# A Human-Centric Pipeline for Aligning Large Language Models with Chinese Medical Ethics

arXiv: https://arxiv.org/abs/2601.07954 · HTML: https://mlsanity.com/paper/2601.07954/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical LLM alignment, one of 10 directions in LLM alignment / RLHF / preference optimisation.
- Builds on 11 of its 28 references that are in the map.
- First posted on arXiv 12 Jan 2026.

## Placed in

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

## Builds on (most cited first, 11 of 11)

- [Training language models to follow instructions with human feedback](https://mlsanity.com/paper/2203.02155/) (2022)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [Qwen2.5-Math Technical Report: Toward Mathematical Expert Model via Self-Improvement](https://mlsanity.com/paper/2409.12122/) (2024)
- [Artificial Intelligence, Values and Alignment](https://mlsanity.com/paper/2001.09768/) (2020)
- [ChatDoctor: A Medical Chat Model Fine-Tuned on a Large Language Model Meta-AI (LLaMA) Using Medical Domain Knowledge](https://mlsanity.com/paper/2303.14070/) (2023)
- [Adapted Large Language Models Can Outperform Medical Experts in Clinical Text Summarization](https://mlsanity.com/paper/2309.07430/) (2023)
- [Seedream 3.0 Technical Report](https://mlsanity.com/paper/2504.11346/) (2025)
- [Preference Leakage: A Contamination Problem in LLM-as-a-judge](https://mlsanity.com/paper/2502.01534/) (2025)
- [Citrus: Leveraging Expert Cognitive Pathways in a Medical Language Model for Advanced Medical Decision Support](https://mlsanity.com/paper/2502.18274/) (2025)
- [MedEthicEval: Evaluating Large Language Models Based on Chinese Medical Ethics](https://mlsanity.com/paper/2503.02374/) (2025)

## Abstract (arXiv)

Recent advances in large language models have enabled their application to a range of healthcare tasks. However, aligning LLMs with the nuanced demands of medical ethics, especially under complex real world scenarios, remains underexplored. In this work, we present MedES, a dynamic, scenario-centric benchmark specifically constructed from 260 authoritative Chinese medical, ethical, and legal sources to reflect the challenges in clinical decision-making. To facilitate model alignment, we introduce a guardian-in-the-loop framework that leverages a dedicated automated evaluator (trained on expert-labeled data and achieving over 97% accuracy within our domain) to generate targeted prompts and provide structured ethical feedback. Using this pipeline, we align a 7B-parameter LLM through supervised fine-tuning and domain-specific preference optimization. Experimental results, conducted entirely within the Chinese medical ethics context, demonstrate that our aligned model outperforms notably larger baselines on core ethical tasks, with observed improvements in both quality and composite evaluation metrics. Our work offers a practical and adaptable framework for aligning LLMs with medical ethics in the Chinese healthcare domain, and suggests that similar alignment pipelines may be instantiated in other legal and cultural environments through modular replacement of the underlying normative corpus.