• J Eval Clin Pract · Apr 2022

    The radical and requisite openness of viable systems: Implications for healthcare strategy and practice.

    • Felice Borghmans.
    • Faculty of Education, Monash University, Wellington Road, Clayton, Victoria, 3800, Australia.
    • J Eval Clin Pract. 2022 Apr 1; 28 (2): 324-331.

    AbstractThis paper addresses an ontological question about the nature of health and challenges some underpinning assumptions in western healthcare. In its analysis, health in its various statuses, is framed as a naturally occurring complex adaptive system made up of dynamically interacting subsystems that include the physiological, psychological, and social 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, health, healthcare, and more. This paper draws on the complexity sciences and Levinasian philosophy to explicate the essential role of system openness in individual, population, and systemic viability. 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 health.© 2021 John Wiley & Sons Ltd.

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