I'm going to start on a slightly somber note.

少し重い話になりますが

Two thousand and seven, five years ago,

2007年―今から５年ほど前に

my wife gets diagnosed with breast cancer.

家内が乳がんと診断されました

Stage IIB.

ステージ IIB でした

Now, looking back, the most harrowing part of that experience

いま当時を振り返って一番

was not just the hospital visits --

苦しかったことは

these were very painful for my wife, understandably so.

病院に行くことではありません

It was not even the initial shock of knowing that she had breast cancer

もちろん本人がつらいのは わかります

at just 39 years old,

乳がんだと知らされた―

absolutely no history of cancer in her family.

ショックでもありません まだ39歳で

The most horrifying and agonizing part of the whole experience

癌の家族歴もなかったのです

was we were making decisions after decisions after decisions

この一連の経験で もっとも恐ろしくて

that were being thrust upon us.

苦しかったのは

Should it be a mastectomy? Should it be a lumpectomy?

決断を次から次へと

Should it be a more aggressive form of treatment,

求められ続けたことです

given that it was stage IIB?

乳房切除をすべきか？ それとも乳腺腫瘤の摘出か？

With all the side effects?

ステージ IIB なのだから

Or should it be a less aggressive form of treatment?

積極的な治療に委ねるべきなのか？

And these were being thrust upon us by the doctors.

副作用があっても？

Now you could ask this question,

それとも そこまで積極的でなくてもいいのか？

why were the doctors doing this?

次から次へと決断を求めてくるのが

A simplistic answer would be,

医師なのです

the doctors are doing this

不思議に思うかもしれません

because they want to protect themselves legally.

医師はなぜ こうしたのか？

I think that is too simplistic.

単純に考えると医者自身が

These are well-meaning doctors,

法的に自分を守りたいためですが

some of them have gone on to become very good friends.

実はそんな単純な話ではありません

They probably were simply following the wisdom

彼らは善意の医者であり

that has come down through the ages,

何人かとは良い友人になりました

this adage that when you're making decisions,

きっと長年受け継がれてきた

especially decisions of importance,

古い考え方に従ったまでなのでしょう

it's best to be in charge, it's best to be in control,

「意思決定 特に重責を伴う意思決定は

it's best to be in the driver's seat.

他人の判断に任せずに 自分の意思で決めよ

And we were certainly in the driver's seat,

つまり助手席に座るよりも 運転席に乗るべきである」

making all these decisions.

そこで我々は運転席に座らせられ

And let me tell you -- if some of you have been there,

多くの意思決定を下すことになったのです

it was a most agonizing and harrowing experience.

同じ経験をされた方もいるでしょうが

Which got me thinking.

何よりも苦しくて恐ろしい経験となりました

I said, is there any validity to this whole adage

そして考えてみました―

that when you're making decisions,

決断をすることに関する考え方は

it's best to take the driver's seat,

本当に正しいのだろうか？

be in charge, be in control?

運転席に乗ることが一番良いのか？ 主導権を握って

Or are there contexts where we're far better off

制御するのが良いのか

taking the passenger's seat

逆に 状況によっては我々が助手席におさまり

and have someone else drive?

誰かに運転席を任せた方が良い場合もあるのでは？

For example, a trusted financial advisor,

例えば 信頼できる金融専門家や

could be a trusted doctor, etc.

信頼できる医者などです

And since I study human decision making,

私は「意思決定の仕組み」を研究していますので

I said, I'm going to run some studies

いくつかの実験を行い

to find some answers.

答えを導き出すことにしました

And I'm going to share one of these studies with you today.

早速 ここで研究成果のひとつをご紹介します

So, imagine that all of you are participants in the study.

皆さんは その実験に参加しているつもりで聞いてください

I want to tell you that what you're going to do in the study is,

この実験では皆さんに

you're going to drink a cup of tea.

まず 一杯のお茶を飲んでいただきます

If you're wondering why, I'll tell you why in a few seconds from now.

