On November 2-3, 2024, the 17th Conference on Medical Professionalism was successfully held at Peking University Health and Science Center (PUHSC). This year’s conference was hosted by China-U.S. Center on Medical Professionalism, PUHSC (hereinafter referred to as “the Center”) and School of Medical Humanities of Peking University, and co-organized by the Chinese journals the  Medicine and Philosophy ,  Chinese Medical Ethics , and  Chinese Journal of Medical Education . Focusing on the cutting-edge theme of Medical Artificial Intelligence (AI) and Clinical Ethics, the conference discussed the latest development of AI technology and its applications in medical practice, analyzed their possible social impacts and ethical controversies, and explored future strategies. More than 100 participants attended the conference, including Chinese and foreign scholars, clinicians, ethicists, medical humanists, healthcare administrators and medical students.

(Group photo of the conference)

The conference started on November 2 in Qiong Yuan Lecture Hall of Peking University Medical Library. Prof. Cong Yali (School of Medical Humanities of Peking University, Deputy Director of the Center, and Chairman of the Medical Ethics Branch of the Chinese Medical Association) spoke on behalf of the hosts and reviewed the efforts and achievements of the Center since its establishment. Prof. Wang Weimin (Deputy Director of PUHSC and Chief Editor of  Chinese Journal of Medical Education ) delivered a speech on behalf of the faculty and co-organizers. Dr. Micah Prochaska, Associate Director of the McLean Center for Clinical Medical Ethics at the University of Chicago, delivered a keynote speech on the topic of “Research on Surrogate Decision-Making”, in which he systematically introduced the necessity of surrogate decision-making and its ethical basis, and analyzed the rationale and potential conflict of interests in choosing relatives as surrogate decision-makers. By referencing the case of Cruzan v. Director, Missouri Department of Health, he further illustrated the importance of patient autonomy, especially how the surrogate decision maker, in the absence of clear advance directives, should take into account the patient’s values and past expressed preferences to decide in the best interest of the patient. After the presentation, the participating experts lively discussed surrogate decision-making for patients who lack decision-making capacity. Cong Yali highly praised Micah’s keynote speech. She suggested in her comment that there is currently a lack of critical reflection on surrogate decision-making in China, and that surrogate decision-makers must not only consider the patient’s best interests, but also understand the patient’s true wishes, rather than projecting on the decision maker’s own preferences onto the patient. Cong also emphasized that since there is no fixed “best interest” for the patients, the decisions to be made should also be reviewed as “best judgments”.

（Dr. Micah Prochaska’ keynote speech）

The first session was moderated by Associate Prof. Tang Jian from Tianjin Medical University and commented by Prof. Yin Mei from Harbin Medical University. Firstly, Prof. Song Hongjiang (Deputy Director of Gastrointestinal Surgery Department of the Affiliated Cancer Hospital of Harbin Medical University) gave an in-depth analysis of Ethical Considerations of Laparoscopic Robotic Surgery. Song introduced the ethical principles of the perioperative period, discussed the ethical dilemmas in surgery, and pointed out that clinical surgeons currently lack attention to surgical ethics and reflection on decision-making ethics. Song also discussed the ethical issues of robotic surgery, especially informed consent and the protection of patients’ rights. The widespread use of robotic surgery necessitates the concept of “human-centered” surgery and developing doctors’ ability in ethical decision-making in case of unforeseen consequences of new technology. Liu Ruishuang (associate professor of health law at Peking University’s School of Medical Humanities) analyzed the impact of AI on the principle of attribution of responsibility for medical damage. He discussed the principle of attribution of responsibility for medical damages in traditional Chinese law, and emphasized the impact of AI in the medical field on the current law and their limited compatibility. Experts at the conference agreed that with the wider application of AI in healthcare, it is particularly necessary to define the responsibility of physicians and AI systems in medical damages, so as to prevent disputes between doctors and patients caused by unclear attribution of responsibility. Subsequently, Dr. Xie Guangkuan (School of Medical Humanities of Peking University and the Center) made an academic report entitled “Artificial Intelligence and Physician Professionalism”. He claimed that the new technological revolution of AI technology will have profound impacts on human society, and medical professionalism must also face up to its challenges. He examined the possible impact of AI technology on basic principles and physician responsibilities of medical professionalism from both positive and negative aspects. During the Q&A session, Associate Professor Yang Yang of Dalian Medical University and Associate Professor Dai Xiaohui of Hebei Medical University engaged in a discussion with each of the presenting experts. Professor Yin Mei pointed out in her comments that the application of AI has brought great convenience to healthcare, but doctors should always prioritize their professional responsibilities and should not blindly rely on the technology. She emphasized that AI technology, however strong, cannot replace doctor’s human compassion for patients, and physicians’ values lie in their constant responsibility and care for the patients despite the instruments they use.

