# VITAL: A New Dataset for Benchmarking Pluralistic Alignment in Healthcare

arXiv: https://arxiv.org/abs/2502.13775 · HTML: https://mlsanity.com/paper/2502.13775/

## Key facts

- Cited by 17 papers in the map (data through 14 Oct 2026).
- Placed in Medical LLM alignment, one of 10 directions in LLM alignment / RLHF / preference optimisation.
- Builds on 34 of its 74 references that are in the map.
- First posted on arXiv 19 Feb 2025.

## Placed in

- LLM alignment / RLHF / preference optimisation / [Medical LLM alignment](https://mlsanity.com/alignment/medical-llm-alignment/)

## Builds on (most cited first, 30 of 34)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [Deep reinforcement learning from human preferences](https://mlsanity.com/paper/1706.03741/) (2017)
- [Training a Helpful and Harmless Assistant with Reinforcement Learning from Human Feedback](https://mlsanity.com/paper/2204.05862/) (2022)
- [Constitutional AI: Harmlessness from AI Feedback](https://mlsanity.com/paper/2212.08073/) (2022)
- [Learning to summarize from human feedback](https://mlsanity.com/paper/2009.01325/) (2020)
- [Red Teaming Language Models with Language Models](https://mlsanity.com/paper/2202.03286/) (2022)
- [Ethical and social risks of harm from Language Models](https://mlsanity.com/paper/2112.04359/) (2021)
- [ChatGPT Outperforms Crowd-Workers for Text-Annotation Tasks](https://mlsanity.com/paper/2303.15056/) (2023)
- [Whose Opinions Do Language Models Reflect?](https://mlsanity.com/paper/2303.17548/) (2023)
- [Out of One, Many: Using Language Models to Simulate Human Samples](https://mlsanity.com/paper/2209.06899/) (2022)
- [Artificial Intelligence, Values and Alignment](https://mlsanity.com/paper/2001.09768/) (2020)
- [Towards Measuring the Representation of Subjective Global Opinions in Language Models](https://mlsanity.com/paper/2306.16388/) (2023)
- [Trustworthy LLMs: a Survey and Guideline for Evaluating Large Language Models' Alignment](https://mlsanity.com/paper/2308.05374/) (2023)
- [MedAgents: Large Language Models as Collaborators for Zero-shot Medical Reasoning](https://mlsanity.com/paper/2311.10537/) (2023)
- [Symbolic Knowledge Distillation: from General Language Models to Commonsense Models](https://mlsanity.com/paper/2110.07178/) (2021)
- [Large Language Model Alignment: A Survey](https://mlsanity.com/paper/2309.15025/) (2023)
- [Get Your Vitamin C! Robust Fact Verification with Contrastive Evidence](https://mlsanity.com/paper/2103.08541/) (2021)
- [From Persona to Personalization: A Survey on Role-Playing Language Agents](https://mlsanity.com/paper/2404.18231/) (2024)
- [Two Tales of Persona in LLMs: A Survey of Role-Playing and Personalization](https://mlsanity.com/paper/2406.01171/) (2024)
- [The political ideology of conversational AI: Converging evidence on ChatGPT's pro-environmental, left-libertarian orientation](https://mlsanity.com/paper/2301.01768/) (2023)
- [Modular Pluralism: Pluralistic Alignment via Multi-LLM Collaboration](https://mlsanity.com/paper/2406.15951/) (2024)
- [What Evidence Do Language Models Find Convincing?](https://mlsanity.com/paper/2402.11782/) (2024)
- [LLM Discussion: Enhancing the Creativity of Large Language Models via Discussion Framework and Role-Play](https://mlsanity.com/paper/2405.06373/) (2024)
- [Flames: Benchmarking Value Alignment of LLMs in Chinese](https://mlsanity.com/paper/2311.06899/) (2023)
- [Assessing LLMs for Moral Value Pluralism](https://mlsanity.com/paper/2312.10075/) (2023)

## Built on by (most cited first, 17 of 17)

- [A Survey on Progress in LLM Alignment from the Perspective of Reward Design](https://mlsanity.com/paper/2505.02666/) (2025)
- [MedSentry: Understanding and Mitigating Safety Risks in Medical LLM Multi-Agent Systems](https://mlsanity.com/paper/2505.20824/) (2025)
- [COLD-Steer: Steering Large Language Models via In-Context One-step Learning Dynamics](https://mlsanity.com/paper/2603.06495/) (2026)
- [Benchmarking Overton Pluralism in LLMs](https://mlsanity.com/paper/2512.01351/) (2025)
- [Multi-level Value Alignment in Agentic AI Systems: Survey and Perspectives](https://mlsanity.com/paper/2506.09656/) (2025)
- [XGUARD: A Graded Benchmark for Evaluating Safety Failures of Large Language Models on Extremist Content](https://mlsanity.com/paper/2506.00973/) (2025)
- [Pluralistic Alignment for Healthcare: A Role-Driven Framework](https://mlsanity.com/paper/2509.10685/) (2025)
- [What Does the AI Doctor Value? Auditing Pluralism in the Clinical Ethics of Language Models](https://mlsanity.com/paper/2605.18738/) (2026)
- [Structuring the Space of Sociotechnical Alignment](https://mlsanity.com/paper/2607.01250/) (2026)
- [Classical AI vs. LLMs for Decision-Maker Alignment in Health Insurance Choices](https://mlsanity.com/paper/2510.06093/) (2025)
- [VISPA: Pluralistic Alignment via Automatic Value Selection and Activation](https://mlsanity.com/paper/2601.12758/) (2026)
- [Jailbreaking Large Language Models with Morality Attacks](https://mlsanity.com/paper/2604.17053/) (2026)
- [Not All Subjectivity Is the Same! Defining Desiderata for the Evaluation of Subjectivity in NLP](https://mlsanity.com/paper/2603.28351/) (2026)
- [A Roadmap to Impactful Pluralistic Alignment Research](https://mlsanity.com/paper/2607.22305/) (2026)
- [CultureMINE: Datasets and Methods for Improving the Cultural Capabilities of NLP Systems](https://mlsanity.com/paper/2609.22494/) (2026)
- [Narrowing the Horizon: Quantifying Topic Saliency Shifts in Generative Monoculture](https://mlsanity.com/paper/2609.35302/) (2026)
- [Demographic Pluralism: Inference-Time Modeling of Pluralistic Human Preference Distributions](https://mlsanity.com/paper/2609.38555/) (2026)

## Abstract (arXiv)

Alignment techniques have become central to ensuring that Large Language Models (LLMs) generate outputs consistent with human values. However, existing alignment paradigms often model an averaged or monolithic preference, failing to account for the diversity of perspectives across cultures, demographics, and communities. This limitation is particularly critical in health-related scenarios, where plurality is essential due to the influence of culture, religion, personal values, and conflicting opinions. Despite progress in pluralistic alignment, no prior work has focused on health, likely due to the unavailability of publicly available datasets. To address this gap, we introduce VITAL, a new benchmark dataset comprising 13.1K value-laden situations and 5.4K multiple-choice questions focused on health, designed to assess and benchmark pluralistic alignment methodologies. Through extensive evaluation of eight LLMs of varying sizes, we demonstrate that existing pluralistic alignment techniques fall short in effectively accommodating diverse healthcare beliefs, underscoring the need for tailored AI alignment in specific domains. This work highlights the limitations of current approaches and lays the groundwork for developing health-specific alignment solutions.