お茶を飲む理由は後で説明します

You are going to solve a series of puzzles,

そしてパズルをいくつか解いてもらいます

and I'm going to show you examples of these puzzles momentarily.

パズルの実例も後ほどお見せします

And the more puzzles you solve,

正解数が多ければ多いほど

the greater the chances that you'll win some prizes.

賞品をもらえる可能性が大きくなります

Now, why do you have to consume the tea?

ところでなぜお茶を飲むのか？

Why? Because it makes a lot of sense:

理由は単純明快です

In order to solve these puzzles effectively, if you think about it,

パズルを効果的に解くために

your mind needs to be in two states simultaneously, right?

精神が同時に２つの状態にならないといけません

It needs to be alert,

そうでしょう？神経がピンと張り詰めた状態

for which caffeine is very good.

これにはカフェインが効果的ですし

Simultaneously, it needs to be calm --

同時に 心穏やかでなければいけません

not agitated, calm --

苛つかず 心が落ち着いた状態 これにはカモミールが最適です

for which chamomile is very good.

さて被験者間で何を変えるのかという ABテストの

Now comes the between-subjects design,

デザインを説明します

the AB design, the AB testing.

早速ですが 皆さんを適当に

So what I'm going to do is randomly assign you to one of two groups.

２つのグループに分けます

So imagine that there is an imaginary line out here,

ここに架空の線があると想像してください

so everyone here will be group A,

こちらの皆さんはグループAに

everyone out here will be group B.

こちらの皆さんはグループBにします

Now, for you folks, what I'm going to do is I'm going to show you these two teas,

グループAの皆さんには

and I'll go ahead and ask you to choose your tea.

２種類のお茶をお見せして

So you can choose whichever tea you want.

自分で好きな方を

You can decide, what is your mental state:

選んでいただきます

OK, I choose the caffeinated tea,

さぁ 選んでみてください 決めましたか?

I choose the chamomile tea.

そうだ 私はカフェイン入りのお茶を

So you're going to be in charge, you're going to be in control,

私はカモミールを選ぼう

you're going to be in the driver's seat.

自分で決める―

You folks, I'm going to show you these two teas,

選択権を持ち 運転席に座っているのです

but you don't have a choice.

グループBの皆さん ここに２種類のお茶がありますが

I'm going to give you one of these two teas,

選んでいただくことはできません

and keep in mind, I'm going to pick one of these two teas

どちらかをお渡しします

at random for you.

どちらか一方のお茶を

And you know that.

ランダムにお渡しします

So if you think about it, this is an extreme-case scenario,

覚えておいてください

because in the real world,

もちろん これは非常に極端な例です

whenever you are taking passenger's seat,

なぜなら 実社会では

very often the driver is going to be someone you trust,

あなたが助手席に座るときにはまず

an expert, etc.

たいてい運転席には信頼をおける人や

So this is an extreme-case scenario.

専門家がいる筈だからです これはかなり極端なシナリオです

Now, you're all going to consume the tea.

ここで皆さんにはお茶を飲んでいただきます

So imagine that you're taking the tea now,

お茶を楽しんでください

we'll wait for you to finish the tea.

飲み終るまでもう少し待ちましょう

We'll give another five minutes for the ingredient to have its effects.

お茶の成分が効果を発揮するまで あと５分ほど待ちましょう

Now you're going to have 30 minutes to solve 15 puzzles.

さて これから30分かけて15問のパズルを解いてください

Here's an example of the puzzle you're going to solve.

ひとつサンプルをご紹介します

Anyone in the audience want to take a stab?

どなたか分かりますか？（文字の並び替えクイズ）

Audience member: Pulpit! Baba Shiv: Whoa! OK.

（観衆：PULPIT ）　素晴らしい！

That's cool.

凄いですね！

Yeah, so what we'd do if we had you who gave the answer

さて あなたのようにすぐ解る人がいたらどうするか

as a participant,

被験者のレベルに合わせて　 パズルの難易度を

we would have calibrated the difficulty level

調整する必要がありました

of the puzzles to your expertise.

