Position: The Pitfalls of Over-Alignment: Overly Caution Health-Related Responses From LLMs are Unethical and Dangerous
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Abstract (arXiv)
Large Language Models (LLMs) are usually aligned with "human values/preferences" to prevent harmful output. Discussions around the alignment of Large Language Models (LLMs) generally focus on preventing harmful outputs. However, in this paper, we argue that in health-related queries, over-alignment-leading to overly cautious responses-can itself be harmful, especially for people with anxiety and obsessive-compulsive disorder (OCD). This is not only unethical but also dangerous to the user, both mentally and physically. We also showed qualitative results that some LLMs exhibit varying degrees of alignment. Finally, we call for the development of LLMs with stronger reasoning capabilities that provide more tailored and nuanced responses to health queries. Warning: This paper contains materials that could trigger health anxiety or OCD. Dataset and full results can be found in https://github.com/weathon/over-alignment.
Key facts. Cited by 3 papers in the map (data through 14 Oct 2026). First posted on arXiv 27 Aug 2025.
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Citing papers per year: 2025: 1; 2026: 2.
3 papers.
- 2025Position: Universal Aesthetic Alignment Narrows Artistic Expressioncited by 1
- 2026MissingBench-Verified: Probing Vision-Language Models' Inability to Detect Missing Object Partscited by 0
- 2026Reinforcement Learning over Patient Trajectories for Clinical Reasoning in EHR Foundation Modelscited by 0
- 2026Reinforcement Learning over Patient Trajectories for Clinical Reasoning in EHR Foundation Models10 Sep 2026
- 2026MissingBench-Verified: Probing Vision-Language Models' Inability to Detect Missing Object Parts21 Jul 2026
- 2025Position: Universal Aesthetic Alignment Narrows Artistic Expression9 Dec 2025
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- 2025Unintended Harms of Value-Aligned LLMs: Psychological and Empirical Insights
- 2024Aligning (Medical) LLMs for (Counterfactual) Fairness
- 2026When Medical Safety Alignment Fails: A Benchmark for Evaluating LLMs on High-Risk Medical Queries
- 2026Understanding LLM Behavior When Encountering User-Supplied Harmful Content in Harmless Tasks
- 2025Do LLMs Align Human Values Regarding Social Biases? Judging and Explaining Social Biases with LLMs
- 2023Fake Alignment: Are LLMs Really Aligned Well?
- 2023Gaining Wisdom from Setbacks: Aligning Large Language Models via Mistake Analysis
- 2025Picky LLMs and Unreliable RMs: An Empirical Study on Safety Alignment after Instruction Tuning