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| Main Authors: | , , , , , , , , |
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| Format: | Preprint |
| Published: |
2026
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| Subjects: | |
| Online Access: | https://arxiv.org/abs/2601.13268 |
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Table of Contents:
- Large Language Models (LLMs) are increasingly applied in healthcare, yet ensuring their ethical integrity and safety compliance remains a major barrier to clinical deployment. This work introduces a multi-agent refinement framework designed to enhance the safety and reliability of medical LLMs through structured, iterative alignment. Our system combines two generative models - DeepSeek R1 and Med-PaLM - with two evaluation agents, LLaMA 3.1 and Phi-4, which assess responses using the American Medical Association's (AMA) Principles of Medical Ethics and a five-tier Safety Risk Assessment (SRA-5) protocol. We evaluate performance across 900 clinically diverse queries spanning nine ethical domains, measuring convergence efficiency, ethical violation reduction, and domain-specific risk behavior. Results demonstrate that DeepSeek R1 achieves faster convergence (mean 2.34 vs. 2.67 iterations), while Med-PaLM shows superior handling of privacy-sensitive scenarios. The iterative multi-agent loop achieved an 89% reduction in ethical violations and a 92% risk downgrade rate, underscoring the effectiveness of our approach. This study presents a scalable, regulator-aligned, and cost-efficient paradigm for governing medical AI safety.