This study systematically reviewed publications on natural language processing and large language models in the field of physician–patient relationships using bibliometric methods, and analyzed publication trends, current research status, and thematic evolution. Publications were selected from the PubMed database. Bibliometric research was conducted using CiteSpace, including keyword co-occurrence and clustering, timeline analysis, and keyword burst analysis. A total of 128 publications were included. Literature fluctuated at a low level before 2019, but increased markedly following the release of ChatGPT, peaking in 2024. Keyword co-occurrence and clustering identified seven core thematic categories: artificial intelligence, natural language processing, large language models, patient education, clinical decision-making, social media, care experience, and e-Health. Timeline analysis indicated a recent shift toward shared decision-making and emotional support. Keyword burst analysis further revealed that large language models, clinical decision support, and generative AI emerged as prominent topics after 2024. The rise of large language models has accelerated research in the physician–patient relationship domain, shifting research hotspots toward human-centered scenarios, particularly in areas such as patient experience, clinical decision support, and e-Health.

Palliative medicine is a newly emerging branch of clinical medicine,with palliative care forming the core of its clinical practice.It is experiencing dynamic progress in China.This paper analyzes the similarities and differences among four definitions of palliative care to reveal the theoretical breakthroughs emerging from its localization process.From the perspective of body philosophy,it elucidates the shift in clinical reasoning from symptom management to holistic care.Palliative care,grounded in the integrity of the human body,implements the holistic care that approaches patients' pain,suffering,social relationships,and meaning making as an integrated system.This paper argues that the body possesses dual ontological status as both a site of medical intervention and an existential medium of intersubjectivity.And the body philosophy provides one of the philosophical foundations for the practice and disciplinary development of palliative medicine.

Healthcare professionals play a crucial role in healthcare systems, but their demanding work significantly impacts their mental and physical health, affecting patient care. This study investigates the interplay of work environment, doctor-patient relationships, media influence, and self-reported health among healthcare professionals. This study employed a stratified sampling approach to survey 8386 healthcare professionals from 40 hospitals across 8 provinces in China. Gaussian Graphical Modeling was used to analyze factors impacting well-being, including physical and mental health, work environment, doctor-patient relationship, and media influence. Network visualization identified key nodes, and the accuracy and stability of the network were assessed. The work environment emerged as a critical bridging factor in the interconnected network. Strong correlations were observed within the work environment cluster, covering aspects related to career, financial, and working conditions. Mental health issues like anxiety and depression also demonstrated moderate co-occurrence. Centrality analysis further identified key nodes associated with job satisfaction, physical fatigue, and mental health symptoms. Work environment plays a central factor interconnecting healthcare professionals' mental health, physical health, doctor-patient relationships, and media influence. Key insights include strong correlations within the work environment cluster, co-occurrence of mental health issues, and the close relationship between physical and psychological well-being. Addressing workplace stressors, fostering positive doctor-patient relationships, and mitigating negative media portrayals can contribute to a healthier environment for healthcare professionals. Comprehensive programs addressing both mental and physical health needs, including mental health screenings, stress management techniques, and promoting physical activity, are crucial.

Focusing on the novel issue of moral bioenhancement, this article critiques the concept of 'moral genetic enhancement' on three fronts: its lack of a scientific basis, the inevitability of value conflict, and its destructive impact on the social-moral fabric. The article ultimately advocates for robust ethical oversight and public engagement to preserve the wholeness of human nature and the human essence of morality.

Purpose Although the doctor-patient relationship (DPR) in China has improved during the COVID-19 pandemic, conflicts still persist, especially in high-pressure environments like emergency departments (EDs). Previous research has not explored how media portrayal of healthcare professionals impacts this relationship in emergency settings. This study aims to analyze the correlation between media representation of healthcare professionals and DPR in Chinese EDs, with the goal of identifying strategies to improve patient satisfaction, enhance trust and promote effective medical outcomes. Design/methodology/approach This cross-sectional study was conducted across 40 hospitals in 8 provinces in China. Using a self-designed electronic questionnaire, data were collected from healthcare professionals. Multiple linear regression models were employed to analyze the correlation between the DPR and the portrayal of healthcare professionals by the media in ED. Findings The results indicated a higher rate of verbal and physical conflicts in EDs, suggesting a tense DPR. The positive portrayal of healthcare professionals by the media is positively correlated with DPR and doctor-patient trust. Furthermore, the positive portrayal of healthcare professionals by the media is negatively correlated with the frequency of physical conflicts. Originality/value The study highlights the media’s critical role in shaping public perceptions that impact DPRs, especially in high-stress settings. A comprehensive multi-stakeholder approach is recommended, involving media self-regulation, government policy, healthcare organization initiatives and empowered healthcare professionals. By strategically managing the media’s influence through this coordinated approach, the findings can drive enhanced trust, improved patient satisfaction and more effective medical outcomes.

