This paper interrogates the regulatory lacunae that emerge when algorithmic systems, ostensibly therapeutic, encroach upon the sacrosanct domain of spiritual autonomy within pluralistic healthcare regimes. Framed at the nexus of health law, medical ethics, and the anthropology of healing, the analysis posits that contemporary governance paradigms, tethered to evidence-based biomedicine, systematically efface the ontological pluralism that underwrites indigenous, faith-based, and esoteric curative practices. By deploying a tripartite heuristic: (i) the algorithmic reification of probabilistic ontologies, (ii) the juridical commodification of belief as “data exhaust,” and (iii) the epistemic violence latent in risk-benefit calculus, the study unmasks how AI-mediated interventions transmute sacred epistemologies into actuarial variables, thereby vitiating the inviolability of spiritual self-determination. Methodologically, drawing upon comparative constitutional jurisprudence (inter alia, the Indian Supreme Court’s articulation of “essential religious practices,” the European Court of Human Rights’ margin of appreciation doctrine, and the African Charter’s communal dignity jurisprudence), the paper contends that extant regulatory frameworks, premised on paternalistic beneficence, fail to apprehend the incommensurability between machine rationality and transcendent healing. A novel conceptual scaffold is proffered: the “spiritual harm threshold,” a juridical metric that obliges regulators to demonstrate not merely empirical efficacy but also phenomenological non-interference with the patient’s cosmogonic narrative. This threshold, operationalized through mandatory “ontological impact assessments,” inverts the burden of proof, compelling algorithmic proponents to negate existential displacement rather than merely affirm clinical outcomes. The argumentation culminates in a provocative normative claim: absent a statutory entitlement to “algorithmic abstention” in matters of sacral therapeutics, pluralistic polities risk the quietus of metaphysical diversity under the guise of precision medicine. Conclusively, by foregrounding the irreducibly hermeneutic character of sacred healing, the paper challenges health law scholars to reconceive autonomy not as volitional consent but as ontological sovereignty, an exigency that confounds utilitarian aggregation and demands a radical reconfiguration of regulatory reason.
