1.ChatGPT-driven medical intelligent decision-making: ethics, law, and regulation
Chinese Medical Ethics 2025;38(2):139-149
With the rapid development of generative artificial intelligence (AI) technology, the application of natural language processing models such as ChatGPT has become possible in the medical field. However, the issues of ethics, law, and regulation involved in medical intelligent decision-making have gradually become prominent. This paper analyzed the application and potential risks of ChatGPT in the medical field, focusing on challenges such as data privacy protection, decision fairness, and legal adaptability. It also proposed regulatory strategies, including formulating a legal framework for intelligent medical decision-making, establishing ethical norms and guidelines, strengthening regulatory mechanisms and supervisory measures, enhancing the practical ability for intelligent decision-making, and other aspects, to promote the sustainable development of medical intelligent decision-making and ensure the balance of ethics, law, and social responsibility.
2.Front-end access regulation and liability adjustment of infringement in the middle and back-ends of medical artificial intelligence
Chinese Medical Ethics 2025;38(2):150-158
Based on the unique characteristics of medical artificial intelligence (AI) that differ from general medical devices, it was found that the clinical application of medical AI has brought different levels of impacts on the front-end access supervision and regulation, the mid-end informed consent right design, and back-end post-damage liability adjustment. In this regard, it is necessary to appropriately relax the admission review, strengthen the coordination of supervision before and after listing, and simultaneously adjust the comprehensive judgment ideas of “safe and effective” medical AI; clarify the “breadth” of notification and “depth” of disclosure regarding the patients’ informed consent rights; based on current product liability and liability for medical malpractice system, typologically adjust the allocation of liability, while strengthening the supplemental application of medical compulsory liability insurance, so as to enhance the relief of patients’ damage, rationalize risk allocation, and minimize social costs.
3.Ethical reflections on the clinical application of medical artificial intelligence
Fangfang CUI ; Zhonglin LI ; Xianying HE ; Wenchao WANG ; Yuntian CHU ; Xiaobing SHI ; Jie ZHAO
Chinese Medical Ethics 2025;38(2):159-165
Medical artificial intelligence (AI) is a new type of application formed by the combination of machine learning, computer vision, natural language processing, and other technologies with clinical medical treatment. With the continuous iteration and development of relevant technologies, medical AI has shown great potential in improving the efficiency of diagnosis and treatment, and service quality, but it also increases the possibility of triggering ethical issues. Ethical issues resulting from the clinical application of medical AI were analyzed, including the lack of algorithmic interpretability and transparency of medical AI, leading to information asymmetry and cognitive discrepancies; the concerning status of security and privacy protection of medical data; and the complex and unclear division of responsibilities due to the collaborative participation of multiple subjects in the clinical application of medical AI, resulting in increased difficulty in the identification of medical accidents and clarification of responsibilities. The paper proposed the principles of not harming patients’ interests, physician’s subjectivity, fairness and inclusiveness, and rapid response. It also explored the strategies and implementation paths for responding to the ethical issues of medical AI from multiple perspectives, including standardizing the environment and processes, clarifying responsibility attribution, continuously assessing the impact of data protection, guaranteeing data security, ensuring model transparency and interpretability, carrying out multi-subject collaboration, as well as the principles of being driven by ethical values and adhering to the “human health-centeredness.” It aimed to provide guidance for the healthy development of medical AI, ensuring technological progress while effectively managing and mitigating accompanying ethical risks, thereby promoting the benign development of medical AI technology and better serving the healthcare industry and patients.
4.Ethical examination of the research and application of artificial intelligence in the field of rehabilitation
Lijun MENG ; Yiting LI ; Yingwei SUN ; Yu WU ; Shicai WU
Chinese Medical Ethics 2025;38(2):166-172
With the rapid development of artificial intelligence (AI) technology, the ethical governance of AI has gained increasing attention. The Recommendation on the Ethics of Artificial Intelligence was issued by the United Nations Educational, Scientific and Cultural Organization in 2021, which clarified several principles for the ethical governance of AI. In the field of rehabilitation medicine, the research and application of AI technology have significantly improved patients’ quality of life and survival. However, due to the specificity of the service population in rehabilitation medicine, which is mostly for the sick, injured, disabled, and elderly, a series of complex ethical issues have also arisen. This paper analyzed in detail the ethical issues and challenges encountered in the research and application of AI technology in the field of rehabilitation medicine from various aspects, such as informed consent, security of privacy and data, patients’ physical and mental rehabilitation, compliance regulation, protection of specific groups, and promotion of equity. According to the principles of the Recommendation on the Ethics of Artificial Intelligence and others, response strategies were proposed, including multi-party collaboration and interdisciplinary cooperation, improving and refining relevant laws and regulations, strengthening ethical education across society, establishing accountability mechanisms, increasing investment, promoting equity, and other measures, to promote the healthy development of research and application of AI technology in the field of rehabilitation, as well as benefit humanity.
