Towards medical AI misalignment: a preliminary study
On the map: LLM safety and security → Safety alignment, refusal and guardrails
Abstract (arXiv)
Despite their staggering capabilities as assistant tools, often exceeding human performances, Large Language Models (LLMs) are still prone to jailbreak attempts from malevolent users. Although red teaming practices have already identified and helped to address several such jailbreak techniques, one particular sturdy approach involving role-playing (which we named `Goofy Game') seems effective against most of the current LLMs safeguards. This can result in the provision of unsafe content, which, although not harmful per se, might lead to dangerous consequences if delivered in a setting such as the medical domain. In this preliminary and exploratory study, we provide an initial analysis of how, even without technical knowledge of the internal architecture and parameters of generative AI models, a malicious user could construct a role-playing prompt capable of coercing an LLM into producing incorrect (and potentially harmful) clinical suggestions. We aim to illustrate a specific vulnerability scenario, providing insights that can support future advancements in the field.
Key facts. No citing papers in the map yet (data through 14 Oct 2026). Placed in Safety alignment, refusal and guardrails, one of 12 directions in LLM safety and security. Builds on 17 of its 26 references that are in the map. First posted on arXiv 22 May 2025.
Builds on
17 of 26 references.
References · 17
- 2023Judging LLM-as-a-Judge with MT-Bench and Chatbot Arenacited by 8,626
- 2023Universal and Transferable Adversarial Attacks on Aligned Language Modelscited by 3,104
- 2022Large Language Models Encode Clinical Knowledgecited by 1,830
- 2023Jailbroken: How Does LLM Safety Training Fail?cited by 1,651
- 2023Bias and Fairness in Large Language Models: A Surveycited by 639
- 2023Capabilities of GPT-4 on Medical Challenge Problemscited by 638
- 2023"Do Anything Now": Characterizing and Evaluating In-The-Wild Jailbreak Prompts on Large Language Modelscited by 489
- 2023Catastrophic Jailbreak of Open-source LLMs via Exploiting Generationcited by 451
- 2023Low-Resource Languages Jailbreak GPT-4cited by 309
- 2023A Comprehensive Capability Analysis of GPT-3 and GPT-3.5 Series Modelscited by 246
- 2024Jailbreak Attacks and Defenses Against Large Language Models: A Surveycited by 230
- 2024JailbreakRadar: Comprehensive Assessment of Jailbreak Attacks Against LLMscited by 95
5 more
- 2024LLMs Will Always Hallucinate, and We Need to Live With Thiscited by 78
- 2024Visual-RolePlay: Universal Jailbreak Attack on MultiModal Large Language Models via Role-playing Image Charactercited by 68
- 2024GUARD: Role-playing to Generate Natural-language Jailbreakings to Test Guideline Adherence of Large Language Modelscited by 48
- 2024Superhuman performance of a large language model on the reasoning tasks of a physiciancited by 28
- 2024Language Models are Surprisingly Fragile to Drug Names in Biomedical Benchmarkscited by 17
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- 2025Towards Safe AI Clinicians: A Comprehensive Study on Large Language Model Jailbreaking in Healthcare
- 2026Ethical Risks in Deploying Large Language Models: An Evaluation of Medical Ethics Jailbreaking
- 2025A Practical Framework for Evaluating Medical AI Security: Reproducible Assessment of Jailbreaking and Privacy Vulnerabilities Across Clinical Specialties
- 2026The Mirage of LLM Guardrails: A Case Study in AI-Assisted Medical Note Manipulation
- 2025CARES: Comprehensive Evaluation of Safety and Adversarial Robustness in Medical LLMs
- 2025Medical Malice: A Dataset for Context-Aware Safety in Healthcare LLMs
- 2025Too Good to be Bad: On the Failure of LLMs to Role-Play Villains
- 2024Ensuring Safety and Trust: Analyzing the Risks of Large Language Models in Medicine