What's in a Name? Morphological Shortcuts by LLMs in Pharmacology

The morphological form of a word can often give cues to its meaning, but purely relying on these mappings can lead to overgeneralization in high-stakes domains. In the medical domain, for instance, LLMs can confidently reason about fictitious drugs from their affixes alone (e.g., wugcillin) and generate plausible-looking clinical content. We present a behavioral and mechanistic study of LLM "affix heuristics" in pharmacology. Using fictitious drug names built from real affixes, we show that affix signals alone elicit class-level pharmacological responses. We introduce a framework for identifying whether a model's drug semantics are driven mainly by the affix, the stem, or the drug name as a whole. Applied across 653 drugs, our framework reveals that models often induce drug meaning primarily through affix cues, yet rarely explicitly indicate this reliance, and sometimes incorrectly conflate properties among affix-sharing drugs. Activation patching across models further localizes this behavior to early-mid layers. These findings show that morphological shortcuts pose a subtle but measurable risk to safety.

Faithfulness vs. Safety: Evaluating LLM Behavior Under Counterfactual Medical Evidence

In high-stakes domains like medicine, it may be generally desirable for models to faithfully adhere to the context provided. But what happens if the context does not align with model priors or safety protocols? In this paper, we investigate how LLMs behave and reason when presented with counterfactual or even adversarial medical evidence. We first construct MedCounterFact, a counterfactual medical QA dataset that requires the models to answer clinical comparison questions (i.e., judge the efficacy of certain treatments, with evidence consisting of randomized controlled trials provided as context). In MedCounterFact, real-world medical interventions within the questions and evidence are systematically replaced with four types of counterfactual stimuli, ranging from unknown words to toxic substances. Our evaluation across multiple frontier LLMs on MedCounterFact reveals that in the presence of counterfactual evidence, existing models overwhelmingly accept such "evidence" at face value even when it is dangerous or implausible, and provide confident and uncaveated answers. While it may be prudent to draw a boundary between faithfulness and safety, our findings reveal that there exists no such boundary yet.