The third session of the conference focused on the Action Program for Enhancing Medical Humanistic Care (2024-2027) (hereinafter referred to as the Action Program). This session was moderated by Associate Prof. Dong Yuanyuan from China Medical University, with Prof. Liu Yun from Hebei Medical University as the commentator. Prof. Guo Liping (Dean of School of Medical Humanities, Peking University) explained the Action Program in detail, pointing out that the program aims to comprehensively enhance medical humanistic care through measures in management, service and culture. She emphasized that the cultivation of humanistic qualities should be carried out throughout the whole process of medical education and career development, and should not be limited to theoretical courses, but cultivated in practice. During the Q&A session, participants discussed specific targets and solutions of the Action Program. Liu Yun (Hebei Medical University) commented that the Program provides new standards and directions for medical humanities education and further clarifies the direction of future medical education.

(Guo Liping giving a speech)

The last panel was moderated by Shang Dan(the Journal of  Chinese Medical Ethics ) and commented by Yang Yang, director of  Medicine and Philosophy and associate professor of Dalian Medical University. Associate Professor Ren Quansheng from the School of Electronics, Peking University, first delivered a report on “Research Hotspots of Medical Artificial Intelligence Technology”. Connecting technology to the current hotspots of AI research, he introduced the development in fields such as AI processing technology and AI-assisted diagnosis of multi-physiological signals such as EEG signals, and proposed future directions for in-depth use in medical fields. Afterwards, Dr. Li Ji, chief physician of internal medicine department of Peking Union Medical College Hospital, discussed the scenarios of application and ethical considerations of medical AI around internists in his report “Role of Internists in Medical AI Practice”. He emphasized that despite the new challenges posed by AI technology, clinicians in the new era should actively embrace AI as well as adhere to ethical judgment and professional responsibility in the process. Yang Yang gave a wonderful comments and questions on the above reports.

In the afternoon, the fifth session, “Artificial Intelligence in Clinical Departments”, further explored the practical application of AI in specific clinical settings, moderated by Prof. Zhao Li from Beijing University of Chinese Medicine (BUCM), and commented by Associate Prof. Peng Yingchun from Capital University of Medical Sciences (CUMS). Huang Xuebing, Director of the Clinical Psychology Center of Peking University Sixth Hospital, firstly presented “The Practice and Application of Artificial Intelligence Psychological Services”, sharing her research on the application of AI technology in the Department of Psychiatry. She introduced in detail the development and application of the mental health service robot “Beixiaoliu” in Peking University Sixth Hospital No. 6, and pointed out the advantages and limitations of AI technology in psychological services, especially how AI can pay attention to patients’ emotional experience when providing psychological interventions. Associate Professor Chen Haidan from the School of Medical Humanities, Peking University, presented on “Ethical Issues of Dialog Intelligence in Depression Treatment”. She analyzed the advantages of AI dialog systems in depression treatment, but also pointed out that its ethical risks such as low robustness, patient privacy sensitivity, algorithmic bias, and empathy and patient reliance. She also argued that although conversational intelligences can provide psychological support, it is important to clarify their role as auxiliary rather than substitute, and avoid neglecting the patient’s emotions due to overreliance of the technology. Finally, Dr. Li Dai, Deputy Chief Physician of Peking University Third Hospital, shared a presentation entitled “Clinical Application and Ethical Reflection of Digital Therapy in Sports Medicine Rehabilitation”. She discussed the prospects of digital therapies in sports medicine in the context of clinical practice in rehabilitation medicine, and emphasized the importance of technical ethics. In the comment and Q&A session, Associate Professor Peng Yingchun summarized the above presentations, and the speakers engaged in a lively discussion with the attendees.

