Ethical and regulatory challenges of large language models in medicine

Jasmine Chiat Ling Ong; Shelley Yin-Hsi Chang; Wasswa William; Atul J Butte; Nigam H Shah; Lita Sui Tjien Chew; Nan Liu; Finale Doshi-Velez; Wei Lu; Julian Savulescu; Daniel Shu Wei Ting

doi:10.1016/S2589-7500(24)00061-X

Ethical and regulatory challenges of large language models in medicine

Lancet Digit Health. 2024 Apr 23:S2589-7500(24)00061-X. doi: 10.1016/S2589-7500(24)00061-X. Online ahead of print.

Authors

Affiliations

¹ Division of Pharmacy, Singapore General Hospital, Singapore; Duke-NUS Medical School, National University of Singapore, Singapore.
² Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Department of Biomedical Sciences and Engineering, Mbarara University of Science and Technology, Mbarara, Uganda.
⁴ Bakar Computational Health Sciences Institute, and Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA; Center for Data-Driven Insights and Innovation, University of California Health, Oakland, CA, USA.
⁵ Stanford Health Care, Palo Alto, CA, USA; Department of Medicine, and Clinical Excellence Research Center, School of Medicine, Stanford University, Stanford, CA, USA.
⁶ Department of Pharmacy, National University of Singapore, Singapore; Singapore Health Services, Pharmacy and Therapeutics Council Office, Singapore; Department of Pharmacy, National Cancer Centre Singapore, Singapore.
⁷ Duke-NUS Medical School, National University of Singapore, Singapore.
⁸ Harvard Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA.
⁹ StatNLP Research Group, Singapore University of Technology and Design, Singpore.
¹⁰ Murdoch Children's Research Institute, Melbourne, VIC, Australia; Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Oxford Uehiro Centre for Practical Ethics, Faculty of Philosophy, University of Oxford, Oxford, UK.
¹¹ Duke-NUS Medical School, National University of Singapore, Singapore; Artificial Intelligence and Digital Innovation, Singapore Eye Research Institute, Singapore National Eye Center, Singapore Health Service, Singapore; Byers Eye Institute, Stanford University, Palo Alto, CA, USA. Electronic address: daniel.ting@duke-nus.edu.sg.

PMID: 38658283
DOI: 10.1016/S2589-7500(24)00061-X

Abstract

With the rapid growth of interest in and use of large language models (LLMs) across various industries, we are facing some crucial and profound ethical concerns, especially in the medical field. The unique technical architecture and purported emergent abilities of LLMs differentiate them substantially from other artificial intelligence (AI) models and natural language processing techniques used, necessitating a nuanced understanding of LLM ethics. In this Viewpoint, we highlight ethical concerns stemming from the perspectives of users, developers, and regulators, notably focusing on data privacy and rights of use, data provenance, intellectual property contamination, and broad applications and plasticity of LLMs. A comprehensive framework and mitigating strategies will be imperative for the responsible integration of LLMs into medical practice, ensuring alignment with ethical principles and safeguarding against potential societal risks.

Publication types

Review