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Honors Alum Considers the Ethical Implications of Infectious Disease Outbreak Response

picture of ariadne nichol
Sep 2 2020
Sara Button

It didn’t take the current COVID-19 pandemic to inspire this Ethics in Society Honors Program alumna to pursue infectious disease. Growing up with two parents who work as public health scientists meant Ariadne Nichol, 18, had some interesting dinner table conversations.

“Ebola, Crimean-Congo hemorrhagic fever, Lassa, there are all these nasty bugs out there,” Nichol explains, “and [my parents] often went to field responses when they’d pop up in Asia, Africa.” But what interested Nichol most were the discussions of personal interactions between workers like her parents and local community members. “There’s potential for conflicts that’ll come up as outsiders. They are having to take into consideration the cultural, religious, political state of that community and making sure to be respectful of that.” 

The summer before her freshman year at Stanford, Nichol interned at the Center for Disease Control. It was 2014—and there was an Ebola outbreak. As part of the Ebola emergency operations team, Nichol saw first-hand the conversations taking place about using experimental therapeutics and the issues surrounding treatment allocation when there are limited resources. That experience inspired her to pursue the topic as a student at Stanford. 

To do this, Nichol decided to major in human biology, with a concentration in medical ethics. She decided to complete an honors thesis with the McCoy Family Center for Ethics in Society because of its interdisciplinary focus. Her honors thesis focused on the just distribution of experimental therapeutics in emerging infectious disease outbreak responses.

After graduation, Nichol directly applied her bioethics background during an internship at the World Health Organization. As part of the Global Health Ethics Unit, she was involved in creating training for research ethics in outbreak responses and conducted research in clinical trial transparency, about which she prepared an internal WHO report. “This idea of taking real-world issues, looking at them from a philosophical lens, and being able to share the potential impacts and considerations with others who aren’t familiar with ethics but know the real-world realm was really rewarding for me.”

The opportunity to examine real-world, ethical issues surrounding emerging pathogens has certainly been at the forefront this year with the COVID-19 pandemic. Despite extensive exposure to discussions about the challenges of containing outbreaks growing up, “living through COVID-19 has given me a greater appreciation of the social and economic implications of what one virus can do,” she says.

Since 2019, Nichol has worked as a researcher at Stanford’s Center for Biomedical Ethics. She focuses on machine learning and predictive analytics for different diseases and purveying precision medicine—work she feels all the more confident in thanks to her preparation in the Ethics in Society honors program. Currently, an ethical challenge that has emerged due to the pandemic is the use of AI-based contact tracing applications. “My colleagues and mentors often bring up the fact that we focus on privacy when discussing contact tracing apps, but that in actuality there is a trade-off being made with other ethical values, such as the potential benefit of contact tracing in mitigating the transmission of disease in the broader context of a pandemic.”

Recently, Nichol and her colleagues presented on the ethical implications of machine learning and AI in medicine at the 2020 ELSI Congress hosted (virtually) by Columbia University. Nichol will present again virtually in October at the American Society for Bioethics and Humanities on the same topic. 

Today, Nichol is in Connecticut working remotely for the Center for Biomedical Ethics, dabbling in pickleball, and looking forward to the publication of two forthcoming papers. Her most recent piece, “Potential Implications of Testing an Experimental mRNA-Based Vaccine During an Emerging Infectious Disease Pandemic,” came out in The American Journal of Bioethics in April. In addition to her research on contract tracing apps’ application during infections disease responses, she’s also examining how to use machine learning to assess HIV risk in Africa. “These research ethics issues are complex and technical, but I love getting to dive into these issues at the intersection of infectious disease, medicine, and biomedical ethics,” she says.

Her other big project these days? Medical school applications. Nichol hopes to apply her biomedical ethics learnings and commitment to just and equitable health care for all as a future infectious disease expert. “I find emerging infectious diseases fascinating in what they shift society towards,” Nichol says. “It’s really interesting to see the interconnectedness and cultural implication when [a disease like] Ebola or SARS hits different communities in different parts of the world, and how best to shift responses to specific communities so you can respect the religious or cultural or political state of those communities—while also improving health.”

Sara Button is a writer and editor. She lives in Oakland.

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