医学人工智能临床应用的伦理困境：从信息系统到机器人.pdfVIP

医学高新技术伦理

医学与哲学2025

年5

月第46

卷第

9

期总第764期

医学人工智能临床应用的伦理困境：

从信息系统到机器人*

1△2△3

王兰英郑睿刘宪伟

摘要：分析从经典的影像诊断信息系统到智能决策、自主操作的手术机器人等不同自主程度的医学人工智能所面临的主要伦

理困境，探讨数据三角定位导致的隐私泄露、数据价值的分配、针对罕见病与弱势群体的偏见、医学人工智能对医生角色的

挑战和对医患关系的重塑、患者个体获益不明确、责任归属不清晰等核心问题，提出按照自主程度对医学人工智能进行分级

管理；医学伦理理论为医学人工智能的系统发展提供框架；教育引导医患双方正确认识和使用医学人工智能等治理对策。

关键词：医学人工智能，数据伦理，医疗责任归属，人机关系，医患关系，医疗大规模预训练模型

中图分类号：R-05文献标识码：A文章编号：1002-0772(2025)09-0024-06

DOI：10.12014/j.issn.1002-0772.2025.09.05

EthicalDilemmasintheClinicalApplicationofMedicalArtificialIntelligence:FromInformationSystemstoRoboticsWANG

123

Lanying,

ZHENGRui,

LIUXianwei．1.

StudentAffairsDepartmentofthePartyCommittee,DalianMedicalUniversity,Dalian

116044,China;

2.

StudentAffairsDepartment,TheFirstAffiliatedHospitalofDalianMedicalUniversity,Dalian116021,China;

3.

TheOffice,LanwanBranch,TheSecondAffiliatedHospitalofDalianMedicalUniversity,Dalian116027,China

Abstract：This

paper

analyses

the

main

ethical

dilemmas

faced

by

medical

artificial

intelligence

(AI)

across

different

levels

of

autonomy,

from

the

classical

imaging

diagnostic

information

system

to

intelligent

decision-making

and

independently

operating

surgical

robots.

It

explores

core

issues

such

as

privacy

leakage

caused

by

data

triangulation,

distribution

of

data

value,

prejudice

against

rare

diseases

and

vulnerable

groups,

challenges

of

medical

AI

to

the

role

of

doctors

and

reshaping

of

the

doctor-patient

relationship,

unc