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Kristina Orfali

Columbia University
Dignity versus autonomy: bioethics in the making, a comparison between France and the USA
01 February 2021 -
31 May 2021
History, philosophy and sociology of science

Kristina Orfali is a Professor of Bioethics at Columbia Medical Center, as well as a clinical ethicist and a member of the NY Presbyterian Morgan Stanley Children’s Hospital Clinical Ethics Committee. Trained in France at the Ecole Normale Supérieure and the Institut d'Etudes Politiques de Paris, she holds a Ph.D. in Social Sciences from the Ecole des Hautes Etudes en Sciences Sociales in Paris. Before joining CUMC, she has been an Assistant Professor in Medicine and Associate Director at the MacLean Center for Clinical Ethics at the University of Chicago and a Research Scholar at the Institute for Social and Economic Research and Policy (ISERP) at Columbia. Kristina Orfali’s comparative research and publications span a variety of ethical issues and her work has been extensively published in Social Science & Medicine, Sociology of Health & Illness, Journal of Clinical Ethics, American Journal of Bioethics and others; she has also co-edited several books. Her most recent work is at the intersection of law, medicine and bioethics.

Her fellowship benefits from the support of the RFIEA+ LABEX, with a national funding (Grant ANR-11-LABX-0027-01). 

Research Interests

Cross-cultural perspective on clinician and family decision-making, Neonatal ethics, Prognostication, Life and death decision-making under uncertainty, International comparisons of bioethical models.

Dignity versus autonomy: bioethics in the making, a comparison between France and the USA

Contemporary bioethics emerged as a movement concerned with the moral dimensions of life sciences and healthcare in the 60s in the US, and then spread all over the world. Why did this movement begin in the US a decade or more earlier than elsewhere? How did the emergence and development of bioethics take place across different social and cultural settings? Why does the bioethical debate in the US mainly focus on abortion and embryo personhood, while European bioethics seems obsessed by genetics and reproduction?  The goal of this study is to analyze the emergence of bioethics through a comparative lens. From that perspective, France and American societies constitute an enticing couple: beyond largely identical technological and scientific contexts, they share similar, universalistic pretensions through their history and their secular (“laïque”) Constitutions. While American Bioethics has made autonomy the prevailing norm in law, society and medicine, France has developed an ‘alternative’ (and often presented as ‘opposed’) model to American bioethics, and particularly to the autonomy paradigm, enacting dignity as the fundamental value. The project will analyze the birth of bioethics in each context, exploring through archives, literature review and interviews why and how each nation defined what was morally acceptable, and ended up prioritizing one principle over another. 


Contemporary period (1789-…)
World or no region