Artificial intelligence has brought leapfrog development to medical education， and the fourth generation of medical education， characterized by health-centered， cross-disciplinary integration and extensive application of AI technologies， is on the horizon. AI-empowered medical education provides educators with multifaceted assistance， such as aiding in lesson plan design and facilitating curriculum planning. However， the particularity of medical education and the mechanical nature of AI algorithms have led to ethical dilemmas when AI is integrated into medical education， such as alienation of the teacher-student relationship and imbalance of teaching and learning relationship， the loss of humanistic spirit and deviation from the essence of medical education， as well as failure of subject rights and algorithm infringement of personal rights and interests. Confronting the ethical dilemmas of AI-empowered higher medical education， collaborative governance among the government， society， hospitals， and schools is necessitated. Countermeasures must be implemented across multiple dimensions， such as reshaping the individual teachers and students to consolidate the balance of teaching， strengthening the humanistic spirit to return medical humanities to their essence， and improving the ethical environment to safeguard the legitimate rights and interests of the subjects.