“Everything is in a state of flux, including the status quo.” — Robert Byrne

Life is getting more complex.

Take seriously for a moment Steven Johnson’s notion of the “Sleeper Curve” from his book “Everything Bad is Good for You”. He argues that contrary to current in-house wisdom, video games, television and films – mainstays of the nonliterary popular culture – are getting more challenging, increasingly complex, and inviting of a new type of “cognitive labor” particularly suited to an information-flooded, technology-driven, and network-obsessed society.

And that’s just pop culture.

In health care, complexity is off the charts. Most prognosticators of the future in health care cite genetic science as a powerful force shaping much of the complexity in store for us. But as the old saying goes, the future is already here, just unevenly distributed.

Two parallel examinations of that complexity, one moral, the other in political economy, make this point quite obvious.

Harvard University’s Michael Sandel, for example, in his “The Case Against Perfection” thoughtfully examines present concerns about what lies in wait for us as our genomic future acts itself out.

“Breakthroughs in genetics present us with a promise and a predicament. The promise is that we may soon be able to treat and prevent a host of debilitating diseases. The predicament is that our new found genetic knowledge may also enable us to manipulate our own nature – to enhance our muscles, memories, and moods; to choose the sex, height, and other genetic traits of our children; to improve our physical and cognitive capacities; to make ourselves “better than well.”

But this “predicament” is not just a concern for the future. It’s here and now.

“(G)enetic testing creates a burden of decision that did not exist before. Prospective parents remain free to choose whether to use prenatal testing and whether to act on the results. But they are not free to escape the burden of choice that the new technology creates. Nor can they avoid being implicated in the enlarged frame of moral responsibility that accompanies new habits of control.”

The moral complexities of an emerging “genetic supermarket” and what has been disturbingly termed a new “liberal eugenics” is beginning to weigh heavily on our collective conscience.

While important as these concerns may be, they are somewhat familiar worries that ethicists and theologians have been sermonizing about for a while now. It is in Kaushik Sunder Rajan’s book “Biocapital” – a dense, highly nuanced, but fascinating and penetrating academic tome – where we jump to another level of questioning and theorizing altogether.

According to Rajan, genetics has transformed both our way of knowing about life and our understanding of the workings of capitalism as an economic system. Life sciences, through the advances in genomics, are becoming informational sciences. And biotechnology, as a form of enterprise, has become inextricable from contemporary capitalism, a new phase if you will.

“Biocapital” is a concept that marks the relationship between the scientific and the economic; it implies a system of exchange, one in which genomic science acts as the epistemic rational for this new biotechnology market.

One interesting example of this “exchange” is how genomics has moved the notion of “diseased” or “healthy” patients, to one of “patient-in-waiting.” (This idea reminds me of the old joke about the Soviet Union, where everyone was a criminal, a past criminal, or a soon-to-be criminal.) This suggests that “Every person, no matter how healthy, is possibly someone who might fall ill . . .” which in turn enlarges the therapeutic to include the prophylactic and consequently enlarges and promotes the biotech market as well. We can’t help mentioning the increased social burden that any assessment of health risk – calculating and mitigating contingency – will also fall under.

These two examinations – more like explorations really – reveal the formidable and complex forces in the world of health care that await us: from the moral, to the scientific, to the political and economic spheres. Our proper appreciation of the possibilities and problems of this coming transformative avalanche is definitely in order.