Ethics in Hospitals: In less than a decade, Indian hospitals have moved from paper files to AI-assisted scans, teleconsultations and cloud-based health records. The Ayushman Bharat Digital Mission (ABDM) aims to create interoperable electronic health records for every citizen, anchored by ABHA health IDs and a national health-data platform. At the same time, the Digital Personal Data Protection Act (2023) and ABDM’s own data policies have forced hospitals to take privacy and consent much more seriously.
Amid this rapid change, India’s first bioethics centres and hospital ethics committees have played a crucial role. They translate abstract principles—dignity, autonomy, justice—into real decisions: whether to deploy an AI model, how to share data with a start-up, or when to override an algorithm in the interest of a single patient. By 2026, their influence is visible across wards and boardrooms.
Why Hospital Ethics Suddenly Matters in the Age of AI
AI is no longer limited to research labs. Large public hospitals and private chains now use machine learning for radiology reads, sepsis prediction, appointment scheduling and insurance claims verification. Government initiatives under ABDM encourage digital prescriptions, cloud-stored reports and “scan & share” QR systems that move patient data directly from phones into hospital software.
National strategies such as NITI Aayog’s Responsible AI framework stress that AI deployments must reflect constitutional values—equality, privacy, non-discrimination—and be governed by clear safeguards. In healthcare, this means:
- Fairness: Algorithms must not under-perform for women, Dalits, Adivasis or under-represented regions.
- Accountability: Hospitals must know who is responsible when AI outputs harm patients.
- Transparency: Patients should understand when an AI tool is influencing their diagnosis or treatment.
In 2021, the Indian Council of Medical Research (ICMR) released dedicated Ethical Guidelines for Application of AI in Biomedical Research and Healthcare, setting expectations for safety, transparency, human oversight and bias audits whenever medical AI is used.
These frameworks are powerful on paper. But it is India’s bioethics centres and ethics committees inside hospitals that turn them into everyday practice.
India’s Early Bioethics Pioneers Inside Hospitals
From Faith-Based Ethics Centres to Academic Bioethics Hubs
Long before “AI in healthcare” became a buzzword, some Indian institutions had already begun teaching and practicing healthcare ethics in a structured way.
- The FIAMC Healthcare Ethics Centre in Mumbai has run a nine-month certification course in healthcare ethics since 2004, guiding clinicians on moral decisions in areas like intensive care, end-of-life care and organ donation.
- These early centres created a culture where doctors were encouraged to discuss difficult cases—such as withdrawing ventilation from terminal patients or handling conflicts with families—through an ethical lens, not just a legal one.
As digital tools grew, these same centres became natural places to ask new questions:
Should an AI system be allowed to suggest palliative care options?
Can hospital data be shared with a start-up to “train” its algorithm?
Who speaks for patients who do not understand the tech?
The First Ethics-Dedicated Centre in a Medical College
A key turning point came when the Centre for Ethics at Yenepoya (Deemed to be University) in Mangaluru was set up as the first ethics-dedicated centre in a medical college in India. It offers structured academic programmes in research ethics and bioethics, including a two-year Master’s in Research Ethics supported by international grants.
The Centre was created explicitly to “reawaken” medical ethics and bioethics in healthcare, using teaching, research and cultural exchanges. By 2020s:
- Many hospital ethics committees across the country included at least one member trained or mentored through such programmes.
- Workshops on topics like informed consent in digital health and data sharing in collaborative research became routine.
- Younger clinicians began to see ethics not as an exam topic but as part of professional identity.
New Bioethics Centres in a Changing Tech Landscape
In 2025, an important milestone was the launch of “India’s first Centre of Bioethics” at Bhaikaka University in Karamsad, Gujarat, under the International Chair in Bioethics. This centre focuses explicitly on the ethical challenges raised by technologies such as AI, gene editing and data privacy. It plans to:
- Run certificate courses and workshops for hospital staff on AI ethics and digital health.
- Support hospital ethics committees in identifying and resolving tech-driven dilemmas.
- Develop digital resources that make complex ethics questions accessible to busy clinicians.
Together, these pioneering bioethics centres create a network of expertise that hospitals can lean on as AI and data-driven tools arrive at the bedside.
