This article explores bioethics as a multidimensional phenomenon, existing in a global context but rooted in interdisciplinarity and philosophical reflection. The authors' analysis provides a foundation for understanding the role of bioethics in responding to global challenges such as pandemics and rapid technological advances, which further advances its relevance as a platform for dialogue and substantiates the current theoretical and methodological shift. This study analyzes two different approaches to understanding the genesis and essence of bioethics, revealing a key theoretical and methodological shift in its development. On the one hand, there is a local, or technocratic, approach, which developed as a response to specific biomedical challenges (from medical scandals to technological breakthroughs) within specific cultural and legal traditions. On the other hand, there is a universalist, pluralistic model that interprets bioethics as a global project, normatively grounded in the human rights system and responding to universal challenges. Based on a comparison of socio-cultural characteristics, historical conditions and practices in the USA and Russia, the unique contribution of the Russian school is formulated. The relevance of this study is determined, on the one hand, by the need for a systematic comparative analysis of Western and Russian bioethical paradigms, and on the other, by the need to identify the heuristic potential of the domestic model for addressing global health issues. The aim of this article is to reconstruct the main conceptual approaches to understanding the genesis, theoretical content, and sociocultural foundations of bioethics in the West and Russia, and to demonstrate that their mutual enrichment leads to the formation of a more sustainable and universal system of bioethical regulation adequate to the complexity of the modern era.