5.Development status and ethical challenges of artificial intelligence in traditional Chinese medicine
Jiaqing DAI ; Yuxuan JIANG ; Jingnan HU ; Liu YANG ; Lifang GUO
Chinese Medical Ethics 2025;38(2):173-178
In the context of the rapid development of 5G technology, the development of artificial intelligence (AI) in traditional Chinese medicine (TCM) faces new opportunities and challenges. Focusing on how to uphold tradition while innovating in the development of AI in TCM, starting from the current development status of AI in Chinese medicine, including the integration of four diagnostic methods, syndrome differentiation and treatment, auxiliary diagnosis and treatment, research and development of Chinese herbal medicine, prevention and treatment of diseases, knowledge inheritance, and other aspects, this paper discussed the support of policies and technical advancements, as well as development opportunities such as increased demand for health. Regarding machine ethics, data ethics, regulatory review, and other aspects, it also proposed some suggestions that the training algorithm should be improved to assist medical work; data ownership should be clarified to ensure data security; and an AI ethics committee should be set up to improve the review system, aiming to maximize the advantages of smart healthcare and accelerate the modernization of TCM for the benefit of patients and the service of human health.
6.Ethical examination of artificial intelligence application in Alzheimer’s disease imaging diagnosis
Chinese Medical Ethics 2025;38(2):179-186
Alzheimer’s disease is a progressive, fatal, and neurodegenerative disease, clinically characterized by gradually developed cognitive and memory function decline, language and visuospatial disorders, and other aspects. It remains incurable and irreversible to date. In clinical settings, Alzheimer’s disease usually faces the possibility of untimely diagnosis, causing difficulties in the early intervention of the disease. Thus, it is essential to improve diagnostic efficiency and help patients diagnose Alzheimer’s disease as early as possible. With the continuous development of artificial intelligence (AI) technology, its application in Alzheimer’s disease imaging diagnosis has shown great potential. Meanwhile, it is also accompanied by many ethical issues. By exploring the ethical challenges brought by AI in the research and application of Alzheimer’s disease imaging diagnosis, such as data security, interpretability, algorithmic discrimination, and disclosure of incidental findings, the paper proposed the corresponding countermeasures, with a view to providing certain ethical guidance for the AI application in medical imaging diagnosis, protecting the rights and interests of subjects/patients, and promoting the healthy development of technology.
7.The application advantages, ethical dilemmas, and responses of artificial intelligence robots in medical education
Chinese Medical Ethics 2025;38(2):187-194
Artificial intelligence (AI) robots, as a dynamic force sweeping the world, have demonstrated remarkable influence in the field of medical education since their inception. They have continuously participated in medical education through online-assisted teaching of medical theory, interpretation of imaging materials, clinical skills practice, and other forms, bringing new opportunities and challenges for the development of medical education. Concurrent with transforming the field of education, AI technology has also given rise to a series of ethical issues due to the constraints of technological logic, such as algorithmic discrimination, technological dependence, data privacy breaches, emotional communication crises among teaching subjects, and blurred power boundaries. While drawing on Western ethical principles, it is crucial to maintain a sober awareness of local issues, pay attention to the realistic relationship between Confucian bioethics and medical education in China, emphasize the value-oriented function of benevolence principle in mitigating physical and mental risks, and guide students to become adults in “achieving success”; improve the institutional construction guided by the principle of the value of life, resist the risks of educational AI technology, and achieve technological goodness; build a harmonious human-machine relationship by adhering to the principle of human nature to prevent the development risks of educational AI.
8.Ethical exploration of the text-to-video large model Sora empowering healthcare
Chinese Medical Ethics 2025;38(2):195-200
As an emerging artificial intelligence (AI), the text-to-video large model Sora possesses powerful functions that previous AI did not have. In the medical field, medical staff can use the Sora model to achieve efficient medical education, patient health consultation, medical research, and other activities. Studying the innovative application scenarios, ethical issues, and governance paths of the current Sora model is of great significance for utilizing the new AI technology to promote and improve medical experience and quality, as well as to grasp the future development direction of AI in the field of healthcare.
9.The “Shu” and “Dao” of AI in healthcare: the ethical reflections based on Taoist thought
Chinese Medical Ethics 2025;38(2):201-206
The development of the industry represented by “artificial intelligence (AI) +” fully reflects the new requirements of the digital economy era, and AI in healthcare has become a key driving force for innovation in the healthcare industry. AI in healthcare represents the refinement of the “Shu” of medicine. However, a series of ethical issues related to “Dao” raised by AI have not been spared in the healthcare industry. An examination of the ethical issues posed by AI based on the perspective of Chinese Taoist thought found that the excessive application of AI in medicine can lead to the loss of human subjectivity, and the excessive technological intervention can also pose potential risks to the natural life process while raising the issues of data privacy and information security. Based on Taoist thought and reflecting on it, it is suggested that the whole society, especially healthcare institutions, should avoid excessive intervention, apply technology cautiously, protect privacy and dignity, emphasize humanistic care, and pay attention to social justice in the process of using AI in healthcare so that AI can be better used by human beings.
10.Research on the autonomy issues in compulsory medical treatment
Chinese Medical Ethics 2025;38(2):207-213
Compulsory medical treatment is considered a necessary means to maintain public health. It faces many ethical dilemmas during its implementation, primarily concerning issues of autonomy. The discussion of autonomy issues is grounded in the concept, which faces difficulties in explanation and challenges in power structures. In addition to conceptual issues, autonomy also encounters various controversies in practice, including rational suicide, interpersonal relationships, bioethical principles, and other aspects. Faced with challenges, Bjorn Hofmann’s polyvalent concept clarifies the concept of autonomy, and the relational ethical approach provides innovative solutions to the practical issues of autonomy.

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