赋予患者自主权:大语言模型 (LLM) 在医疗实践中的知情同意架构中的作用
Jemima W Allen1,2, Neil Levy2,3, Dominic Wilkinson1,2,4,5,6,7
1Department of Paediatrics, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia.
Bioethics
|September 11, 2025
概括
大型语言模型 (LLM) 通过为信息处理和价值澄清提供个性化的支持,可以增强患者在医疗同意中的自主性. 正确设计的LLM系统可以充当认知支架,改善决策,同时应对实施中的挑战.
科学领域:
- 生物伦理学生物伦理学
- 人工智能的人工智能
- 医疗信息学 医疗信息学
背景情况:
- 传统的患者自主性强调独立的决策.
- 最近的哲学强调了自主决策对社会和认识论支持的依赖.
- "脚手架模型"说明了对分布式认知和外部辅助的依赖.
研究的目的:
- 探索大型语言模型 (LLM) 如何在医疗知情同意中运行支架自主性.
- 认为LLMs可以增强,而不是破坏患者的自主权.
- 检查LLM作为信息处理,价值澄清和文化敏感决策的认知支架.
主要方法:
- 对脚手架自主性和LLM能力的概念分析.
- 在医疗知情同意方面,应用了脚手架自主模型.
- 对LLM整合的临床实践示例的检查.
- 通过脚手架自治的透视来分析实施挑战.
主要成果:
- 在医学同意中,LLM可以作为认知支架,以提高信息可访问性,理解性和价值澄清性.
- 适当设计的LLM系统可以支持个性化和文化敏感的决策.
- 实施需要仔细考虑认识体系责任,选择真实性和人类监督.
结论:
- 通过支架支持,LLM提供了一条有希望的途径,通过支架支持加强医疗知情同意的患者自主权.
- 成功实施需要从简单的信息提供转向支持真正的自主决策.
- 需要进一步的研究和实践指导方针,以在伦理上将LLM整合到技术介导的医疗环境中.
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