The radical and requisite openness of viable systems - implications for
healthcare strategy and practice
Abstract
This paper begs an ontological question about the nature of health and
challenges some underpinning assumptions in western healthcare. In its
analysis, the structure of health, in its various statuses, is framed as
a complex adaptive system made up of dynamically interacting subsystems
that include the physiological, psychological, spiritual, social,
cultural, and more, realms. Furthermore, openness in complex systems
such as health, is necessary for the exchange of energy, information,
and resources. Yet, within healthcare much effort is invested in
constraining systems’ behaviours, whether they be systems of knowledge,
states of health, models of care, and more. This paper draws on the
complexity sciences and Levinasian philosophy to explicate the essential
role of system openness in individual and population health, and the
viability of healthcare systems. It highlights holism to be ‘not
whole-ism’, and system openness to be, not just a reality, but a
critical feature of viability. Hence requisite openness is advocated as
essential to efficacious and ethical healthcare practice and strategy,
and vital for good quality health.