Intended for healthcare professionals

Education And Debate Complexity science

The challenge of complexity in health care

BMJ 2001; 323 doi: (Published 15 September 2001) Cite this as: BMJ 2001;323:625

Perpetual motion machines?


Ian Reid might himself be accused of standing "on the wilder shores
of pseudoscience," [1] when he invokes a "conceptual framework of
Newtonian mechanics," [1] or when he claims that complexity theory is
"deterministic, Newtonian, and subject to scientific analysis," [1].

"The 'new science' of post-Restoration England, culminating in the natural
philosophy of Isaac Newton and his devotees, was consciously religious in
inspiration and implication…the discovery through experiment of certain
immutable laws governing the physical world was…proof positive of a divine
omniscience and will…a striking revelation of the order and harmony which
God had ordained," [2, 164].

And again, "scientifically-demonstrated natural laws…explaining the
divine creation and revealing divine providence," [2, 165]. Such a view
was indeed a "natural religion, founded on the rock of human reason," [2,
166]. Even the celebrated Boyle Lectures had been "endowed under the will
of Robert Boyle for the purpose of proving the Christian religion against
notorious Infidels, viz. Atheists, Theists, Pagans, Jews and Mahometans…"
[2, 166].

Light-heartedly perhaps, but Professor Reid might himself be accused
of being "swamped by the intellectual snake oil," [1] of his own
exudation, for it is clear, and he should know, that "the great machine of
science does not yield answers to problems of metaphysics or morality,"
[3, 305]. So-called complexity theory as applied to healthcare, seems like
an ill-defined monstrosity, a mish mash, all things to all men, and thus
his own interpretation of it amounts to little more than "a bogus
prospectus, the child of an overactive imagination, like designs for a
perpetual motion machine," [4, 110].

On such matters we might as well come clean and admit that we are:

“Lost in a haunted wood,

Children afraid of the night

Who have never been happy or good.” [5]


[1] BMJ Letter, Let them eat complexity: the emperor's new conceptual
toolkit, Ian Reid, 23 September 2001

[2] G Holmes, 1978, Science Reason and Religion in the Age of Newton,
Book Review of The Newtonians and The English Revolution 1679-1720, by
Margaret C Jacob, Harvester Press, 1976, Brit Jnl History of Science, 11,

[3] Isaiah Berlin, 1996, Against the Current - Ideas and their
History, Pimlico, London

[4] Isaiah Berlin, 1979, Concepts and Categories Philosophical
Essays, Oxford University Press, UK

[5] W H Auden, Poem, “1 Sept 1939”,

Competing interests: No competing interests

27 September 2001
Peter Morrell
Researcher, History and Philosophy of Medicine