簡単に解けては無意味ですから

Because we want these puzzles to be difficult.

このクイズは実に巧妙にできてて

These are tricky puzzles,

本能的に TULIP に見えるので 慌てて頭を切り替えたり―

because your first instinct is to say "tulip."

しなくてはいけませんね　 つまり適切な難易度に設定されています

And then you have to unstick yourself.

後に説明しますが簡単に解けては意味がありません

Right?

それではサンプル問題をもうひとつ

So these have been calibrated to your level of expertise,

分かりますか？少し難しいかな？

because we want this to be difficult,

（観客：EMBARK ）　正解！

and I'll tell you why, momentarily.

こちらも難しかったでしょう

Now, here's another example.

KAMBAR や MAKER など

Anyone? This is much more difficult.

ひっかけがたくさんあるのです

Audience member: Embark. BS: Yeah. Wow! OK.

このような問題15問を 30分間で解いてもらいます

So, yeah, so this is, again, difficult.

この実験で

You'll say "kamber," then you'll go, "maker," and all that,

注目していることがあります

and then you can unstick yourself.

正解数が多いのは

So you have 30 minutes now to solve these 15 puzzles.

運転席に乗る場合の

Now, the question we're asking here is, in terms of the outcome --

方でしょうか？

and it comes in the number of puzzles solved --

つまり 飲むお茶を選択できたからこそ 成果が上がるのか

will you in the driver's seat end up solving more puzzles

それともグループBの方が

because you are in control,

正解数が多いのでしょうか？

you could decide which tea you would choose,

系統的な調査データをもとに

or would you be better off,

分析した結果

in terms of the number of puzzles solved?

実は助手席にいる方が

And, systemically, what we will show,

お茶はランダムに割り当てられたものなのに

across a series of studies,

運転席にいる方よりも多く正解しました

is that you, the passengers,

もうひとつ分かったことは

even though the tea was picked for you at random,

運転席にいる方は回答数が少ないうえ

will end up solving more puzzles than you, the drivers.

集中力を欠いています

We also observe another thing,

努力が足りず 粘り強さもない

and that is, you folks not only are solving fewer puzzles,

なぜわかるのか？

you're also putting less juice into the task -- less effort,

２つの客観的指標があるのです

you're less persistent, and so on.

ひとつは問題を解くのに

How do we know that?

かけた解答時間の平均です

Well, we have two objective measures.

グループAの方が平均解答時間が短かったのです

One is, what is the time, on average, you're taking

二つ目です 制限時間は30分ありますが

in attempting to solve these puzzles?

最後まで諦めずがんばるか？ あるいは30分より

You will spend less time compared to you.

前に途中棄権するのか？

Second, you have 30 minutes to solve these;

グループAの方が途中棄権する確率が高かったのです

are you taking the entire 30 minutes

集中力を欠いていることは結果にも現れます

or are you giving up before the 30 minutes elapse?

正解数が少ないのです

You will be more likely to give up before the 30 minutes elapse,

ではなぜ こんな結果になるのか

compared to you.

どのような状況だと こういう結果に―

So you're putting in less juice,

つまり助手席側の方が 運転席側よりも

and therefore, the outcome: fewer puzzles solved.

良い成果を出せるのか？

That brings us now to: why does this happen?

INCA と名付けたもの遭遇する場合に問題となるのです

And under what situations -- when -- would we see this pattern of results

INCA は 意思決定の後のフィードバックの

where the passenger is going to show better, more favorable outcomes,

性質を表す言葉の頭文字です

compared to the driver?

今回のパズル実験を思い出してみてください

It all has to do with when you face what I call the INCA.

変化の激しい株式投資や

It's an acronym that stands for the nature of the feedback you're getting

病気の場合でも同じですが 結果は

after you made the decision.

