Rarely in the long history of our planet, have we faced such dire threats to our survival: nuclear annihilation, out of control pandemics, international terrorism, environmental disasters, racial and ethnic divisions, challenges to the rule of law, attacks on basic liberties including speech and due process, health care policies (or lack thereof) that create disparate life expectancies based on race and nationality, rampant crime, police misconduct, school and other mass shootings and additional dangers. But rarely in our history have we developed tools so capable of predicting and preventing many of these potential disasters. It is the combination of these two phenomena - increasing dangers coupled with increasing capabilities by governments (often aided by private technology) to prevent them- that has given rise to the preventive state. The Preventative State shows how, all in all, the "tragic choices," of evils, or even of goods with some negative consequences decisions that involve high costs on both sides are similar in many predictive-preventive decisions, whether they involve big government, big tech, big medicine, big pharma, big education, big media or any other large-scale institutions that affect the lives of people. There are, to be sure, real differences in kind and degree, depending on the nature and function of the institutions, but the similarities and analogies help inform thoughtful consideration of options and may provide insights into any effort to construct a jurisprudence of prevention based on predictions of harm.