Objective: An ethical framework for the use of large language models (LLMs)
is urgently needed to shape how natural language processing (NLP) tools are
used for healthcare applications. Drawing directly from the voices of those
most affected, we propose a set of guiding principles for the use of NLP in
healthcare, with examples based on applications in maternal health.
Materials and Methods: We led an interactive session centered on an LLM-based
chatbot demonstration during a full-day workshop with 39 participants, and
additionally surveyed 30 healthcare workers and 30 birthing people about their
values, needs, and perceptions of AI and LLMs. We conducted quantitative and
qualitative analyses of the interactive discussions to consolidate our findings
into a set of guiding principles.
Results: Using the case study of maternal health, we propose nine principles
for ethical use of LLMs, grouped into three categories: (i) contextual
significance, (ii) measurements, and (iii) who/what is valued. We describe
rationales underlying these principles and provide practical advice.
Discussion: Healthcare faces existing challenges including the balance of
power in clinician-patient relationships, systemic health disparities,
historical injustices, and economic constraints. Our principles serve as a
framework for surfacing key considerations when deploying LLMs in medicine, as
well as providing a methodological pattern for other researchers to follow.
Conclusion: This set of principles can serve as a resource to practitioners
working on maternal health and other healthcare fields to emphasize the
importance of technical nuance, historical context, and inclusive design when
developing LLMs for use in clinical settings.

使用大型语言模型 (Large Language Models，LLMs) 的伦理框架迫切需要，以指导自然语言处理工具在医疗应用中的使用。根据受影响人群的声音，我们提出了一套在医疗中使用自然语言处理的指导原则，以产科健康应用为例。