From "Healthy China" to "Healthy Family", the emphasis on the value of family health at the national policy level has been increasingly deepened, which has brought about an urgent need to systematically analyze the concept of "healthy family" theoretically. Facing the practical gap between the rapid advancement of the national health strategy and the relatively lagging academic theoretical research, this paper endeavors to systematically unpack the conceptual connotations of "Healthy Family" and draw on the ethical framework of Confucian familism to excavate its cultural value implications, so as to provide academic support and practical reference for the construction of "Healthy Family". "Healthy Family" is not only a key indicator in the health governance system of modern society, but also a modern reconstruction and sublimation of the values of Chinese excellent traditional culture.

With the increasing incidence of cancer worldwide, palliative care has become an effective intervention to relieve cancer patients' pain and improve their quality of life, although the present development of palliative medicine and hospice care in many Asian countries remains insufficient. To this end, this review comprehensively discussed the main challenges that influence the promotion of palliative medicine, from the perspective of both healthcare professionals and cancer patients. We further proposed and summarized a series of potentially effective countermeasures and solutions, including the shared decision-making modal, multidisciplinary professional cooperation, application of modern science and technology, standardization training for medical workers, personalized palliative treatment regimens, and others, aiming to improve the clinical quality of palliative care practice for cancer patients and promote the development of palliative medicine in Asian regions.

BackgroundHealthcare practice environment plays a vital role in evaluation and the development of health sector in China. However, there are few comprehensive reviews and studies focusing on its state and changing trends. This study aimed to examine the dynamic trends in Chinese healthcare professionals' perceptions of their practice environment from 2008 to 2023 using age period cohort (APC) analysis.MethodsFour national cross-sectional surveys of healthcare professionals were conducted in 2008, 2013, 2018, and 2023. APC analysis was performed to distinguish effects of age, period and cohort. Covariates like gender, department, job satisfaction, and doctor-patient relationships were also analyzed.ResultsBetween 2008 and 2023, healthcare professionals' perceptions of their practice environment first declined and then improved. Those aged 28-38 during 2013-2018 and born between 1978 and 1988 had the most negative perceptions. After 2018, perceptions improved, peaking in 2023. Those under 23 and over 43 exhibited larger age effects. Birth cohorts after 1993 also had more positive effects. Controlling for covariates attenuated APC effects. Females, those in obstetrics and emergency medicine, nurses, technicians, and administrators perceived better environments. Higher job satisfaction and doctor-patient relationship harmony are also associated with more positive perceptions. Income matching efforts and perceptions of promotion fairness had positive impacts, while increasing severity of physical fatigue and psychological anxiety negatively influenced perceptions of the practice environment.ConclusionsThe APC analysis provided nuanced insights into evolving practitioner perceptions amid healthcare reforms in China. Tailored policies focused on career stage and generation are needed to address disruptions and sustain improvements. Monitoring feedback on reforms and changes is essential for optimizing the practice environment over time.

以科技创新与高质量发展要求为背景来解读2023年颁布的《涉及人的生命科学和医学研究伦理审查办法》(以下简称《办法》),解析了该《办法》的总体框架与监管范围、伦理原则与审查要求、风险控制与知情同意,以及公平分配负担与受益.结合干细胞临床研究项目和健康医疗大数据研究,考察了其伦理审查要点.最后,作者提出《办法》不足之处,一是未明确研究者提交给伦理审查委员会材料清单的若干细节内容;二是的对伦理审查委员会的职责的若干规定有商榷之处.

Artificial intelligence (AI) is developing rapidly and is being used in several medical capacities, including assisting in diagnosis and treatment decisions. As a result, this raises the conceptual and practical problem of how to distribute responsibility when AI-assisted diagnosis and treatment have been used and patients are harmed in the process. Regulations on this issue have not yet been established. It would be beneficial to tackle responsibility attribution prior to the development of biomedical AI technologies and ethical guidelines.In general, human doctors acting as superiors need to bear responsibility for their clinical decisions. However, human doctors should not bear responsibility for the behavior of an AI doctor that is practicing medicine independently. According to the degree of fault—which includes internal institutional ethics, the AI bidding process in procurement, and the medical process—clinical institutions are required to bear corresponding responsibility. AI manufacturers are responsible for creating accurate algorithms, network security, and insuring patient privacy protection. However, the AI itself should not be subjected to legal evaluation since there is no need for it to bear responsibility. Corresponding responsibility should be borne by the employer, in this case the medical institution.

