Algorithms are the operational key for medical artificial intelligence(AI)to optimize the patients seeking medical treatment.With the gradual implementation and application of medical AI algorithms,their decision-making presents the main characteristics of the data-driven,algorithmic black box,and probabilistic paradigms in generating patterns.These characteristics have driven the transformation from artificial diagnosis and treatment to intelligent diagnosis and treatment,but have also simultaneously spawned corresponding practical problems such as"algorithms"replacing doctor decision-making,"algorithmic Leviathan"resolving patients'basic rights,and doctor-patient trust crisis.To effectively prevent ethical risks arising from medical AI algorithm decision-making,it is necessary to call for a return to the subject-centered approach with doctors as the main body and algorithm technology as the wings,strengthen the doctor's decision-making ability,respect patients'basic rights,promote algorithm optimization,train technology to improve,anchor risk keys,and strengthen doctor-patient trust construction.