The Risks of Knowing Your Risk | Hacker News Reader

The Risks of Knowing Your Risk

points.datasociety.net

35 pointsimartin2k12 comments

At the risk (ha!) of a bad car analogy, I've experienced a similar feeling when I was regularly doing used oil analysis on my car. One day the analysis came back and told me I was getting elevated levels of metals that indicated abnormally high bearing wear. From that point forward I worried needlessly about when the motor was going to croak, and I realized that I was not willing to preemptively rebuild it just because an oil analysis showed a higher risk. So it was good for nothing except higher anxiety.

Moral of that story -- I sold the car about 100K miles later and it was still just fine. I've never bothered with the oil analysis since.

Software related anecdote: I left a team that at one point, where an unforeseen occurrence, think something like 1 in a million happened, taking our production systems offline. Our decision makers became so risk averse to change for fear of another similar event that we completely stopped innovating and spent three years wrapping ourselves up in tape and saran wrap to protect ourselves from getting hurt again because "risk". The thing that took us down required a pretty trivial version upgrade and we never saw it again, even when creating deliberate conditions for the bug.

I ended up leaving the company, I couldn't spend another year mitigating other people's terror, the word "risk" became a trigger word, other engineers started leaving in droves and eventually, they shut down months later.

You need to reach that Zen state of mind with your "service engine soon" lights to own a used car.

I don't understand. Knowing the worst case scenario doesn't necessarily mean that it will happen, but helps you get prepared for it in case it does. Who would choose bliss over knowledge?

Worry and anxiety and depression have been shown to have negative physical results, no? So if you are prone to those psychological reactions, being informed of risks you weren't aware of could literally make you less healthy, even if that particular risk never happens.

It's not universal by any means, but it would certainly affect a nonzero number of people.

edit for anecdata: I know someone who has this reaction, and trouble grokking statistics and risks (gets it intellectually, but has trouble internalizing), so being informed of their risk factor for a given condition can cause them to become consumed with anxiety and worry for a time.

Worry and anxiety aren't treated like the secondary emotions that they are. People are expected to manage their anger, yet many are encouraged to cultivate their anxiety as part of their social script.

The difference here is fundamentally one of personality. If you're more neurotic, your response to a signal indicating a relatively small risk could be more dangerous than the risk itself; if less so, knowing is probably safer than not knowing.

There's another axis of this though, where people who would not react all that poorly to the bad news nonetheless avoid hearing it. That is, I think, a problem that loved ones will have to fix or live with.

Me neither. I know people who didn't go to the doctor because of this, or because "if you go to the doctor they will always find something wrong". Some of these people died leaving sons and daughters without parents, grandkids without grandparents. I not only don't understand the attitude, I find it borderline irresponsible/selfish. And I'm saying this from the pain of being one such son left without a father far too soon and in avoidable circumstances.

Unnecessary treatment can be wasteful, harmful or both. Medical professionals and public policy experts have debated how much cancer screening improves average outcomes.

Portraying anyone who questions the value of medical testing as irrational and selfish is denying the fact that smart, thoughtful people have a hard time defining what is best practice on average. As many as 3/4 of positive cancer screening test results can be false positives, and if you get one, you have to then do further testing and possibly treatment, which entails risks.

'overscreening for prostate, breast, cervical, and colorectal cancer screening “is common in both men and women, which not only increases health care expenditure but can lead to net patient harm.” ' [1]

My father was diagnosed (and eventually died) of cancer shortly before the age at which periodic screening was recommended, in the early 80s. Nowadays, screening is recommended at a younger age, and if he had been tested, then it might have been caught in time. However, I reject the idea that anyone is irresponsible based on hindsight in a single case. It's just bad luck. And public policy needs to be set based on what is best for everybody.

[1] http://www.ascopost.com/issues/october-15-2014/overscreening...

This reminds me of my father. He was digging water wells for a living, but never checked his equipment. One day the link from the wire rope broke and he fell to his death 20 meters inside a well. This could have been avoided if he was taking care of his equipment. Hell even a simple check would have been enough.

> But what if precision medicine leads to negative psychological outcomes, including worry, loss of control, or worse?

Hey, do I get depressed because I planned a picnic with my friends tomorrow and today the weatherman tells me it's going to rain? Would I be worse off if I know there is a high chance of rain on my wedding which is planned next week? Would I rather want to know whether it's going to rain tomorrow so I know to prepare an umbrella, or I'd rather start every day as a complete surprise? Maybe you like it to be a complete surprise, I think I and most people would rather know. You can choose to start every day as a complete surprise and not listen to the weatherman -- sure -- but that's probably not a popular choice.

Other than that, it is a very big win to know personal genetics to me. With personal genetics, I know the weakness of mine that I wasn't aware before. For example, I know I have a higher chance of depending on drugs, so I don't touch the hard ones. I don't take pain medication unless I can't bear it.

I wrote about it a couple of days ago here, and I offer you a different perspective. http://www.tnhh.net/posts/personal-genetics-and-me.html

I suspect it's more likely it will turn into a joke. If I tell you you're at risk of 1 or 2 types of cancer, you might worry. If I give you a list of 800 things you're at risk of, you'll either ask your doctor, or glance at the results and ignore it.

Reply on news.ycombinator.com