{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T07:18:19Z","timestamp":1787815099696,"version":"build-2784847793"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T00:00:00Z","timestamp":1785628800000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To develop a conceptual analysis of clinician\u2010facing deepfakes and their implications for clinical epistemology, diagnostic reasoning, and institutional trust.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Normative and conceptual analysis drawing on virtue epistemology, philosophy of testimony, diagnostic error theory, automation bias research, and socio\u2010technical systems theory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinician\u2010facing 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical ethics must address both sides of the epistemic encounter in medicine. Clinician\u2010facing deepfakes are not merely a symmetrical extension of patient\u2010facing 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\u2010level safeguards, and professional epistemic norms adapted to adversarial information environments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jep.70548","type":"journal-article","created":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T12:08:57Z","timestamp":1785672537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Other Side of the Stethoscope: Clinician\u2010Facing Deepfakes and the Symmetry of Synthetic Deception"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9456-9876","authenticated-orcid":false,"given":"George Rugare","family":"Chingarande","sequence":"first","affiliation":[{"name":"Stellenbosch University Faculty of Medicine and Health Sciences, Division of Medical Ethics and Law  Cape Town South\u00a0Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,2]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.252094"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/CBO9780511606250"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.2307\/2027007"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0017.2010.01394.x"},{"key":"e_1_2_15_6_1","volume-title":"Testimony: A Philosophical Study","author":"Coady C. 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