Leah Pierson, MD-PhD ’25, co-founded the Bio(un)ethical podcast to explore important and often controversial issues in science, medicine, and public health, such as medical aid in dying and the use of race in clinical algorithms. She recently spoke about her time at Harvard T.H. Chan School of Public Health, and her plans for a career balancing patient care, research, and work sparking conversations around bioethics.

What was your path into public health?

I’d intended to major in philosophy or political theory in college, but during my gap year in South Africa and Peru, I saw how much the basic inability to access health care and the social circumstances compatible with health affected people. As an undergraduate at Brown, I studied abroad in India, Brazil, and South Africa, and also worked with NGOs focused on health and community development. I wound up doing an independent major in human rights as a way to bridge my intellectual interests with the practical questions I was exploring around how we actually make global health work for people. After graduation, I became a bioethics fellow at the National Institutes of Health (NIH) and discovered that public health ethics was a discipline where I could build a career.

I was inspired by the careers of Harvard alumni, like Paul Farmer, Jim Kim, and Zeke Emanuel, to pursue an MD-PhD. It seemed like an effective way to combine my desire to have meaningful relationships with patients while also working to make structural change in medicine and public health.

What’s something you learned during your PhD studies in global health that you’ll take with you into your career?

First, some global health interventions are orders of magnitudes more effective than others, and the most impactful interventions aren’t always the ones you’d intuitively expect to be the most impactful. This highlights the importance of doing rigorous global health research, and also setting public health and health care priorities in an evidence-based way.

Second, the amount of progress we have made in global health is simply staggering. In my lifetime, childhood mortality has fallen by half. We’ve eradicated diseases—like smallpox—and are coming close to eliminating others. We’ve developed cures to cancers and infectious diseases that were once fatal. So, although we live in challenging times, and progress is never linear, there are millions of people alive today because of global health efforts. This gives me hope for the future.

What was a highlight of your time at Harvard Chan School?

During COVID, my cohort missed out on some opportunities to build informal relationships, but we still found ways to spend time together. I think that no matter where our careers take us, we’re still going to be gathering informally for game nights, cooking dinners for each other, and inviting each other to collaborate on projects in the decades to come.

What inspired you to start a podcast?

While I was working with a career adviser, I realized that some of my most impactful work has been my public writing, such as my op-eds in the New York Times and Boston Globe. We were brainstorming ways that I could make that more a part of my life, and the idea of a podcast came up.

I had been thinking about how there are a lot of things that we do in medicine, science, and public health that could be done better for ethical reasons. How do we move the needle with this? I think a key piece is helping people understand the issues, while advocating for better policies and practices in these domains.

Who is the podcast aimed at and what feedback have you received?

Our target audience is interested in bioethical issues but doesn’t necessarily have content-area knowledge—for example, a doctor who wants to understand the implications of having a conversation about end-of-life issues with a patient, or a scientist who is frustrated with the IRB system. [Institutional Review Boards are committees that review research involving human subjects to ensure that it is ethical and complies with regulations].

In terms of feedback, my cohost Sophie Gibert and I have five stars across all platforms, and we get nice emails from listeners. But some of the best feedback we’ve gotten has been from guests [who have included former CDC Director Rochelle Walensky and Harvard Chan School Professor of Epidemiology Marc Lipsitch]. They appreciate the level of depth in our questions, and how closely we engage with their work. I also take it as a good sign that famous bioethicists whose work I read in school are reaching out and asking to be interviewed.

I’d like to ask you the question you ask all your guests: What is a rule or norm related to public health or medicine that you would change if you could and why?

I think we need a more progress-oriented bioethics. Discourse around, for example, gene therapy often focuses on potential problems. But our status quo is not acceptable. People are dying from diseases unnecessarily, we have massive racial health inequities, there’s the threat of the next pandemic, and so many people don’t have access to basic health care. The mandate has to be that we find solutions to these problems. I would like to see bioethics as a field be more oriented around fixing things rather than problematizing potential solutions.

What are your career goals? Do you see yourself continuing the podcast?

I want to pursue a career as a physician-researcher, but to also be oriented towards ensuring that sound ethical arguments—for example, around issues in health care priority setting, organ donation, participation in medical research, and medical aid in dying—move from academic spaces to public policy.

I hope to continue the podcast. I’m about to start medical residency and Sophie is about to start a fulltime job as a professor, so we’ll probably have to make some changes. But we are both happy with the product and excited that people are listening to it and seem to derive a lot of value from it.

It’s a little tricky because I don’t think a podcast pays the same kind of academic dividends as a high-impact publication, and it takes a lot of time. But personally, as someone who wants to really make positive change in the world, I think that the podcast is a key avenue for making an impact. A goal of the podcast has been to make quality information about bioethical issues accessible to everyone, and to spark conversations that hopefully lead listeners to research ideas or projects that they might want to work on—to create a space for serendipity to happen—and I think we’re doing that.

Quick hits

Favorite way to unwind: I love being outside. During COVID, my best friends and I started walking around the Esplanade a couple times a week, and those walks have continued. I also travel a lot. I have a more relaxed clinical schedule this year and have three backpacking trips planned.

Special skill: I’m an artist. I don’t paint as much these days as I did when I was in high school, but I draw a lot. When I’m sitting in lectures, I’m always doodling the things that are around me, like a water bottle, my left hand, or various objects in the classroom. I derive a lot of inspiration from trying to see the world as it is, through my scholarship but also through my art.

Book recommendation: The Scout Mindset by Julia Galef. It’s about breaking out of psychological biases and finding truth. Her podcast, Rationally Speaking, also informed our model for Bio(un)ethical. She really does her homework on her guests, and this comes across in her interviews.

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