动物实验是医学研究与教育中不可或缺的环节,也是培养其科研伦理意识的实践途径.对410名医学研究生的研究结果显示:56.8％的人称不应开展雄性连体鼠受孕实验,58.1％的人称此实验违背了3R原则,76.3％的人称此类研究需要接受伦理委员会的伦理审批.被调查医学研究生的动物实验伦理认知情况尚好.因此建议医学院校和科研院所要加强动物实验伦理教育,提高医学研究生和科研人员的伦理意识和伦理决策能力,健全伦理审查制度,优化医学科技伦理治理环境.

Brain-computer interface (BCI) technology is an emerging disruptive technology, whose potential risks have been exposed in clinical trials and applications. BCI technology has the characteristics of dual use, and the BCI testing process involves unclear or uncertain risks. Therefore, ethics committees should fully review the ethical aspects of BCI trials in clinical settings.

中医治疗模式丰富且独具特色,患者主导型决策、医生主导型决策、医患平等型决策均有,但医生主导型决策较为常见.中医医患共享决策内涵丰富,不仅包括医患信息的顺畅流动、鼓励支持患者平等参与,还包括基于中医特点的整体观念,对影响健康的饮食、运动、情志、起居和生理、心理、社会、自然诸方面问题的探讨.将"共享决策"融入中医的治疗过程,可按照"诊断治疗"的过程分为四个步骤.中医共享决策有优势,也受限,需要医患双方都满足一定的客观条件,中医治疗中也有不能运用共享决策的特殊情况.多种途径提升医患的决策能力、科学的评估和匹配治疗方案,开发辅助决策的工具、畅通信息传递的渠道均可提升医患的共享决策能力.

Objective To understand the current status of Chinese medical researchers' knowledge regarding the ethical norms of the research involving humans or laboratory animals,and provide reference for further improving the ethics review norms. Methods The questionnaire method was employed to survey the applicants for the 2019 projects supported by the Department of Medical Sciences,National Natural Science Foundation of China (NSFC) about their knowledge of ethical requirements.Furthermore,the ethical supervision of the NSFC and affiliations at the project application and implementation stages was analyzed. Results The survey showed that 29.9% medical researchers were familiar with NSFC's ethical requirements for research involving human or laboratory animals.During the project application stage,59.0% affiliations adopted the simplified review method.Regarding the ethical supervison,95.5% medical researchers believed that the affiliations should fulfill the ethical supervision obligations and take relevant measures during the project implementation period.In addition,55.0% medical researchers fully agreed to discuss with the review experts about the ethical issues involved in the project. Conclusions The NSFC should establish rules and regulations to improve institutional management responsibilities and institutionalize the training about research ethics to comprehensively strengthening the training.Taking the management of research project ethics as a starting point,the NSFC should form a multi-party linkage between project funding and management and establish an accountability mechanism for ethics management.Furthermore,the NSFC should double the endeavors at the review of ethical issues during expert review and process management and attach importance to the research,judgment,and prevention of ethical risks.

心血管疾病病情复杂,临床决策方式多元,患者及家属各方面负担均重,基于冠心病及植入式复律除颤器植入案例,分析阐述心血管疾病中的共享决策框架.在共享决策框架下,患者参与诊疗决策会增强其可控制感和获得感.提高共享决策质量的策略包括开发有效的决策辅助工具,增强患者的风险感知能力,以及赋能患者以提升决策能力.

医学以人为本,作为医学人文研究对象的人,在自然属性和社会属性方面表现出多元性和复杂性.在麻风病数千年的防治中,体现出医学的进步、防治观念的变化,同时也反映出不同时代背景、社会背景等对疾病防治的影响.从医学史、医学伦理学和医学社会学视角出发,对我国麻风病的防治进行简要梳理,探讨麻风病防治过程中的人文属性,希望能为其他疾病防治提供人文思考.

