关于非个人化同意的风险和在医疗决策中安全实施LLM的风险
1Medical Ethics and Humanities Unit, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong carlh@hku.hk.
Journal of medical ethics
|July 11, 2025
概括
大型语言模型 (LLM) 在医疗决策中显示出患者沟通的前景. 然而,排除人类医疗保健专业人员会因为不灵活和缺乏同情心而危及患者的自主权和信任.
科学领域:
- 医学伦理 医学伦理
- 医疗保健中的人工智能
- 患者与医疗服务提供者之间的沟通
背景情况:
- 大型语言模型 (LLM) 正在探索医疗决策中的患者-临床医生沟通.
- 虽然LLM提供了潜在的好处,但其实施引发了伦理方面的考虑.
- 从决策过程中删除人类医疗保健专业人员 (HCP) 引入了目前讨论中尚未完全解决的风险.
研究的目的:
- 识别和讨论与将医疗从业人员从LLM驱动的医疗决策中移除相关的风险.
- 突出患者同意的重要性以及支持其的过程.
- 探索医疗保健的潜在非人道化及其对患者和医疗保健工作者的影响.
主要方法:
- 在患者沟通中实施LLM的概念分析.
- 识别与自主性,不灵活性和同理心相关的风险.
- 在临床决策支持中整合人工智能的伦理考虑.
主要成果:
- 将医疗保健专家排除在LLM辅助决策之外,可能会减少患者的情境自主权.
- LLM的不灵活性可能会给患者的自主性带来障碍.
- 在LLM沟通中缺乏人类同情心,可能会降低患者的舒适性和信任.
结论:
- 解决非人道化风险对于最大限度地发挥医疗保健中LLM的好处至关重要.
- 伦理框架必须优先考虑患者的同意和在医疗决策中保持人与人之间的联系.
- 需要进一步的研究来减轻危害,并增强LLMs对患者护理的积极影响.
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