  In 2020, the U.S. Department of Defense officially disclosed a set of ethical
principles to guide the use of Artificial Intelligence (AI) technologies on
future battlefields. Despite stark differences, there are core similarities
between the military and medical service. Warriors on battlefields often face
life-altering circumstances that require quick decision-making. Medical
providers experience similar challenges in a rapidly changing healthcare
environment, such as in the emergency department or during surgery treating a
life-threatening condition. Generative AI, an emerging technology designed to
efficiently generate valuable information, holds great promise. As computing
power becomes more accessible and the abundance of health data, such as
electronic health records, electrocardiograms, and medical images, increases,
it is inevitable that healthcare will be revolutionized by this technology.
Recently, generative AI has captivated the research community, leading to
debates about its application in healthcare, mainly due to concerns about
transparency and related issues. Meanwhile, concerns about the potential
exacerbation of health disparities due to modeling biases have raised notable
ethical concerns regarding the use of this technology in healthcare. However,
the ethical principles for generative AI in healthcare have been understudied,
and decision-makers often fail to consider the significance of generative AI.
In this paper, we propose GREAT PLEA ethical principles, encompassing
governance, reliability, equity, accountability, traceability, privacy,
lawfulness, empathy, and autonomy, for generative AI in healthcare. We aim to
proactively address the ethical dilemmas and challenges posed by the
integration of generative AI in healthcare.
