Does gender moderate the relationship between bullying victimization and depression? A longitudinal study.

Since 2023, the rapid growth of generative artificial intelligence (AI) sparked by large language models (LLMs) has begun to transform the healthcare system [, ]. While early generative AI primarily focused on natural language processing and information summarization, by late 2024, agentic AI capable of autonomous planning, execution, and self-evaluation, alongside multimodal AI that integrates multiple data types such as text, images, and voice, emerged as core drivers of healthcare innovation []. As agentic and multimodal AI proliferate in clinical settings [], ethical dilemmas qualitatively distinct from those of traditional predictive AI are surfacing. In particular, the autonomy of generative AI, hallucination based on probabilistic reasoning [], and decontextualization—where the source and context of information are lost—create serious ethical challenges that obscure the locus of responsibility in medical practice. Regulatory approaches to healthcare AI vary significantly across nations, complicating the establishment of an integrated governance framework []. The European Union, through the AI Act, categorizes medical AI as high-risk systems, with core high-risk obligations scheduled from August 2026 []. Meanwhile, South Korea’s Framework Act on AI, promulgated on January 21, 2025 and in force since January 22, 2026, classifies healthcare AI that poses risks to life or safety as high-impact AI, but adopts an approach centered on self-verification and best-efforts obligations rather than prior approval []. Despite these policy discussions, however, there remains insufficient provision of concrete, actionable ethical standards that researchers and clinicians who actually develop and validate generative AI can reference for routine decision-making []. The United States established a risk-based regulatory framework under the Biden administration’s Executive Order on the Safe, Secure, and Trustworthy Development and Use of AI (14110, 2023). However, the Trump administration revoked this and replaced it with an innovation-driven Executive Order (14179, 2025), shifting the direction toward securing technological competitiveness through deregulation [, ]. Such disparities in regulatory approaches impact international joint research and multinational clinical trials, with the lack of practical implementation guidelines being particularly problematic.