I am currently reading Steven Pinker’s book Enlightenment Now and he makes a good case for being optimistic about human progress. In an age when it is popular to write about human failures, whether it is wealthy but unhappy athletes wrecking their cars, the perilous state of democracy, or impending climate doom, the responsible message always see ms to be warning about how bad things are. But Pinker argues that things are not that bad and that they are getting better. Pinker’s writing directly contradicts some earlier reading that I have done, including the writing of Gerd Gigerenzer who argues that we unwisely bet on technology to save us when we should be focused on improving statistical thinking and living with risk rather than hoping for a savior technology.
In Risk Savvy, Gigerenzer writes about the importance of statistical thinking and how we need it in order to successfully navigate an increasingly complex world. He argues that betting on technology will in some ways be a waste of money, and while I think he is correct in many ways, I think that some parts of his message are wrong. He argues that instead of betting on technology, we need to develop improved statistical understandings of risk to help us better adapt to our world and make smarter decisions with how we use and prioritize resources and attention. He writes, “In the twenty-first century Western world, we can expect to live longer than ever, meaning that cancer will become more prevalent as well. We deal with cancer like we deal with other crises: We bet on technology. … As we have seen … early detection of cancer is also of very limited benefit: It saves none or few lives while harming many.”
Gigerenzer is correct to state that to this point broad cancer screening has been of questionable use. We identify a lot of cancers that people would likely live with and that are unlikely to cause serious metastatic or life threatening disease. Treating cancers that won’t become problematic during the natural course of an individual’s life causes a lot of pain and suffering for no discernable benefit, but does this mean we shouldn’t bet on technology? I would argue that it does not, and that we can see the current mistakes we make with cancer screening and early detection as lessons to help us get to a better technological cancer detection and treatment landscape. Much of our resources directed toward cancer may be misplaced right now, but wise people like Gigerenzer can help the technology be redirected to where it can be the most beneficial. We can learn from poor decisions around treatment and diagnosis, call out the actors who profit from misinformation, uncertainty, and fear, and build a new regime that harnesses technological progress in the most efficient and effective ways. As Pinker would argue, we bet on technology because it offers real promises of an improved world. It won’t be an immediate success, and it will have red herrings and loose ends, but incrementalism is a good way to move forward, even if it is slow and feels like it is inadequate to meet the challenges we really face.
Ultimately, we should bet on technology and pursue progress to eliminate more suffering, improve knowledge and understanding, and better diagnose, treat, and understand cancer. Arguing that we haven’t done a good job so far, and that current technology and uses of technology haven’t had the life saving impact we wish they had is not a reason to abandon the pursuit. Improving our statistical thinking is critical, but betting on technology and improving statistical thinking go hand in hand and need to be developed together without prioritizing one over the other.