Building the Foundations: ICMR and National Bioethics Frameworks
National Ethical Guidelines and Ethics Committees
India’s bioethics infrastructure is anchored in the ICMR National Ethical Guidelines for Biomedical and Health Research Involving Human Participants (2017). These guidelines:
- Mandate that all biomedical and health research involving humans must undergo ethics committee review.
- Cover new areas like digital health research, biobanking and big-data analytics.
- Emphasise respect for autonomy, informed consent, privacy and community engagement.
To operationalise this, the Department of Health Research created the National Ethics Committee Registry for Biomedical and Health Research (NECRBHR), which requires ethics committees across the country to register and follow ICMR’s standards.
By 2026, this means:
- Any hospital running AI-driven clinical research must present its protocols to a registered ethics committee.
- Ethics committees are expected to consider issues like algorithmic bias, secondary use of data and long-term storage of digital records.
- External audits and registrations make it harder for “paper” ethics committees to exist only for compliance.
The ICMR Bioethics Unit: Quietly Training the Trainers
The ICMR Bioethics Unit in Bengaluru supports and promotes ethical conduct of biomedical and health research nationwide. It develops policies on research integrity and publication ethics, advises ICMR institutions and helps update national guidelines.
Over time, the unit’s training programmes and webinars have:
- Introduced ethics committee members to AI-specific issues like data drift, model explainability and continuous monitoring.
- Familiarised hospital administrators with the responsibilities that come with digital health partnerships.
- Encouraged integration of ethics into medical and allied health curricula.
This “training the trainers” approach amplifies the influence of bioethics centres far beyond their immediate campuses.
When Algorithms Enter the Ward: AI Ethics in OPDs and ICUs
ICMR’s AI Guidelines Change Research Proposals
ICMR’s AI-specific ethical guidelines require that AI projects in biomedical research and healthcare address:
- Safety & Risk Management – clear plans for validation, monitoring and fallback when AI makes errors.
- Transparency & Explainability – ability for clinicians to understand and, when needed, challenge AI recommendations.
- Human Oversight – AI cannot replace clinical judgment; doctors remain accountable for final decisions.
- Non-discrimination & Fairness – bias assessments across diverse Indian populations.
By 2026, typical research proposals submitted to hospital ethics committees are expected to include:
- A description of training datasets and how representative they are of Indian patients.
- Plans for informing patients when AI tools are used in their care.
- Governance structures for handling adverse events linked to AI outputs.
Not every ethics committee is equally prepared—but where bioethics centres have trained members, the questions asked during review are far sharper.
Responsible AI Meets Hospital Reality
NITI Aayog’s Towards Responsible AI for All papers position constitutional morality—fundamental rights to equality and privacy—as the moral backbone of AI deployment in India.
In hospitals, this plays out in concrete decisions:
- Whether to use AI triage tools in understaffed emergency rooms, knowing that errors may disproportionately hurt poorer or non-digitally literate patients.
- How to design consent forms so patients understand that their CT scan will be stored and possibly used to improve future algorithms.
- When to say “no” to a vendor whose AI is powerful but opaque, offering no meaningful explanation of outputs.
Leaders at premier institutes like AIIMS Delhi have publicly acknowledged that while technology can heal, empathy must remain central to healthcare. This echoes a broader shift: AI is welcome, but only if it serves human-centred care.
Health Data Goldmine: ABHA, ABDM and the Privacy Test
Digital Health Records at Scale
Under ABDM, health facilities across India are being linked into a national digital ecosystem that uses the Ayushman Bharat Health Account (ABHA) number to create longitudinal records.
Hospitals like Ranchi’s Sadar Hospital have already registered more than a lakh ABHA cards and introduced QR-based “scan & share” systems that send patient data directly into hospital information systems, cutting queues and data entry.
ABDM’s data management and privacy policies explicitly align themselves with the Digital Personal Data Protection Act, requiring clear consent, purpose limitation and safeguards for health data.
All of this sounds ideal—but the ethics depends on how these tools are used:
- Do patients really understand what “linking your ABHA” means?
