AI医学叙事的哲学批判与马克思主义主体间性重构

Philosophical Critique of AI-Mediated Medical Narratives and Marxist Intersubjectivity Reconstruction

摘要: 在当代医疗实践中，人工智能(AI)对医学叙事的介入引发深刻变革，但存在提升效率与剥离医学叙事本质属性的矛盾，使医患间“主体间性”面临挑战。本文以马克思主义“社会关系”理论与“生命间性”哲学为批判视角，揭示AI医学叙事中“主体间性”危机表现与根源，提出以“算法生命间性”为核心的重构路径。结论指出，医学人文在AI时代的使命是划定伦理边界，构建“技术–伦理”双重框架，回归医疗本质。未来需跨学科协作，从源头塑造负责任的医疗AI。医学教育核心目标应转向“人文批判力”培养，构建“技术–人文”双重课程体系，培养“全人医生”，守护医学人文精神。

Abstract: In contemporary medical practice, the intervention of Artificial Intelligence (AI) in medical narratives has triggered profound changes. However, there exists a contradiction between enhancing efficiency and stripping away the essential attributes of medical narratives, posing challenges to the “intersubjectivity” between doctors and patients. Drawing on Marxist theory of “social relations” and the philosophy of “life-intersubjectivity” as critical perspectives, this paper reveals the manifestations and root causes of the “intersubjectivity” crisis in AI-mediated medical narratives and proposes a reconstruction path centered on “algorithmic life-intersubjectivity”. The conclusion points out that the mission of medical humanities in the AI era is to define ethical boundaries, construct a “technology-ethics” dual framework, and return to the essence of healthcare. In the future, interdisciplinary collaboration is required to shape responsible medical AI from the source. The core objective of medical education should shift towards cultivating “humanistic critical thinking”, establishing a “technology-humanities” dual curriculum system, nurturing “holistic doctors”, and safeguarding the humanistic spirit of medicine.