Meta - the term boomed as never before. This combination of digital and virtual worlds will become even more seamless with the mass spread of augmented, virtual, and mixed realities.

Several big companies (Meta, Microsoft, Steam, HTC, Sony) are simultaneously working on the new generation of a relatively old form factor of devices - virtual reality goggles. Several companies are just entering the race (Apple, Lenovo). And there are also completely new players, which have collected a significant amount of investments based on the promise to deliver the next-level experience with their products (Magic Leap).

Many people still think about the metaverse only in the sense of a virtual world, even if it’s isolated not only from adjacent virtual worlds but also from the real world. Several virtual worlds are proclaiming their creation “the metaverse”. Among those are the newborn Decentraland and Sandbox, whose claim is not only to be the metaverse but also to provide a web 3.0 experience - blockchain-based assets, such as NFTs (non-fungible tokens) and cryptocurrency support, gained some traction in 2022, although the future of these worlds is uncertain, as the virtual realms of the projects are mostly empty. There are also more mature players - Roblox and Fortnite. Roblox is a platform for mini-worlds, games, and virtual experiences, all built by users themselves. Fortnite is an online game, initially started as a battle royale and now expanded into a whole platform of user-created experiences. Both platforms are incredibly popular and combined have over 100 million regular users worldwide.

The metaverse, being a persistent virtual world, opens space to sell virtual goods, which are not limited to certain activities (for example, like in-game items for video games), but can be applied widely. So, this is a brand new market with revenue potential, which makes the concept of the metaverse literally for everyone who has something to do with digital space. For creatives, the metaverse is a space to show off your work. Digital art is blooming as never before, and the metaverse is a place where all these pieces can find their place. That means more people can enjoy expressing themselves and make a living out of it.

Covid showed us that isolation is not for everyone. People sought entertainment, that’s why sales of video games received a solid boost during the pandemic. The metaverse would provide a place to spend time with your friends and family, even if you are not an avid gamer. And developers of Fortnite and Roblox are actively collaborating with artists and musicians, already providing virtual music concerts inside these games - the pandemic was the catalyst for this initiative.

Some services are not necessarily to be provided in the physical world. If the metaverse would provide a solid substitute for personal meetings, a lot of jobs would be possible to execute remotely. For example, Seoul announced it would become the first metaverse-ready city and claimed to open citizen service offices in virtual space.

Currently, experiences are mostly provided on flat screens, but considering the amount of virtual reality goggles in development and production, it is safe to say that this is going to be the form factor of choice for the digital space in the future. The switch from external flat screens to virtual reality should not be underestimated, as the immersion level will jump to a whole new level. Multiple studies showed that the immersion is actually so prominent that virtual reality can be used to treat chronic pain, phobias, post-traumatic stress disorders. Social problems, such as loneliness.

-isolation-with-awe-and-empathy-on-earth-and-in-space-170189, can also be addressed with the utilization of this technology. Low mobility seniors would be able to meet friends, have some degree of replacement for traveling, and therefore maintain cognitive activity, which is crucial for quality of life.

Currently, it seems that the metaverse will not be seamless. At least it won’t be for a rather long time. The problem is, the metaverse is being developed by profit-oriented companies. And in this case, profit means such an enormous amount of money, that some might say it’s de-facto unlimited. For such corporations, it might not be easy to skip such an amazing source of income. For example, Meta is charging a pretty devastating 47% commission from whoever is developing the experiences for their Horizon Worlds. Even Apple’s 30% App Store commission does not sound so bad in comparison to this. That means companies would be pushed towards creating their own virtual worlds, calling them the metaverse and charging their own commissions. This fragmentation is already present - no two virtual worlds currently share a single foundation for assets and virtual items. Every metaverse functions on its very own technology stack and in order to move your assets from one world to another, one would need to have this asset recreated completely from scratch for another world. That is a very uneasy task, especially if one would consider the legal barriers of using assets on independent platforms. In fact, we could actually face a similar situation with the worldwide web, if CERN researcher Sir Timothy John Berners-Lee had not insisted on making the internet a free-for-all and non-patented technology.

Additionally, the internet itself experiences uneasy times with all the geopolitical tension and informational wars. The balkanization of the internet is already obvious - China was the pack’s leader in this trend to separation. Iran and Turkey followed close by. In recent years, Russia has outperformed most of them. So far, the internet folks are still pushing back by utilizing the best available technologies to resist censorship and bring down the digital walls. One such project is The Truth Wins (the-truth-wins.com) - a collaboration between Reporters Without Borders (RSF), marketing agency DDB, and a Hyperinteractive digital innovation studio. The project used several angles to bypass censorship on social networks - starting with the usage of numbers from national lotteries as a way to always have “the number of truth” to find local journalists’ accounts; and to the bleeding-edge technology distributed domain accompanied with a smart redirection system, making the blocking of the campaign web pages an utterly complicated and resource-heavy task.