直ちに分かりますよね (Immediate)

So if you think about it, in this particular puzzle task --

パズルが解けたかどうか すぐ分かります

it could happen in investing in the stock market,

そして 結果は通常良くない (Negative)

very volatile out there,

パズルの難易度は

it could be the medical situation --

意図的に高く設定されていました

the feedback here is immediate.

これは医療の現場でも同じです

You know the feedback, whether you're solving the puzzles or not.

例えば 治療のごく初期には

Right? Second, it is negative.

良い結果も見えず 状況や手ごたえは厳しいものです

Remember, the deck was stacked against you,

これは株式市場でも同じです

in terms of the difficulty level of these puzzles.

荒れた株式市場では 直ちに否定的な結果が得られます

And this can happen in the medical domain.

そして フィードバックは具体的です (Concrete)

For example, very early on in the treatment,

曖昧ではありません 正解か 不正解か

things are negative, the feedback, before things become positive.

さらにこの「即時性 (I)」

Right? It can happen in the stock market.

「ネガティブ (N)」「具体的 (C)」に

Volatile stock market, getting negative feedback, it is also immediate.

「主体感 (Agency)」が加わります

And the feedback in all these cases is concrete, it's unambiguous;

自分の決断には責任が伴います

you know if you've solved the puzzles or not.

するとどうなるのか？

Now, the added one,

選ばなかった選択肢が気になるのです

apart from this immediacy, negative, this concreteness --

だから もう一方のお茶を選んでればよかったのに―

now you have a sense of agency.

（笑）

You were responsible for your decision.

心の迷いが　意思決定を乱し

So what do you do?

意思決定の自信低下

You focus on the foregone option.

良い成果への自信低下

You say, you know what?

問題解決能力の低下につながります

I should have chosen the other tea.

課題解決に身が入らないので

(Laughter)

正解数が少なくグループBより劣る結果となります

That casts your decision in doubt,

これは医療分野でも十分に起こりえますね

reduces the confidence you have in the decision,

患者を運転席に座らせた場合

the confidence you have in the performance,

活力に欠け 回復のプロセスを促す

the performance in terms of solving the puzzles.

運動や 健康維持の努力に 身が入らなくなってしまいます

And therefore less juice into the task,

大切だといわれているのにです これは良くないですね

fewer puzzles solved

ですからINCAに遭遇したら

and less favorable outcomes compared to you folks.

フィードバックが即時でネガティブであり

And this can happen in the medical domain, if you think about it, right?

具体的で 自己責任を感じる時

A patient in the driver's seat, for example.

その場合は―誰かに運転席を任せ

Less juice, which means keeping herself or himself

助手席に座ったほうがずっと良いのです

less physically fit, physically active to hasten the recovery process,

今日は重苦しい

which is what is often advocated.

トーンで始まったので

You probably wouldn't do that.

最後は陽気なトーンで締め括りましょう

And therefore, there are times when you're facing the INCA,

あれから５年が経過し―正確には５年以上ですが

when the feedback is going to be immediate, negative, concrete

非常に喜ばしいことに

and you have the sense of agency,

家内の癌は未だ寛解期に留まっています

where you're far better off taking the passenger's seat

治療も順調に進んだわけです

and have someone else drive.

ただし ひとつだけ言ってなかったことがあります

Now, I started off on a somber note.

二人で相談した結果 家内の初期治療のときから

I want to finish up on a more upbeat note.

我々は助手席に座ることを決めました

It has now been five years, slightly more than five years,

そのことで得られた心の平安のおかげで

and the good news, thank God, is that the cancer is still in remission.

病気の回復に集中できたことが

So it all ends well.

この結果につながったと思います

But one thing I didn't mention was that very early on into her treatment,

我々は医者に運転席を譲り

my wife and I decided that we would take the passenger's seat.

すべての意思決定を任せました

And that made so much of a difference

ありがとうございました

in terms of the peace of mind that came with that;

（拍手）

we could focus on her recovery.

We let the doctors make all the decisions

and take the driver's seat.

Thank you.

(Applause)