Ethics of trustworthy AI in healthcare: Challenges, principles, and practical pathways

Artificial Intelligence (AI) is transforming healthcare by enhancing diagnostics, personalizing treatment planning, and streamlining patient care. Yet, its adoption is hindered by persistent ethical challenges, including algorithmic bias, lack of transparency, privacy risks, and unclear accountability. Existing international frameworks articulate high-level principles but seldom provide operational guidance for clinical deployment. We bridge this gap by synthesizing trust dimensions for healthcare, with measurable metrics for fairness, explainability, privacy, accountability, and robustness, and proposing the Healthcare AI Trustworthiness Index (HAITI), a composite, context-aware readiness score with explicit normalization, weighting, and uncertainty reporting. We outline a development–deployment–governance blueprint and present two case studies (diagnostic bias mitigation; privacy-preserving federated learning). Together, these contributions translate ethical principles into measurable practices that can foster trust, improve equity, and accelerate responsible AI integration in clinical settings.