Counterfactual Fairness Audits of Multi-Step Clinical LLM Agents Require a Measured Per-Action Instability Floor

תקציר מקורי באנגליתarXiv:2609.03221v2 Announce Type: replace Abstract: Counterfactual audits are the standard tool for checking whether a clinical agent treats demographically distinct but clinically identical patients differently. They report a flip rate: how often an action changes when only the patient descriptor changes. We show that this quantity is uninterpretable on its own. Re-running an identical condition ten times over sixteen vignettes (same narrative, same descriptor string, nothing varied) moved a clinical agent's action in 8.7% of outcome-vignette cells, and instability was heterogeneous across actions by a factor of eight, from 0.022 for ICU escalation to 0.179 for controlled-substance caution. No demographic contrast in our data was distinguishable from that floor. A second model gives a poo