Artificial intelligence (AI), by transforming diagnostics, therapy, and surgery, generates not only new opportunities but also fundamental bioethical and legal dilemmas that require a reconsideration of established models of responsibility. This article focuses on a comparative analysis of Western and Russian bioethical paradigms in their responses to the challenges of digital healthcare. Particular attention is paid to the conceptual ambiguity of the very concept of "responsible digital healthcare" (RDH), which is actively developed as an ethical and legal framework in Western literature but remains peripheral and terminologically vague in Russian scientific discourse. Russian bioethics, while maintaining continuity with pre-revolutionary medical ethics and Soviet deontology, proposes an alternative model based on a balance between individual autonomy and the collective good. The article substantiates the need to achieve conceptual clarity in understanding AI ethics as a first and essential step toward developing an adaptive normative platform. A distributed responsibility model is proposed as a solution, defining the responsibilities of the AI system developer, physician, and healthcare organization based on their roles in hybrid human-AI systems. Creating a safe and equitable healthcare system requires an adaptive regulatory framework capable of aligning AI development with bioethical and legal standards. The success of such regulation depends not only on interdisciplinary dialogue between technologists, physicians, lawyers, and legislators, but also on public participation, which ensures trust and the ethical legitimacy of these technologies.