Abstract Purpose: Palliative care is an essential intervention to improve the quality of life for patients with cancer, whereas the ongoing COVID-19 pandemic poses a challenge to supportive and palliative care providers. This survey aims to explore the current status of palliative care practice for cancer and the specific influence of COVID-19, from the perspective of oncologists.Methods: The mixed-mode surveys including electronic questionnaires, face-to-face interactions, and telephone interviews were adopted to investigate specialised physicians working in cancer-related departments. Data including demographics, experiences and opinions of oncologists regarding the impact of COVID-19 on clinical work in oncology, their personal lives, and palliative care practice were collected and qualitatively analysed. Individual suggestions on coping strategies were further proposed.Results: Thirty-seven oncologists participated in this study from September 2021 to January 2022. The majority of them believed COVID-19 significantly and negatively affected their clinical work routines (75.7%), personal daily lives (67.6%), and palliative care practice (64.9%). Most specialists considered that nowadays the palliative care system remained underdeveloped (73.0%), and other factors besides COVID-19 were associated with this situation (78.4%). Participants further proposed some suggestions to promote palliative care practice during COVID-19, including more online guidance on palliative care for cancer patients (35.3%), strengthening remote multidisciplinary cooperation (29.4%), encouraging home-based palliative care (17.6%), and updating more information on COVID-19 in palliative medicine guidelines (5.9%), etc.Conclusion: COVID-19 had significantly adverse effects on cancer palliative care practice, while other factors should not be overlooked. Corresponding measures to encourage supportive and palliative care during COVID-19 are warranted.

基于对全国11164名医学科研人员的抽样调查数据,分析了中国医学科研人员对科研伦理的了解、态度和遵守情况.调查发现,虽然大多数医学科研人员自称对科研伦理规范比较了解,但其科研伦理的客观知识的认识水平不容乐观;获取科研伦理知识的渠道多元化,但正规化培训渠道不足.大多数人对遵从科研伦理规范持积极态度,但男性、35岁以下青年、高级职称及东北地区的受访者相对消极.超过半数的人称中国目前的科研伦理监管基本到位,但也有部分人称违反科研伦理的现象比较普遍,部分科研人员反映伦理审查存在"直接盖章同意和批复"现象.相对于医疗机构,企业和高校是科研伦理培训教育和审查的薄弱环节.基于以上现状,提出加强科研伦理培训和伦理审查要求和政策建议.

科研伦理意识的认知和态度影响着个体研究者遵循研究伦理规范的意愿和程度.考察了中国医学科研人员(n=11164)对科研伦理规范知识的知晓度、获得途径及培训需求.调查发现:超过50.0％的人知晓"黄金大米事件""头颅移植术";80.0％的人知晓《涉及人的生物医学研究伦理审查办法》.90.0％的人认为"尊重人"和"不伤害"是基本伦理原则,但分别有42.8％的人和75.1％的人选择了"有益"和"公正".超过60.0％的人通过"自学""单位组织的专门培训"或"导师或同事的言传身教"获得科研伦理知识,仍有30.0％的人近三年未参加过科研伦理讲座.在培训需求方面,超过50.0％的人选择了"研究和应用的伦理规范",其次为"前沿领域伦理问题"(41.0％)和"伦理审查"(36.7％).基于此,提出了改进中国科研伦理教育培训内容和形式的建议.

This essay is the starting point of a new column in Intelligent Medicine that invites interdisciplinary perspectives on the social, ethical, legal, and responsibility aspects of the use of artificial intelligence (AI) in medicine and health care. Papers in this column will examine the practical, conceptual, and policy dimensions of the use of AI for health-related purposes from comparative and international perspectives. We invite contributions from around the world in all application areas of AI for health, including health care, health research, drug development, health care system management, as well as public health and public health surveillance. The column aims to provide a forum for reflective and critical scholarship that contributes to the ongoing academic and policy debates about the development, use, governance, and implications of AI in medical and health care settings. To launch the column, we first provide an overview of recent approaches that have been developed to identify and address the effects and potential impacts of science and technology innovations on human societies and the environment. These include ethical, legal, and social implications/aspects (ELSI/A) research, responsible research and innovation (RRI), sustainability transitions research, and the use of international standard-setting instruments for responsible and open science issued by the United Nations Educational, Scientific, and Cultural Organization (UNESCO), the World Health Organization (WHO), and other international bodies. In Part Two of this essay, we discuss some of the central challenges that arise with regard to the integration of AI and big data analytics in medical and health care settings. This includes concerns regarding (i) the control, reliability, and trustworthiness of AI systems, (ii) privacy and surveillance, (iii) the impact of AI and automation on health care staff employment and the nature of clinical work, (iv) the effects of AI on health inequalities, justice, and access to medical care, and (v) challenges related to regulation and governance. We end the essay with a call for papers and a set of questions that could be relevant for future studies.