Danielle Pacia | Class of 2020

Growing up in rural Appalachia, Danielle Pacia, MBE, encountered questions about health care long before she had the language to describe them. During the national debates surrounding the Affordable Care Act, she watched communities across Tennessee continue to struggle with access to primary care and other essential health services. The issues were often presented as straightforward political disagreements, but they never felt that simple to Pacia.

“I needed a better way to think through these issues,” she says. “They seemed simple on the surface, but became more and more complicated as I tried to unravel the sociopolitics and the systemic problems associated with not having access to primary care.”

That search for a more structured way of thinking led her to the University of Alabama. With the support of faculty mentors, Pacia designed an interdisciplinary undergraduate major in bioethics that combined philosophy, health policy, medicine, and the humanities into a single course of study. By the beginning of her senior year, however, she wanted to continue digging deeper.

“I wasn’t ready to give up my bioethics education yet,” she says. “I felt that it wasn’t complete.”

She found that next step in the Master of Science in Bioethics program at Harvard Medical School’s Center for Bioethics. Drawn by the program’s broad curriculum and its home within one of the world’s leading medical schools, Pacia saw an opportunity to study bioethical questions alongside the clinicians, researchers, and policymakers who were confronting them every day.

Coming directly from college, Pacia entered a cohort composed largely of physicians, nurses, attorneys, and other experienced professionals. Their diverse perspectives quickly reshaped the way she approached ethical questions.

“There were certain times I would say something, and a physician or a nurse would turn to me and say, ‘We just don’t have time to do the kind of ethical deliberation that you want by the bedside,’” she recalls.

Those conversations taught Pacia that ethical analysis could never exist in isolation. Good ideas had to withstand the realities of patient care, institutional constraints, and the urgency of clinical decision-making.

“As somebody right out of undergrad, I needed to anchor my ethical analysis in a way that was practical,” she says. That immersion extended outside the classroom. Although she did not intend to become a clinician, studying within Harvard Medical School gave Pacia unique insights that she believes would have been difficult to find elsewhere.

One of the defining experiences of the program was her capstone project under the mentorship of Jonathan J. Darrow, SJD, JD, MBA. Together, they explored bacteriophage therapy—an emerging approach that uses viruses to combat antibiotic-resistant bacteria—and the legal, ethical, and regulatory questions surrounding its development.

“The antibiotics we have just aren’t working as well anymore because bacteria are developing resistance to them,” Pacia explains.

Their research examined not only the promise of bacteriophage therapy, but also the patent questions raised by naturally occurring viruses and the incentives needed to encourage the development of new antimicrobial treatments. The collaboration continued well beyond graduation, eventually resulting in a co-authored scholarly publication, “CRISPR-phage antibacterials to address the antibiotic resistance crisis: scientific, economic, and regulatory considerations,” in the Journal of Law and the Biosciences.

Pacia credits Darrow with helping her understand how thoughtful legal and ethical analysis can directly influence scientific innovation. The project also demonstrated something that she would witness repeatedly throughout her career: the questions raised in bioethics rarely belong to a single discipline.

Her final semester unfolded during the onset of the COVID-19 pandemic. After students left campus for spring break, they never returned in person. Even so, Pacia remembers the transition as remarkably seamless. “I felt like I didn’t lose that much connection,” she says. “The faculty responded incredibly well, and they set up networks that kept us connected.”

The program also broadened her understanding of what a legal career could become. Before Harvard, she had considered law school, but conversations with faculty working across medicine, law, ethics, and public policy revealed a much wider range of possibilities.

“The program totally opened me up to all of these different kinds of lawyering, and also to being an academic, which I had no interaction with before,” she says.

After graduating, Pacia joined The Hastings Center for Bioethics in Garrison, NY, where she conducted interdisciplinary research on health policy, artificial intelligence in health care, Medicaid, CRISPR therapeutics, federally qualified health centers, and precision medicine. The experience strengthened her interest in using legal systems to improve health care and ultimately led her to Yale Law School, where she now focuses on health law, administrative law, and health policy.

Pacia still finds herself returning to the intellectual tools she developed at Harvard. “Bioethics provides a way to start from the ground up,” she says. “That’s why I continue to reach for bioethics scholarship and use the tools that were taught to me in the program.”

Whether reading judicial opinions or analyzing health policy, Pacia instinctively looks beneath the conclusions to examine the ethical frameworks driving them. “I’m able to ask, ‘What kind of thinking is this?’ Is this utilitarian thinking, where the argument is based on maximizing resources, or is it more principled thinking that is deontological in nature?”

Learning to recognize those patterns prepared her for law school in ways that Pacia had not anticipated. Rather than focusing solely on individual cases, she developed the ability to think systematically about how institutions, policies, and legal structures influence health care.

“To be in an environment where you actually take those frameworks and apply them in real time to real cases is so incredibly valuable,” she says. “I felt really equipped when I entered those discussions in law school.”

Just as influential as the curriculum was the community she found at Harvard. Two of her classmates later stood beside her as bridesmaids at her wedding. Pacia’s closest friendships—and relationships with many of the mentors who continue to shape her career—began during her year in the program.

Before arriving at Harvard, Pacia had read the work of Robert D. Truog, MD, and assumed that someone of his stature would be inaccessible to students. Instead, she found a faculty culture built around generosity and mentorship.

“It was incomprehensible to me that he would actually take the time to talk to students,” she says. “Again and again, teachers and professors had that level of mentorship and support.”

Today, Pacia hopes to build a career improving health care access through health law. Her work has already included advocating for Medicaid beneficiaries through the Tennessee Justice Center, and she remains interested in federal agencies such as the U.S. Food and Drug Administration and the U.S. Department of Health and Human Services.

Whatever path she ultimately chooses will be grounded in the same questions that first drew her to bioethics: how institutions make decisions, whose interests those decisions serve, and how health systems can better support the people who depend on them.

Pacia encourages prospective students to talk to current students. “A lot of them are really eager to speak with people about whether it’s a good fit for their career trajectory.” She also urges them to remain open to where the discipline might lead.

“Keep an open mind about what bioethics can do for you,” she says. “Because the field is interdisciplinary, it acts almost like a hub for all these different methods, disciplines, and professions. You can make the program what you want it to be.”

Written by Bailey Merlin