This Thursday, Emily Shi (12) described how the prioritization of treatment in the global health system affected the severity of pandemics such as the Ebola virus and the Zika virus in her independent study titled “​Global Health Ethics and Inequities: Crisis Triage.​”

Crisis triage refers to the way experts respond to a threat and the allocation of resources and aid during the crisis, which can be inequitable, she said. For example, in an Emergency Room, someone with a heart attack will have their care prioritized over a patient with a broken foot. Shi presented triage through three lenses: utilitarianism, or what benefits the most people, egalitarianism, or what helps those most in need, and solidarity, which is mutual respect and prioritization for those inside a particular society.

During her independent study, Shi had groups of students analyze medical situations using these three ethical lenses. Then, she discussed how triage was applied during the Ebola and Zika virus pandemics and the inequalities present in those distributions. For example, women who had the Zika virus and recovered, before later getting pregnant, gave birth to children with neurological defects. Instead of prioritizing women —  who had the most significant long term effects — when studying and treating the virus, some countries did not make a large distinction in which patients received immediate care. The misuse of triage in this instance caused the Zika virus to have greater impacts on the communities it affected.

Shi first became interested in this topic during her sophomore year in a unit about science and technology in her French class, where she learned how different countries respond to scientific research, Shi said. In her class, she discovered that there are no legally-binding universal frameworks through which people look at global health ethics, Shi said.

Later, while researching for her Junior Research Paper in English 11, Shi focused on how the public perceives pandemics and the different factors that go into how healthcare organizations, the government, and the media respond to those perceptions. That research made her realize how important it is to understand the technical science of response efforts to public health crises while also considering the underlying ethics and cultural impacts, connecting multiple fields that Shi took an interest in, she said.

Science Department Chair Dr. Lisa Rosenblum is Shi’s mentor. The two meet weekly to discuss Shi’s research and progress. During their sessions, Shi begins by sharing her research from the past week.

“Dr. Rosenblum has been incredibly helpful because I normally have so many different ideas that I want to explore, and she helps me take a step back to understand how they all intersect,” she said. 

Rosenblum thinks of herself as a guide for Shi during her research, she said. Shi came in with very broad ideas of topics she wanted to research, and Rosenblum helped her create a roadmap to structure the development of her independent study for both the first and second semesters, Rosenblum said.

For Shi, the most difficult part of the independent study process was narrowing the scope of her project, as global health ethics is a vast field of study. “For the first quarter, I explored how cultural differences impact clinical research and trials,” she said. From there, she focused on public health emergencies such as the Ebola and Zika virus responses. 

This project has inspired Shi to look for interdisciplinary approaches to studying science, as she has enjoyed looking at this topic through political, social, and ethical lenses, Shi said. “I want to continue to study many different fields to understand how they come together in avenues like this.”