Organisational Relativity—Changing Our Perspective on Health and Health Care

Nearing the 160th anniversary of the publication of Darwin’s theory of evolution, it is important to reflect that he expressed two sides to the process of evolutionary change, ‘survival of the fittest’ and a ‘tangled bank’. The ‘tangled bank’ he envisaged saw the interplay between organisms of different species ‘dependent on each other in so complex a manner’. More recently, Kauffman reframed the ‘survival’ and ‘variation’ questions in terms of new doors opening for species by variation, rather than survival against the odds due to random evolutionary bias. This alternate view of the ‘adjacent possible’ recognises, as Darwin did, that within organisms there exists natural variation, this variation opens up new possibilities for life to evolve. The ‘adjacent possible’ opened up by the humble telephone has given rise to the Internet, to the success of Amazon, Google, and Twitter, all of which have flooded this space opened up by mass communication and smart phones. Kauffman contests that life exists in the complex domain between ordered and chaotic systems poised at the edge of chaos, where the capacity of a system to evolve is optimised. More recently Noble has introduced the concept of biological relativity in which, in deference to Einstein, contests that there is no privileged position of control in biology, that the genome is neither the ‘blind watchmaker’ nor the conductor of the orchestra. In reality, Noble suggests, it is the complex interaction of the environment with the organism, its cells and intracellular environment that brings out life in all its diversity and co-evolutionary development—Darwin’s tangled bank.