Toward multiplex health: integrating complexity, normativity, and Open Science

Contemporary healthcare remains constrained by models grounded in linear causality, predictive logic, and biomedical reductionism-models that often fail to address the lived, relational, and spiritual dimensions of health, especially under uncertainty. This paper introduces the Multiplex Health (MH) framework as a coherent alternative, rooted in critical complexity theory and multiplex ontology and epistemology. MH advances six core principles: (1) multiplex ontology-viewing humans as multi-layered beings encompassing material, metaphysical, and spiritual domains; (2) multiplex epistemology-integrating empirical, experiential, and interpretive ways of knowing; (3) pluralistic modeling-combining mechanistic, statistical, and semiotic approaches; (4) critical complexity-recognizing health as emergent, open, and irreducible to single models; (5) triangulated science-linking Big Data and Small Data, and balancing prediction with understanding; and (6) comparative multiplex ethics- drawing on Islamic BioFiqh to integrate legal, moral, and spiritual reasoning in health decision-making. By foregrounding the behavioral, ethical, and conceptual dimensions often overlooked in conventional approaches, MH offers a foundational framework for advancing Population Health Management (PHM). A PHM case study focused on mental health illustrates how MH can navigate complexity, enhance relational care, and broaden the scope of well-being beyond reductionist paradigms. MH challenges the dominance of closed, optimization-driven models in precision health and artificial intelligence, instead calling for a "both-and" logic that embraces uncertainty, diversity, and contextual nuance.