Schwartz David, Lanphier Elizabeth
University of Central Florida, Orlando, USA.
Cincinnati Children's Hospital Medical Center, Cincinnati, USA.
Monash Bioeth Rev. 2025 Jun 8. doi: 10.1007/s40592-025-00256-z.
While on the surface the rapid adoption of generative artificial intelligence (AI) in healthcare signals a new technological innovation that may sideline the social sciences, arts, and literature comprising the medical humanities, we argue that one way to understand the applications of AI based on large language models (LLM) in healthcare is as a deeply narrative project. LLM-based AI endorses narrative and humanistic value insofar as it is trained on vast amounts of narrative data as inputs and generates outputs in narrative formats. We contend that the medical humanities, rather than being replaced by AI in healthcare, are all the more essential to understand the practical and ethical opportunities and constraints for responsible use and integration of such tools. By analyzing two case studies of generative AI in healthcare reported in literature, we show that narrative medicine and the medical humanities provide crucial theoretical frameworks and disciplinary skills to assess, integrate, and critique the roles and impacts of such technologies in healthcare. Rather than offsetting narrative practice via AI, responsible use of LLM-based AI in healthcare requires attention to the functions of narrative in medicine and the importance of the medical humanities.
虽然从表面上看，生成式人工智能（AI）在医疗保健领域的迅速采用标志着一项新的技术创新，这可能会使包括医学人文在内的社会科学、艺术和文学边缘化，但我们认为，理解基于大语言模型（LLM）的人工智能在医疗保健领域的应用的一种方式是将其视为一个深度叙事项目。基于LLM的人工智能认可叙事和人文价值，因为它以大量叙事数据作为输入进行训练，并以叙事形式生成输出。我们认为，医学人文在医疗保健领域非但不会被人工智能取代，对于理解负责任地使用和整合此类工具的实际和伦理机遇与限制反而更为重要。通过分析文献中报道的两个医疗保健领域生成式人工智能的案例研究，我们表明叙事医学和医学人文提供了关键的理论框架和学科技能，以评估、整合和批判此类技术在医疗保健中的作用和影响。在医疗保健领域负责任地使用基于LLM的人工智能，并非通过人工智能来抵消叙事实践，而是需要关注叙事在医学中的作用以及医学人文的重要性。
