The Other Side of the Stethoscope: Clinician-Facing Deepfakes and the Symmetry of Synthetic Deception.

backgroundClinical ethics scholarship on deepfakes has focused primarily on patients as targets of synthetic deception, in which fabricated audiovisual material alters patient beliefs about clinicians and care. This focus neglects the reverse epistemic vulnerability: clinicians themselves as recipients of synthetic, adversarially generated clinical information.

objectiveTo develop a conceptual analysis of clinician-facing deepfakes and their implications for clinical epistemology, diagnostic reasoning, and institutional trust.

methodsNormative and conceptual analysis drawing on virtue epistemology, philosophy of testimony, diagnostic error theory, automation bias research, and socio-technical systems theory.

resultsClinician-facing deepfakes constitute a distinct epistemic risk category producing three primary harms: (1) diagnostic error cascades, (2) testimonial contamination of clinical knowledge transmission, and (3) institutional epistemic fragility. We introduce the concept of epistemic role reversal, defined as the systematic decoupling of perceptual reliability from epistemic justification under adversarially generated clinical inputs, resulting in the collapse of expert perceptual advantage in bounded domains.

conclusionsClinical ethics must address both sides of the epistemic encounter in medicine. Clinician-facing deepfakes are not merely a symmetrical extension of patient-facing deception but a structurally distinct class of epistemic threat. While empirical prevalence remains unknown, evidence from adjacent literatures supports their plausibility. A precautionary framework of clinical epistemic hygiene is therefore warranted, combining institutional verification infrastructure, workflow-level safeguards, and professional epistemic norms adapted to adversarial information environments.