One more problem is the perception of the digital world. Most internet users are not used to virtual experiences - for decades, it was the reign of gamers, competitive or recreational. Now, the non-gaming community enters this realm, and that does not always go smoothly. The problem is, the gaming community, especially in e-sports, can be very toxic and unwelcoming to newcomers. This has already given birth to many scandals about sexual harassment in the virtual worlds and forced mainstream companies like Meta to introduce restrictions like “personal sphere” (an unpenetrable space around the virtual avatar) to prevent this from happening. The cause of this problem is the goals of these different types of users: while gamers come to play, the new wave of virtual citizens come to live their lives. That’s why while the first group of users can “take it easy” and mostly just ignore, mute, or report those who behave inappropriately, the second group of users feel incredibly offended, as they take it personally - they don’t have any other goals in the digital realm but to have social interaction, and if that interaction turns out to be unpleasant, that is a “game over”.

Blockchain in Healthcare

We live on the fringe of Web 3.0 - the new era of the internet, where content is attached to blocks, stored in global networks of nodes, supported by independent parties receiving rewards for keeping this world’s computer infrastructure alive. The term “blockchain” went viral with the introduction of Bitcoin by Satoshi Nakamoto (the real identity of the inventor remains undiscovered) in 2008. Then, for around 10 years, the altcoin market boomed - hundreds, if not thousands, of alternative blockchains emerged, each with their own rules, purposes, and transaction costs. One of the most prominent altcoins is Ethereum, which allows the creation of so-called smart contracts - programs that are autonomously executed. An example use case of such programs could be a royalty split on the marketplace: if a business claims that a certain percentage of the royalty must go to charity, smart contracts can ensure that this percentage goes to the charity from each transaction, no matter what. The nature of the blockchain allows anyone with enough technical understanding to check the execution of the smart contract, making the transparency level of such transactions undeniable.

With Ethereum, a further digital construct was created - a non-fungible token, or NFTs. These are smart contract-based assets that can be traded on the blockchain. Anything can be an NFT - an image, a song, an article, a program. The ownership of an NFT is stored in the blockchain, and the blockchain, being a global ledger, is supposed to ensure that this ownership is indisputable. Nowadays, NFTs are mostly just collectibles for enthusiasts. But many experts think that the true power of NFTs will be unleashed with utility NFTs, allowing real-world experiences to be connected to a digital record. One example of such utility can be a restaurant reservation service, theNFTable.com - developed by the American company UOWNIT in collaboration with the German-based technical partner - Hyperinteractive GmbH. The service provides a unique entrance ticket for the owner of the NFT to high-demand restaurants around the world, which normally have months-long waiting lists.

In the eyes of people unfamiliar with the matter, one might have a feeling that everything happening on the blockchain is anonymized, untraceable, and literally perfect for all kinds of criminal activity. The fact is, blockchain can be both perfectly transparent and anonymous. For unprepared users, it is harder to stay very anonymous in the crypto-world than to be transparent. By default, transactions on the blockchain are open and accessible to everyone. Once a crypto-wallet is connected to a person, all transactions can be tracked and allocated. This is a level of unprecedented transparency, which would actually be great to have in many healthcare fields.

As mentioned before, blockchain technology can also provide a certain level of anonymity. It is more than possible to effectively anonymize data on the blockchain, or even do it on a regular basis so that the personality of the patients, donors, or whoever else remains undisclosed. Those who are interested in knowing more about hiding personality in the crypto world can search for so-called crypto mixers. On top of that, Web 3.0 must fully replace Web 2.0. It is additive technology, which can be integrated into existing Web 2.0 infrastructures.

To make it clear, the whole Web 3.0 technology and economy are far from being perfect. Currently, the majority of the technology solutions on the blockchain are overengineered and barely maintainable. It is still in its early phase, but adoption grows every day, and with the entrance of big players and therefore professional developers, the Web 3.0 projects are becoming more reliable and trustworthy.

Another complication of Web 3.0 is that it is a fairly new concept, and there are not enough precedents to create a solid legal body and regulate the market. Here again, big business brings big law firms into the field, and big law firms will do absolutely everything to satisfy the clients. So, it is a matter of time before the crypto economy becomes just as normal as, for example, stock trading today.