- Are they pressured to share more data than necessary to get treatment?
- How securely do hospitals store and share the data once they have it?
When Things Go Wrong: Fraud and Data Tampering
Recent cases have shown how vulnerable digital health programmes can be. In Uttar Pradesh, authorities uncovered a major cyber fraud under Ayushman Bharat where attackers allegedly tampered with Aadhaar-linked mobile numbers to gain access to National Health Authority portals and illegally issue cards.
Incidents like this highlight why hospital ethics committees and bioethics centres must engage seriously with:
- Cyber-ethics – ensuring strong access controls, audit trails and responsible vendor selection.
- Informed consent in practice – not just a signature, but real understanding.
- Community trust – once trust is broken, marginalised patients may avoid digital systems altogether, widening health inequities.
Bioethics experts are increasingly part of hospital discussions on data-security policies, not just clinical protocols.
How Bioethics Centres Shape Real Hospital Decisions by 2026
Training Doctors, Data Scientists and Ethics Committee Members
By 2026, India’s leading bioethics centres are acting as capacity-builders for entire regions:
- Yenepoya’s Centre for Ethics trains healthcare professionals in research ethics and bioethics, including modules on digital health and cross-border data transfer.
- Bhaikaka University’s Centre of Bioethics designs workshops on AI, genetic editing and data privacy, often in collaboration with hospital ethics committees.
- ICMR Bioethics Unit runs webinars and develops guidance that ethics committees across India rely on when reviewing complex proposals.
Hospital ethics committees then use this training to shape decisions such as:
- Approving AI tools only after independent bias and performance checks.
- Requiring that any external partner using hospital data sign robust data-protection agreements.
- Insisting on clear opt-out options for patients who do not want their data reused for research or algorithm training.
Typical Scenarios Where Ethics Now Leads
1. AI-Assisted Radiology
A tertiary hospital wants to deploy an AI tool to flag possible lung cancer on chest X-rays. The ethics committee, informed by national AI guidelines, asks:
- Was the algorithm trained on Indian datasets or mainly foreign images?
- How will the hospital communicate to patients that AI is being used as a “second reader”?
- Who is liable if the AI misses an early tumour?
Only after satisfactory answers—and a phased clinical validation plan—is the deployment approved.
2. Predictive Models in ICUs
An ICU introduces a model that predicts mortality risk. Bioethics-trained members push for limits: the prediction cannot be shown to families as a fixed “death score”, nor be used alone to deny intensive care to elderly or disabled patients. Instead, it must be framed as one input among many, with strict oversight.
3. Start-ups Requesting Data Access
A start-up proposes to “anonymise” hospital data for AI development. Ethics committees, drawing from ABDM and data-protection principles, demand strong de-identification methods, independent audits, and a clear plan for benefit-sharing with the hospital and community.
In all these cases, bioethics centres supply the intellectual tools and frameworks; hospital committees translate them into rules.
Also Read: Bioethics from Sardar’s Town: India’s First Centre of Bioethics in Karamsad Takes On AI
Challenges on the Road to 2026
Despite progress, several gaps remain:
- Uneven Capacity: Many smaller hospitals either lack registered ethics committees or have committees with limited training in AI and data ethics.
- Workload and Time Pressure: Ethics reviews can feel like “extra paperwork” to overburdened clinicians, leading to superficial scrutiny.
- Limited Patient Representation: Few ethics committees include patient advocates or community representatives, especially from marginalised groups.
- Rapid Tech Change: AI and digital tools evolve faster than guidelines, forcing committees to “catch up” constantly.
For ethics to truly guide AI in hospitals by 2026, bioethics centres will need more funding, more interdisciplinary work with engineers and data scientists, and more engagement with patients themselves.
Ethics Beyond Compliance: Compassion at the Centre of Care
At its core, hospital ethics is not about forms and checklists—it is about how we treat vulnerable human beings. When AI automates triage or predicts which patient is “low priority”, it risks turning people into rows in a dataset.
Union health leaders have repeatedly reminded graduating doctors that while technology can heal, empathy remains essential. That empathy must extend to how we collect, share and monetise patient data.
