New treatments offer hope. Research into gene therapy, for example, can provide perspective for someone with severe heart disease. And a new study may give a patient faster access to promising medicine. But how do we ensure that such progress unfolds fairly? Who benefits from research? Who is allowed to participate, and who unintentionally remains unseen? These are the kinds of questions that concern Rieke van der Graaf. As of February 15, 2026, she has been appointed as Professor of Medical Research Ethics at the Julius Center of UMC Utrecht.
Rieke van der Graaf is trained as a bioethicist and in recent years has built a research program on justice in medical research, both within the Netherlands and internationally.
One central question runs through her work: what health inequalities exist between groups of people, and when are those differences unjust? This relates to health equity, meaning fair opportunities for health. Health differences do not arise solely from the disease or condition that affects someone, but also from income, education, living environment, and access to care. Researchers conducting studies involving human participants must therefore actively consider these social and economic factors in study design, participant recruitment, and dissemination of results.
According to Rieke, medical research should contribute to reducing these inequalities. This begins with the design of studies: are we asking research questions that matter to patients themselves? Who is invited to participate, and which groups are indirectly overlooked? It also matters when people are asked to participate: is information about the study available in the participant’s language? Are participants fairly compensated for their time and expenses? When certain groups participate less often or have less access to new treatments, innovation may unintentionally increase existing inequalities. After the research is finished, we must also examine whether participants can continue to use the treatment if it has been proven effective and whether it will ultimately be included in the basic health insurance package. In addition, research results must be made publicly available. This prevents unnecessary duplication of studies and enables everyone to learn from them.
“Health inequity does not occur only in research conducted in low- and middle-income countries, but also between countries in Europe and within the Netherlands.” For Rieke, the starting point is clear: reducing unjust and avoidable health inequalities is essential for health and wellbeing. And that begins with fair and inclusive research into medical treatments.
The question of who may participate in research becomes particularly tangible in the case of vulnerable groups, such as pregnant women. For a long time, protection primarily meant exclusion. That may seem safe, but it also has unintended consequences. Many medicines are used during pregnancy, yet for a large proportion their effects are unknown precisely because pregnant women are often excluded from scientific research due to safety concerns. However, pregnant women are not vulnerable simply because they are pregnant. They are vulnerable because we do not sufficiently know which treatments are safe and effective during pregnancy. According to Rieke, participation should not be automatically excluded; rather, it must be carefully considered when participation is responsible. “We must be cautious about overprotecting pregnant women, as that too leads to risks for both mother and child.” Well-designed research can actually enable better care.
The medical field is changing rapidly. Research must move faster, innovations follow one another at high speed, and increasing amounts of healthcare data are being used for new studies. At UMC Utrecht, work is being done on innovative study designs, the reuse of healthcare data for research, and the development of new therapies such as gene therapy, including within the Circulatory Health and Child Health programs. These developments create opportunities, but they also require ethically careful choices: when are risks acceptable, and how do we ensure that new treatments become fair and available? For whom is this progress intended, and who truly benefits from it? Particularly in times of rapid innovation, we must continue to ask these questions. For the ZonMw project PSIDER Heart, Rieke contributed to a documentary addressing these issues. On March 10, she will discuss this topic in Blik op de Zorg.
Rieke connects her work at UMC Utrecht with international developments. As Director of the WHO Collaborating Center for Bioethics Utrecht, she contributes to guidelines for fair medical research worldwide. Questions about risks, access, and allocation of resources arise not only in international consultations, but also daily in research projects and clinical practice. “Good research is not something that concerns only the ethicist or the ethics review committee,” says Rieke, “but starts with the researcher.” It requires structurally embedding justice, inclusion, and careful decision-making in everything we do.
Education also plays a key role. Within the Medicine program and the Graduate School of Life Sciences, including the master’s program in Epidemiology, Rieke trains students and PhD candidates in the ethics of medical research. She also organizes an annual Summer School on Global Health Ethics and Equity. In her teaching, she emphasizes that ethics in research is not something you only look at afterwards, but part of professional conduct from the very beginning. She puts it clearly: “Ethics and methodology are inseparably linked: poorly designed research involving humans is unethical, and without attention to ethical aspects, a study does not produce knowledge that is socially or scientifically valuable.”
With the appointment of Rieke van der Graaf, UMC Utrecht strengthens the position of ethics in research, healthcare and education. “At a time when medical innovation is moving faster and faster, attention to ethics remains essential,” says Rieke. “This ensures that medical progress is also inclusive and just.”
Rieke will deliver her inaugural lecture on December 16, 2026.
Rieke van der Graaf studied at Leiden University, where she completed two master’s degrees: Classical Languages (2001) and Theology (2006). In 2010, she obtained her PhD from Utrecht University with the dissertation of Ethical Fundamentals of Human Subjects Research. On Equipoise and Human Dignity.
She has been affiliated with the Julius Center at UMC Utrecht since 2010. She began as Assistant Professor of Bioethics (2010–2019), was appointed as Associate Professor in 2019, and has served as Head of the Department of Bioethics and Health Humanities since 2021.
Since 2023, she has been Director of the WHO Collaborating Center for Bioethics Utrecht. She is also Chair of the Hospital Ethics Committee of UMC Utrecht, a member of the Central Committee on Research Involving Human Subjects (CCMO), a member of MedEthicsEU representing the Netherlands, and a member of the Standing Committee on Vaccinations of the Health Council of the Netherlands.
