Pluralistic Alignment for Healthcare: A Role-Driven Framework

Jiayou Zhong, Anudeex Shetty, Chao Jia, Xuanrui Lin, Usman Naseem


Abstract
As large language models are increasingly deployed in sensitive domains such as healthcare, ensuring their outputs reflect the diverse values and perspectives held across populations is critical. However, existing alignment approaches, including pluralistic paradigms like Modular Pluralism, often fall short in the health domain, where personal, cultural, and situational factors shape pluralism. Motivated by the aforementioned healthcare challenges, we propose a first lightweight, generalizable, pluralistic alignment approach, ETHOSAGENTS, designed to simulate diverse perspectives and values. We empirically show that it advances the pluralistic alignment for all three modes across seven varying-sized open and closed models. Our findings reveal that health-related pluralism demands adaptable and normatively aware approaches, offering insights into how these models can better respect diversity in other high-stakes domains.
Anthology ID:
2025.emnlp-main.1596
Volume:
Proceedings of the 2025 Conference on Empirical Methods in Natural Language Processing
Month:
November
Year:
2025
Address:
Suzhou, China
Editors:
Christos Christodoulopoulos, Tanmoy Chakraborty, Carolyn Rose, Violet Peng
Venue:
EMNLP
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Publisher:
Association for Computational Linguistics
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Pages:
31308–31331
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URL:
https://preview.aclanthology.org/ingest-emnlp/2025.emnlp-main.1596/
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Cite (ACL):
Jiayou Zhong, Anudeex Shetty, Chao Jia, Xuanrui Lin, and Usman Naseem. 2025. Pluralistic Alignment for Healthcare: A Role-Driven Framework. In Proceedings of the 2025 Conference on Empirical Methods in Natural Language Processing, pages 31308–31331, Suzhou, China. Association for Computational Linguistics.
Cite (Informal):
Pluralistic Alignment for Healthcare: A Role-Driven Framework (Zhong et al., EMNLP 2025)
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