Coming back to healthcare, storing and transmitting health records is a major challenge. And at first glance, blockchain might seem like a great idea for solving both problems with one technology stack. Indeed, most people directly think about health records when they hear or read about blockchain in healthcare. But the truth is, blockchain might not be an ideal solution for health records because of its nature as an open ledger. For sure, data can be encrypted to not publish information openly; the problem of expensive blockchain storage space can be addressed with an off-chain storage solution (e.g., with a so-called IPFS - InterPlanetary File Storage). Nevertheless, blockchain can be effectively applied for a variety of problems adjacent to healthcare, even without touching health records.

There are many other ways blockchain can help make the healthcare industry more transparent and accessible: supply chains, medical trials, consent management, business-to-business interactions, proof of qualification for medical

specialists, device-to-device communication, and probably many more ways of how blockchain can revolutionize healthcare.

The supply chain is one of the fields where blockchain can really shine. For example, Russian Gazprom already launched an aircraft fueling system based on blockchain, which reduced bureaucracy and increased transparency. Information about drug batches can be stored in the blockchain and effectively tracked from the origin to the drug stores. This might make it really tricky to label fake drugs, which would increase safety for patients.

Trials data can also be backed up in the blockchain, making the whole process more auditable, resistant to fraud, distributed, and accessible. It can also be safer for those who participate in trials by providing them anonymity on one hand and traceability on another - it can actually be even mixed in one solution, truly giving control into the hands of the user.

Some information must be shared with others in an unaltered way, and blockchain can make exactly this relatively straightforward. For example, consent management can be one field that can profit from the blockchain revolution, providing a possibility to state your will in a way that can be trusted.

Business-to-business relations in healthcare can be made transparent and reliable by the utilization of smart contracts. For example, Ausschreibungen can be a smart contract, which would prohibit or make corruption schemes less possible. Prescriptions issuing, receiving, and applying could be another field for blockchain, making those first almost impossible to forge, and second relatively easy to acquire and use when really needed.

Indirectly connected to healthcare and actually applicable to a broader spectrum of fields is the certification of education. Physicians could have a crypto-certificate bound and non-transferable to anyone else, which would make credential certification systems more verifiable.

Device-to-device communication does not necessarily require human intervention. Blockchain can enable fully automated data exchange and make it secure, fast, and reliable. The key perks of the blockchain in that case are the way to prove data integrity and unforgettable timestamping.

One more interesting phenomenon of the Web 3.0 revolution is the emergence of decentralized autonomous organizations, or DAOs. These organizations are governed by the members holding the tokens. This can be an interesting concept to observe, as it might be something to consider for public health institutions. Imagine a clinic where the patients receiving treatment can actually, to some degree, influence the decision-making process of the whole organization. The concept of DAO is in a very early stage though, and there is still a large amount of uncertainty in it. But in 25 years, if Web 3.0 survives that long, we might see the first clinics where patients act as stakeholders and therefore can’t be neglected.

If done properly, Web3 can make the dream of owning your own data true. Users would be able to truly undock health records from one institution and dock them to another in a fast and permissionless manner - no allowance or bureaucracy required. The simplest case: switching physicians or getting a second opinion can be as easy as connecting and disconnecting your crypto-identity.

One of the points, which makes blockchain rival to the modern banking system, is speed. Bitcoin might be slow, but there are plenty of altcoins that allow virtually instant and very cheap transactions, making cryptocurrencies a very comfortable payment method. In healthcare, the speed of delivery of a message can play an important role. Considering the fact of decentralization and the absence of intermediaries might make records exchange fluent and truly borderless.

Blockchain is not a monolithic technology - the opposite is true - there are hundreds of thousands of different protocols and ways to store, verify, and transmit data on-chain. That means healthcare actors and therefore governmental institutions must, yet again, decide about the standard. If for some economic, political, or competence-related reasons the choice will fall on different technologies, the situation will not change. It will be just another standard with compatibility problems. The good news is - compatibility in blockchain is a long-time discussed theme and there are some successes in that field (there are so-called bridges that allow some limited interoperability for different blockchain technologies).

Complexity and novelty of the on-chain transaction make it less maintainable and therefore less secure if left unsupported. In that term, blockchain is not different from any other digital system though. Decision-makers just should not expect miracles and prepare for long-term investment as with any other technology.

End of Life

If life around us is changing, so too is the way it all ends for us. The anticipation of death has changed multiple times throughout history, but we are probably about to witness the most drastic changes.

Death of Others

The theme of chatbots, as well as AI and big data, has already been touched upon in this chapter. One way to combine these three technologies into a product is to try to reanimate people who have passed away. The way it can work is straightforward - digital traces of a person are collected, an algorithm is trained on this data, and a chatbot (or a more advanced digital construct) is created based on that. As a result, one can get a feeling that the machine answers in a way a real person would, including typos, way of writing, and maybe even a sense of humor.