In the closing session of the main forum, Cong Yali made a concluding speech. She believed that the medical field is facing new challenges and opportunities in the context of rapid development of AI. She pointed out that AI as an auxiliary tool can improve medical efficiency, but the doctor’s duties in the doctor-patient relationship cannot be simply transferred to the machine, and the key lies in rationally assessing whether the use of AI truly contributed to human well-being. She summarized that in this conference, participants deepened their understanding of medical AI technology, and expressed gratitude on behalf of the hosts to all the participating experts, scholars, clinicians and medical students for their participation and highly appreciated the conclusions borne out of multifaceted discussion.

(Cong Yali summarizing the meeting)

(Group photo of student representatives)

Since the 12th Conference on Professionalism of Physicians in 2018, the Chinese Medical Students’ Alliance for the Development of Professionalism of Physicians, initiated by the PUHSC in collaboration with nine medical schools, has been held each year. With the Student Forum as its core activity, the Alliance aims to provide a platform for medical students to exchange and learn about professionalism. After the main forum, a symposium was held for the student representatives of the Alliance to exchange views on the development of professionalism of Chinese medical students. The students visited the PUHSC History Museum, participated in the special activities of the student societies of PUHSC undergraduates and postgraduates, and discussed academic research, internship and career planning, exchanging views from different medical schools.

On November 3, 2024，twenty-four teams from more than ten medical schools participated in the Student Forum and presented on topics such as physician professionalism, ethics education, and AI. At the opening ceremony of the Student Forum, Prof. Sheila Rothman of Columbia University (online) and Prof. Cong Yali gave opening speeches. Yin Xiuyun gave an opening speech entitled “Professionalism Education for Physicians: Misinterpretations and Possibilities”. Zhang Yunpeng, lecturer at Tianjin Medical University and a cardiology resident at the Second Hospital of Tianjin Medical University, gave a fascinating speech titled “From Rhetoric to Reflective Practice: a Resident’s Thoughts on Professionalism Growth” based on his own experience. In the afternoon student forum, Zhao Shengyu, a PhD student from the University of Bristol, was invited to give a presentation titled “Exploring Ethical Issues in Chinese Hospice Care from the Perspective of Western Ethics”.

In the Student Forum, teams from different institutions reported on a variety of topics, including physician professionalism, doctor-patient relationship, geriatric care, narrative medicine, hospice practice, and ethical issues of emerging science and technology. The students actively presented their academic research and practice projects, which were rich in content and wide in range, fully reflecting their deep understanding and unique insights into medical professionalism and ethical issues. Associate Professor Gu Xiaoyang of Capital Medical University, Associate Professor Dong Yuanyuan of China Medical University, Associate Professor Dai Xiaohui of Hebei Medical University, and Ms. Zhang Lijuan, Director of the Office of Counselor Development Center of the Department of Student Work of the Faculty of Medicine of Peking University, carefully commented on the report of each student, and made constructive suggestions for the rigor of the research content and the feasibility of the practical application. The reviewers and teachers not only provided valuable feedback on the students’ research, but also demonstrated interdisciplinary and inter-institutional the academic interaction and exchange. Sui Suili, Yin Xiuyun and Zhao Shengyu from Peking Union Medical College participated in the scoring and evaluation of the student projects. Finally, based on the scoring, the Grand Prize, First Prize and Second Prize were selected, and Prof. Sui Suli announced the winners and awarded the prizes.

(Student Forum Award Ceremony)

In the closing ceremony, Xie Guangkuan reviewed and summarized the Student Forum, and Cong Yali gave a closing speech for the current Student Forum. She believed that since the establishment of the “China Medical Student Physician Professional Spirit Development Alliance”, its core objective is to provide strong support and promotion for the cultivation and education of medical humanism, and to ensure that students practice the value of medical humanism in their future careers in academic research as well as in medical practice. She also emphasized that through this symposium the participants have further deepened their understanding of professionalism, and expressed expectations to continuously strengthen the education of physicians’ professionalism in the future, contributing to the sustainable development of China’s healthcare industry.

Written by: WU Leqian, XIE Guangkuan,ZUO You