This is an interesting perspective. I agree that some types of cold-calling are terrible, like if you sell credit cards and just randomly call anyone who might want a credit card. This is untargeted, and if everyone who sold general-purpose goods did it, we'd all be inundated.
In the B2B context, things seem a little different, especially for startups who have products that are not known. If you work in a particular field and someone calls you to tell you about their new product that is relevant to your company and your specific role, that seems much less terrible than the untargeted calling described above. And in some cases, you may actually be glad that you were called. I don't think it's fair to say that "all cold calling is horrible and unethical", since it can be done in very targeted ways. And small startups in particular (who are here on HN) often try to cold-call in as targeted a way as possible—because when you're spending CEO time on the phone, you're very sensitive to wasting anyone's time.
At the end of the day, it comes down to balancing the benefits to people who are glad you called and the detriment to people whose time you wasted. If you're not targeted, you're likely a net negative to society. If you're very targeted (as many small startups are), there's a much greater chance you're a net positive.