Ensuring Safety and Trust: Analyzing the Risks of Large Language Models in Medicine
On the map: LLM safety and security → Safety alignment, refusal and guardrails
Abstract (arXiv)
The remarkable capabilities of Large Language Models (LLMs) make them increasingly compelling for adoption in real-world healthcare applications. However, the risks associated with using LLMs in medical applications have not been systematically characterized. We propose using five key principles for safe and trustworthy medical AI: Truthfulness, Resilience, Fairness, Robustness, and Privacy, along with ten specific aspects. Under this comprehensive framework, we introduce a novel MedGuard benchmark with 1,000 expert-verified questions. Our evaluation of 11 commonly used LLMs shows that the current language models, regardless of their safety alignment mechanisms, generally perform poorly on most of our benchmarks, particularly when compared to the high performance of human physicians. Despite recent reports indicate that advanced LLMs like ChatGPT can match or even exceed human performance in various medical tasks, this study underscores a significant safety gap, highlighting the crucial need for human oversight and the implementation of AI safety guardrails.
Key facts. Cited by 7 papers in the map (data through 7 Oct 2026). Placed in Safety alignment, refusal and guardrails, one of 12 directions in LLM safety and security. First posted on arXiv 20 Nov 2024.
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Citing papers per year: 2025: 4; 2026: 3.
7 papers.
- 2025Shallow Robustness, Deep Vulnerabilities: Multi-Turn Evaluation of Medical LLMscited by 7
- 2026MPIB: A Benchmark for Medical Prompt Injection Attacks and Clinical Safety in LLMscited by 3
- 2025Constrained Sliced Wasserstein Embeddingcited by 2
- 2025Gene-R1: Reasoning with Data-Augmented Lightweight LLMs for Gene Set Analysiscited by 1
- 2026Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoningcited by 1
- 2025From Retrieval to Generation: Unifying External and Parametric Knowledge for Medical Question Answeringcited by 0
- 2026SingProbe Technical Reportcited by 0
- 2026SingProbe Technical Report31 Aug 2026
- 2026Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoning8 Jul 2026
- 2026MPIB: A Benchmark for Medical Prompt Injection Attacks and Clinical Safety in LLMs6 Feb 2026
- 2025From Retrieval to Generation: Unifying External and Parametric Knowledge for Medical Question Answering21 Oct 2025
- 2025Shallow Robustness, Deep Vulnerabilities: Multi-Turn Evaluation of Medical LLMs14 Oct 2025
- 2025Gene-R1: Reasoning with Data-Augmented Lightweight LLMs for Gene Set Analysis11 Sep 2025
- 2025Constrained Sliced Wasserstein Embedding2 Jun 2025
Similar, not cited
Close in wording, no citation either way
- 2026When Medical Safety Alignment Fails: A Benchmark for Evaluating LLMs on High-Risk Medical Queries
- 2025Towards Safe AI Clinicians: A Comprehensive Study on Large Language Model Jailbreaking in Healthcare
- 2025The Forgotten Shield: Safety Grafting in Parameter-Space for Medical MLLMs
- 2026Improving the Safety and Trustworthiness of Medical AI via Multi-Agent Evaluation Loops
- 2025Beyond the Leaderboard: Rethinking Medical Benchmarks for Large Language Models
- 2026CareGuardAI: Context-Aware Multi-Agent Guardrails for Clinical Safety & Hallucination Mitigation in Patient-Facing LLMs
- 2024Large Language Model Safety: A Holistic Survey
- 2025Balancing Safety and Helpfulness in Healthcare AI Assistants through Iterative Preference Alignment