Reza Gandjei was devoted to resolving difficult dilemmas in bioethics. He pursued an interdisciplinary education that allowed him to work on the interface of clinical medicine, ethics, and public policy. His years of study in Great Britain and his Iranian heritage endowed him with a keen international perspective. When he worked on the world-wide AIDS epidemic, Reza realized the need to take into account each country's culture, history, and medical resources. His approach is vital today, because advances in biomedical research have led to new bioethics problems and the world has become even more interdependent.
Reza's focus on the international aspects of bioethics and on public policies regarding bioethical issues must be pursued to make medical advances available worldwide. While biomedical research on stem cells, genomics, and gene therapy offers great promise for treating diseases, it also raises unprecedented ethical dilemmas. Many countries around the world are making important contributions to this high-technology biomedical research, but with different guidelines and policies regarding such research. Hence biomedical research that is considered appropriate in one country may be considered unethical in other countries. For biomedical research to be translated into new therapies, policies need to address differences in ethical perspectives. The challenge is to establish professional guidelines and public policies that are acceptable to as many nations as possible, so that discoveries made in one country will not be rejected because of ethical concerns in other countries. Similar concerns arise regarding clinical trials, which are essential to test new approaches to therapy. Clinical trials are needed in resource-poor countries that bear the greatest burdens of disease, in order to determine what therapies are effective, safe, and practical there. However, carrying out clinical trials in developing countries presents ethical dilemmas. For example, research on a new approach to preventing AIDS has been halted because of concerns about informed consent, access to care, and affordability of new treatments. Thus there is an urgent need to focus on the ethical issues raised by advanced biomedical research and clinical trials.
In Reza's memory, the Reza Gandjei Program in Bioethics is being established at the University of California San Francisco (UCSF), where Reza carried out his residency training in internal medicine. Reza was poised to become a leader in bioethics. Establishing a bioethics program in his name at UCSF will go beyond memorializing him. It will allow the UCSF Program in Medical Ethics to pursue the important issues that Reza would have addressed. UCSF currently sponsors the annual Reza Gandjei Memorial Lecture in Medical Ethics by a distinguished visiting professor. These lectures have inspired residents about the importance of medical ethics. The goals of Reza Gandjei Program in Bioethics at UCSF will be:
- To resolve ethical dilemmas in biomedical research and clinical trials, taking into account the context and traditions in different countries around the world. Additional funding would allow the Program to add a new faculty member to work specifically on these issues, with the goal of influencing public policies regarding bioethics
- To train the next generation of leaders in bioethics. As Reza demonstrated, innovative work in bioethics requires training in several disciplines, including medicine, ethics, public policy, and law. This endowment will support promising young researchers from the U.S. and other countries at UCSF while they pursue such interdisciplinary training and carry out their research. These young bioethicists will be named Reza Gandjei Scholars in Bioethics, and their training will be a key part of Reza's legacy
- To endow the Reza Gandjei Professorship in Bioethics. An endowed chair will allow a senior faculty member to carry out these important issues in bioethics research, which fall outside the funding priorities of the National Institutes of Health or private foundations. An endowed chair will also allow a distinguished professor time to serve on policy panels and commissions.
UCSF is well positioned to carry out this important new work in bioethics. The Program in Medical Ethics has made major contributions to resolving controversial ethical dilemmas on the levels of clinical practice and public policy. It has conducted major research projects on ethical issues in end-of-life care, the doctor-patient relationship, HIV infection and public health, and biomedical and clinical research. Its work on decisions to forego life-sustaining treatment near the end of life has helped set standards for care. In addition, the Program's publications on carrying out HIV prevention trials in developing countries and on conducting human embryonic stem cell research have influenced other medical centers and national policies.