New technologies are usually reaching toward lofty goals. But achieving those goals may not be possible in the short term. Researchers often encounter institutional obstacles or simply have not adequately figured in how human beings will be able to use the technologies successfully. Or, they may have unwanted side effects. Hence an important step in the development of new technologies is determining how it is possible to proceed toward the future in a responsible way that will actually improve the quality of human life.
The Envision Conference, in its third year at Princeton University, explores the social, economic, and political implications of breakthrough technologies like artificial intelligence, synthetic biology, nanotechnology, and neural enhancement. Its purpose, says co-president of Envision, Baran Cimen, a Princeton junior, is to “gather teachers and leaders in technology from different schools around the U.S. and the U.K. and show them how to responsibly develop and implement break-through, emerging technologies.” This year the conference takes place at Princeton University, Friday, November 30, to Sunday, December 2. Visit entrepreneurs.princeton.edu/events/envision-conference-2018.
One of the speakers, Gregory Stock, research professor in the genetics and genomic sciences and co-director of the Harris Center for Precision Wellness in the Institute for Nextgen Healthcare at Icahn School of Medicine at Mount Sinai, pointed to the possibility that technological advance will leave many people without jobs. “I love technology, and I actually believe that in the larger trajectory of things there will be enormous possibilities,” he says, citing the potential to control the aging process and extending the human life span.
But the downsides of technological change also need to be reckoned with. “It’s very clear that a large fraction of the labor that humans do is going to replaced by robotics and machine learning,” Stock says, yet “there is a lot of hand-waving and denial of the challenges of these things.” He pooh-poohs rationalizations like “Oh, well, we’ll get other jobs — that always happens.” Looking to the past when automation shifted labor from farming to manufacturing and then to service industries, Stock says, “I don’t think that’s going to match the large displacement of labor that will occur in next couple of decades.”
Stock is particularly interested in the relationship between technology and human health. Exploring different aspects of this relationship, Stock highlights some of the issues faced in the development of new technologies.
New technologies need to consider how effectively people can use them: Particularly interested in the implications of data collection for improving health, Stock relates how he has been able to use the Dexcom system to continuously monitor his glucose level as a prompt for changing his diet in ways that may improve his health. He noticed that every time he ate fruits or carbohydrates, his blood glucose bounced up. As someone who “was trending towards pre-diabetes,” Stock says, “Eating fruits and vegetables, which I thought was very healthy — in fact there is not really much science behind the aggressive focus on low-fat diets.”
So now Stock’s diet is more high-fat, low carbohydrate, including “cheeses, avocado, butter — all the good stuff — and minimizing especially simple carbohydrates.” He tends to avoid bread, noodles, rice, and rolls, and instead will eat proteins, like meat, but also will use cream instead of half and half. He explains, “There is not good correlation between the fats you consume and what your blood lipid profile is.”
“I think the move toward low-fat diets, markedly in the last 30 years, is probably one of the root causes of the obesity epidemic in the U.S.,” Stock says.
But the fact that data supplied by technology actually enabled Stock to change his behavior was unusual, he suggests. Yes, passive data collection, for example, counting steps, evaluating sleep, measuring cognitive function (which can be done even via the pacing of keystrokes on your cell phone), is becoming increasingly easy, Stock says. And we can monitor other data like a person’s genome (genetics), metabalome (metabolic factors), biome (bacteria in the gut), genetic expression, physiological state, biochemistry, and molecular status.
Yet, although so much data is available, people are people and don’t change easily. The hope, he says, “is that we’re going to collect all this data and tell you things you don’t already know, magic will happen, and people will make changes.” But what we really need, Stock continues, are “health coaches, to help us make changes — technology is not very good for that.”
But in the future technology may be able to help people negotiate change. “The real application of technology, I think, will be in giving people assistance and feedback on how they can make changes in their lives. It requires real-time feedback and a lot of coaching, which is at an early stage in our technological interfaces,” Stock says.
Institutional stakes can potentially limit the pluses of technological change: “Medicine and healthcare is ultimately a business,” Stock says. Even though he thinks “most people in healthcare and medicine are trying their best to help people, the system isn’t conducive to the most efficient ways of enhancing our health.” One focus of the healthcare system has been on the high-technology aspects of medicine, which he says are “probably the least important to our health.” Most critical to people’s lives are the basic things — like getting antibiotics for infections and getting stitched up in the emergency room. And, he adds, “There is a great deal of overtreatment and over-diagnosis.”
“A lot of legacy forces keep us from changing,” Stock says. “Large medical institutions have huge overhead. There are a lot of MRI machines, and they have to make them pay for themselves. And if you go to a surgeon, you are more likely to get surgery recommended.”
“Our society as a whole is not conducive to good health in terms of alleviation of social isolation, having less stress, and people following behavioral patterns that are healthy generally,” he says.
Purveyors of technological change must consider unintended consequences and find solutions for them: Stock points to social media, which “allows us to connect in all sorts of wonderful ways, yet it’s turning out it is making people feel more isolated, not less.” An unintended result has been “an erosion of face-to-face, authentic interaction.” Instead people, and especially children, spend “an enormous amount of time trying to groom their postings to try to present imagery about how they want to be perceived.” But, he says, “rummaging through the postings of our friends and pseudo-friends to try to figure out what aspects of ourselves we want to display to them to create the right image turns out to be kind of a lonely process.”
Social isolation itself can have many negative consequences. “It is a big risk to health, both in the elderly and across the population. The reason social isolation is detrimental to health is that people feel isolated, not needed, and they lose dignity, sense of value, and purpose,” Stock says.
Stock himself is in the process of developing a social-engagement platform to combat social isolation and “help people deepen intimacy and enrich their connections with others through interaction about questions,” Stock says. It uses games related to his “The Book of Questions.” This platform, he says, is “an example of something outside traditional medicine and healthcare, but the kind of thing that can really have an impact on our health and the richness of our lives.”
Stock started life in Manhattan Beach, California, then moved to Tucson, Arizona (where his dad was an electrical engineer at the University of Arizona), to Britain for grammar school (while his father was working at Cambridge University), then to Baltimore, where he completed three degrees in biophysics from Johns Hopkins University, earning his PhD in 1975. He earned an MBA from Harvard Business School in 1987. In 1997 he became the founding director of the Program on Medicine, Technology, and Society at the UCLA School of Medicine, which, he says, “looked at the impact of cutting-edge technologies on the future.”
Stock also cofounded several biotech companies, including in 2003 Signum Biosciences, “geared toward looking at protectives against Alzheimer’s and neurodegenerative diseases.” In 2010 he cofounded Ecoeos, which develops genetic diagnostics to gauge personal vulnerability to environmental toxins, for example, a genetic test for vulnerability to low-level mercury exposure (it turns out, he says, that in 20 percent of young boys amalgam dental fillings can cause a several year deficit in cognitive performance, memory, and attention).
Technological development has changed our economy in ways that can create “huge gulfs between people” in terms of income and wealth, Stock says. As we develop products “that operate efficiently and that supply many things but don’t employ many people, many individuals will be pushed into the low-level gig economy.”
Society is then left with the challenge of how to deal fairly with wealth distribution. One possibility, Stock suggests, is providing automatic incomes for people, but, he continues, “the real thing is how people can retain dignity, in the sense that many people today, especially males, identify their value by what they can contribute in some way in the commercial environment — they identify with their jobs.”
As we deal with new technologies, Stock concludes, “the higher-level and most fundamental issue is how that’s going to affect society and our lives, our relationships, our sense of self, and what it means to be a human being.”