In fact, Ray Kurzweil - a well-known futurist, Google employee, and one of the founders of Singularity University - actually claimed he succeeded with at least one person - his own father, and the results were quite remarkable. Unfortunately, it seems that the system capable of such digital resurrection, or the model itself, is not available online. But other companies are experimenting with technology too. For example, Amazon announced during their conference re:MARS that they are working on a feature which would allow your smart speaker with Alexa to use the voices of your deceased relatives, for example, one could ask, “Alexa, read me a fairy tale as my grandma would,” and Alexa would simulate the voice and read an audiobook aloud While many people might find it creepy, quite a few find it a great way to cope with loss. It should be left to psychology specialists to evaluate how that would influence the human mental state.

You could also develop such models further - think about learning not only from chats and emails but also from all the scientific papers a deceased person left behind. We as humanity could try to replicate the thinking process of a human being. For example, we could try to “resurrect” Einstein and ask a model to solve the climate crisis. The living are not listening to another living; maybe we will listen to the dead.

Of course, with all the video content and possibilities to create 3D models, and also considering the attempts to create a more seamless and immersive virtual world, in the near future we will see the first person resurrected in the metaverse. Tupac Shakur already performed on stage, but that was only a pre-recorded hologram. We are talking about a place in virtual reality where you can actually meet the person, interact, and talk.

Old ways of saying a final goodbye to the people we love are fading, with people becoming less religious. But as grief is universal and unaware of atheism, naturally people seek new ways to either get over it or at least reduce the pain of loss. A digital post-mortem avatar is just one of such ways.

The idea is already possible, and naturally, the companies that can pull this off right away are all social networks. In the future, the default action in case you pass away might not be to remove your account or make it a digital memorial; it might be to create your digital twin, which can even continue to make posts on your behalf. It can even be profitable for social media companies, as people who were popular during their lives can remain active, attract traffic, ignite discussions - and maybe make profits for the company by participating in ad campaigns. Nothing is free, in the end.

There are possible problems with this, on both the ethics and legal side, as it probably should be possible to prohibit people from bringing you back in any form, also a digital one. As the system can be flawed and we are not always what we speak or write, the model can pick only traits of our character, which we decided to show. A person might act tough while texting but be quite vulnerable on the inside, but the model would probably not be so advanced to somehow understand it. Or maybe it will, as we also start to notice, big data, and AI analysis sometimes can reveal what’s hidden with tiny details. So maybe our digital copies will be even better copies of ourselves.

Death of Yourself

As virtual reality can help people manage pain by distracting them from the real world, where the body may be crippled by suffering, it is possible that some people in the future will prefer to spend their last minutes with a headset on. This might not only make the whole process a bit more tolerable for terminally ill patients, but could also provide the possibility to spend time with relatives who can’t personally be near. Some people might also prefer not to present themselves as sick and weak to their most dear people and would rather spend some time on a virtual lake, instead of looking at a ceiling.

Dying in virtual reality could be an entirely new market and provide not only a headset, but several devices, which can help the user to submerge in the virtual world for several days. For example, it could include an intravenous feeding system, incontinence handling products, and painkiller injectors.

Combined with the previous idea, relatives might not even notice that their loved one has passed. If prepared properly, the illusion of a person being “transferred” to virtual reality can become really smooth and very convincing.

the transition

Imagine this: The estimation for a person is several months. In these months, the person decides to create a digital twin and let it live in one of the virtual worlds. The person collects as much data as possible, makes additional recordings of their voice, provides video recordings - all this data is collected and processed with full consent. The last weeks are spent in full submersion mode - the person lives in a headset, while the body is connected to systems of artificial (and maybe autonomous) life support. The relatives are not around, at least not physically, but the person can spend time with children or grandchildren in VR. In the last moments, the person is still online. The system detects that the final moments are close and starts a special event for the relatives, who are on the other side of reality. For them, it looks like the person’s avatar is changing, becoming even more real in the virtual world, symbolizing the transition. When the digital twin is created, the person in the real world has passed away. A special service (agreement signed upfront) takes care of the body autonomously. A gravestone is not required, as the copy will remain in the digital world, and the relatives and friends can interact with the person almost as before. The only difference is, to meet with the person, they don’t have to drive to another city; it is enough to put on the headset or drop a text message. For the relatives, little has changed. With time, more people will join the person on the other side - it is like an ancestral tree, but much more advanced. Instead of a priest, a headset could accompany us in our last dive into the metaverse. They call this simulation - the New Heaven. Commercial ends. Order now.

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