Here is where spiritual and moral frameworks can reinforce bioethics: they remind professionals that every line on a monitor belongs to a conscious soul with fears, hopes and a family.
Accountability in Medicine
Sant Rampal Ji Maharaj’s teachings, widely available through his official website and satsangs, emphasise that “our race is living being, humanity is our religion”. This universal view of human dignity aligns closely with the core principles of bioethics—respect for persons, justice and non-maleficence.
From a Sat Gyaan perspective:
- Every patient is more than data: A human being is not just a “case” or a “data point”; each is a soul temporarily in a body. Reducing them to risk scores or commercial assets violates their deeper spiritual worth.
- True duty (kartavya) goes beyond legal minimums: Even if law permits certain data uses, a spiritually aware clinician asks whether these uses are compassionate and fair, especially to the poor and voiceless.
- Equality in care: Teachings that reject discrimination on the basis of caste, religion or wealth mirror the ethical demand that algorithms and policies must not systematically disadvantage any group.
Call to Action
What Hospitals and Citizens Can Do Next
Turn Ethics Principles into Daily Practice
- Invest in bioethics capacity: Partner with established bioethics centres such as the ICMR Bioethics Unit, Yenepoya’s Centre for Ethics, and emerging centres like Bhaikaka University’s to train ethics committee members, clinicians and IT teams.
- Adopt and publicise clear AI & data policies: Align internal rules with ICMR’s AI guidelines, ABDM data-protection frameworks and the Digital Personal Data Protection Act.
- Create ethics review pathways for digital tools: Ensure any new AI or digital health product is reviewed not just by IT, but by an ethics committee that includes clinicians, bioethicists, legal experts and patient representatives.
- Ask simple but powerful questions before relying on an AI tool: Is it fair? Is it transparent? Do my patients know it is being used?
- Document and report any harm or near-miss that may be linked to an AI decision or data mishandling.
- Participate in ethics training programmes and consider formal qualifications in bioethics or research ethics.
- Read consent forms carefully before allowing your data to be linked or reused; ask who will see it and for what purpose.
- Use your ABHA and digital health tools, but insist on privacy and security explanations in plain language.
- If something feels wrong—like pressure to share unnecessary data—speak up or seek help from patient-rights groups.
FAQs Ethics in Hospitals, Bioethics Centres and AI in India
1. What is a bioethics centre and how is it different from a hospital ethics committee?
A bioethics centre is usually an academic or training hub that offers courses, research and resources on ethical issues in healthcare and biomedical research. Examples include the Centre for Ethics at Yenepoya (Deemed to be University) and the Centre of Bioethics at Bhaikaka University. A hospital ethics committee is a decision-making body within a hospital that reviews research proposals and sometimes difficult clinical cases. Bioethics centres often train and advise these committees.
2. How do India’s first bioethics centres influence AI use in hospitals?
They design training modules on AI ethics, help develop case-based guidelines, and support ethics committees in evaluating AI proposals. For example, centres at Yenepoya and Bhaikaka University explicitly focus on emerging issues like AI, gene editing and data privacy, and collaborate with hospitals to run workshops and certificate programmes.
3. What national guidelines govern AI in Indian healthcare?
The Indian Council of Medical Research has issued Ethical Guidelines for Application of AI in Biomedical Research and Healthcare, which cover safety, transparency, fairness, accountability and human oversight. NITI Aayog’s Responsible AI documents also set broader principles rooted in constitutional values, while ABDM and the Digital Personal Data Protection Act frame how health data should be collected, used and protected.
4. How does ABDM affect patient privacy and consent in hospitals?
ABDM aims to create interoperable digital health records using ABHA IDs, but its policies require explicit, revocable consent for data sharing and alignment with data-protection law. Hospitals must implement systems where patients can understand and control how their data is used, though the quality of implementation still varies.
5. Are there examples of ethical problems with digital health programmes in India?
Yes. For instance, a recent case in Uttar Pradesh revealed data tampering and suspected cyber fraud in Ayushman Bharat, where Aadhaar-linked mobile numbers were allegedly changed to gain unauthorised access to health portals. Such incidents underline the need for robust ethics, cybersecurity and accountability in digital health systems.
