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This study reveals a critical safety gap in using large language models for robotic health attendants, showing that over half of the evaluated models failed to adhere to medical ethics under simulated harmful instructions. The research highlights that while proprietary models outperform open-weight versions and plausible-sounding prompts are harder to block than destructive ones, current violation rates remain too high for clinical deployment without further intervention. Consequently, safety evaluation must be established as a primary development criterion rather than an afterthought in this specific application domain.
Benchmarking the Safety of Large Language Models for Robotic Health Attendant Control
arXiv:2604.26577v2 Announce Type: replace Abstract: Large language models (LLMs) are increasingly considered for deployment as the control component of robotic health attendants, yet their safety in this context remains poorly characterized. We introduce a dataset of 270 harmful instructions spanning nine prohibited behavior categories grounded in the American Medical Association Principles of Medical Ethics, and use it to evaluate 72 LLMs in a simulation environment based on the Robotic Health Attendant framework. The mean violation rate across all models was 54.4\%, with more than half exceeding 50\%, and violation rates varied substantially across behavior categories, with superficially plausible instructions such as device manipulation and emergency delay proving harder to refuse than overtly destructive ones. Model size and release date were the primary determinants of safety performance among open-weight models, and proprietary models were substantially safer than open-weight counterparts (median 23.7\% versus 72.8\%). Medical domain fine-tuning conferred no significant overall safety benefit, and a prompt-based defense strategy produced only a modest reduction in violation rates among the least safe models, leaving absolute violation rates at levels that would preclude safe clinical deployment. These findings demonstrate that safety evaluation must be treated as a first-class criterion in the development and deployment of LLMs for robotic health attendants.
Abstract:Large language models (LLMs) are increasingly considered for deployment as the control component of robotic health attendants, yet their safety in this context remains poorly characterized. We introduce a dataset of 270 harmful instructions spanning nine prohibited behavior categories grounded in the American Medical Association Principles of Medical Ethics, and use it to evaluate 72 LLMs in a simulation environment based on the Robotic Health Attendant framework. The mean violation rate across all models was 54.4\%, with more than half exceeding 50\%, and violation rates varied substantially across behavior categories, with superficially plausible instructions such as device manipulation and emergency delay proving harder to refuse than overtly destructive ones. Model size and release date were the primary determinants of safety performance among open-weight models, and proprietary models were substantially safer than open-weight counterparts (median 23.7\% versus 72.8\%). Medical domain fine-tuning conferred no significant overall safety benefit, and a prompt-based defense strategy produced only a modest reduction in violation rates among the least safe models, leaving absolute violation rates at levels that would preclude safe clinical deployment. These findings demonstrate that safety evaluation must be treated as a first-class criterion in the development and deployment of LLMs for robotic health attendants.
Artificial Intelligence (cs.AI); Computers and Society (cs.CY); Robotics (cs.RO)
arXiv:2604.26577 [cs.AI]
(or arXiv:2604.26577v2 [cs.AI] for this version)
https://doi.org/10.48550/arXiv.2604.26577 Focus to learn more arXiv-issued DOI via DataCite
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