Intelligence is not the main bottleneck

A dinner conversation with an AI lab employee prompts the author to defend his focus on regulatory and clinical trial bottlenecks in medicine. He argues that even with AGI-level intelligence, progress in fields like drug development is stymied by governance, patent systems, and the high cost of trials, citing Eroom's Law and the struggles of companies like Adaptimmune. He points to China's regulatory reforms as evidence that policy, not intelligence, can unlock innovation, and highlights the potential of AI in optimizing trials through surrogate endpoints, while noting that data access and FDA validation remain major hurdles.
No matter how 'intelligent' AI becomes, if the word still means anything, intelligence is often not the main bottleneck to things changing in the real world.
- scuppernong
"He looked at me incredulously. Surely, a smart person like me should know that AI, or better said, AGI will be hyperpersuasive soon – already on a bunch of benchmarks it exceeds professional debaters at persuasion." I'm always tickled by this tic of this kind of person, that human traits are something that we can maximize to infinity. That if we trained a robot to tell jokes, it would eventually tell jokes so funny we'd die laughing etc. You can't convince someone who doesn't want to be convinced.
- ChrisMarshallNY
In my work, I have always found that the main "blocker" (I hesitate to use the term "bottleneck"), is human nature.
If we design stuff to be used by humans (what I generally do), then it's imperative to take basic human nature into account, and that can be incredibly annoying.
Annoying, or not, human nature is a major factor, and won't go away, no matter how many times we tap our heels together. I think it was Philip K. Dick that said "Reality is that which, when you stop believing in it, doesn’t go away."
Designing stuff for processes and machines to consume, is pretty straightforward. Designing stuff for humans, however, is really challenging (which is one of the reasons that I like doing it).
- MerrimanInd
Climate change is another big problem that frontier AI labs have handwaved away as being "solvable" by AGI. The premise that a pure superintelligence could hand us a plan to beat climate change that's so good and airtight that A) it would definitely work and B) people would execute it.
But there have been entire books written about the fact that right now we have the technology to drastically curtail climate change and yet they're under utilized because of a complicated and murky set of political, social, and systemic reasons. There are a huge numbers of problems for which very good solution plans have been detailed yet the gap is in execution.
The AGI-pilled must think one of two things; either there's an as-yet-undiscovered plan that's both world-changing yet trivial to implement or we'll all worship at the altar of the machine god with such fervor that even if it spits out a relatively obvious and iterative climate change plan the world will eagerly follow it. Both premises seem laughably unlikely to me.
- Veedrac
Indeed. Humans and not other apes reached the moon by our great proclivity to long distance running, through our exceptional sweat glands... ah, wait.
How is it possible to live in the world around us and not see, apparent and transparent, that intelligence is the lever on which everything rests? Humans are surprisingly weird animals, but it's not our hairlessness or our fairly average propensity to violence that did this. We don't have more houses than chimpanzees because we're _strong_. We haven't defeated the tolls of disease because we're atypically devoid of restraint. We don't have more effective governance than termites because we're more communal.
Of course intelligence is the main bottleneck. The arguments here are so confused. What do you think regulation is made of? What do you think money buys? What do you think determines how well you can gather data, or how efficiently you can consume it? But of course, as the genre, after spending the first third waxing about how its opposition could be so foolish, the last third is spent finding a pretty insult and wallowing in it, so as to not to leave enough space for the brief argument in the middle to consider such things as why someone might disagree.
- discreteevent
Alan Kay said "A change in perspective is worth 80 IQ points,".
A change in perspective is often brought about by communication or I/O. In my experience this often bears out. The people who communicate get more done than the clever person who doesn't get out into the problem domain. The limit is I/O not intelligence.
- bwfan123
> no matter how “intelligent” AI becomes, intelligence is often not the main bottleneck to things changing in the real world
A mathematician Terrence Tao said something similar in a recent talk [1]. That, intelligence is bottlenecked by human understanding. Say there is an alien that brings an alien book containing math humans havent seen before. Using said math is bottlenecked by humans comprehending it first.
[1] https://teorth.github.io/tao-web/slides/age-of-ai-icm-2026.p...
- highfrequency
Indeed - if access to data or the permission to act on that data is limited by human gatekeepers (individual or bureaucratic), intelligence is often not the primary bottleneck.
OP points out that this is usually the case in biology/medicine where regulatory bottlenecks dominate.
> Some have been waiting for a year for the NIH to release imaging datasets they can use to produce better biomarkers. If one needs to interact with the FDA to get their endpoint validated, it is even worse: I have previously written about how the validation of Bone Mineral Density (BMD) for use as a surrogate endpoint in osteoporosis trials took 12 years (!), despite the fact that the data to support it already existed in full and the analyses done were basically regressions.
- danielmarkbruce
While this is right on some level... the incentives aren't the main driver. Finding good targets in biotech is just a harder problem to solve. Like way harder. Disease biology is complex as hell. At the other end, figuring the interplay between one target protein and a potential molecule to act as a therapy is much easier (it's still complex, and there is a little more to it than that, but not anything like finding a good target).