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    <Journal>
      <PublisherName>journal-jmsr</PublisherName>
      <JournalTitle>Journal of Medical and Surgical Research</JournalTitle>
      <PISSN>I</PISSN>
      <EISSN>S</EISSN>
      <Volume-Issue>Vol. XIII, n 1</Volume-Issue>
      <PartNumber/>
      <IssueTopic>Multidisciplinary</IssueTopic>
      <IssueLanguage>English</IssueLanguage>
      <Season>June 2026</Season>
      <SpecialIssue>N</SpecialIssue>
      <SupplementaryIssue>N</SupplementaryIssue>
      <IssueOA>Y</IssueOA>
      <PubDate>
        <Year>-0001</Year>
        <Month>11</Month>
        <Day>30</Day>
      </PubDate>
      <ArticleType>JMSR e-Health</ArticleType>
      <ArticleTitle>Health 4.0: Balancing Technological Innovation and Ethics through the CyberEthics H4.0 Framework</ArticleTitle>
      <SubTitle/>
      <ArticleLanguage>English</ArticleLanguage>
      <ArticleOA>Y</ArticleOA>
      <FirstPage>0</FirstPage>
      <LastPage>0</LastPage>
      <AuthorList>
        <Author>
          <FirstName>Aya</FirstName>
          <LastName>Ouarhim</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>N</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Ahlam</FirstName>
          <LastName>Achchar</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Mustapha El</FirstName>
          <LastName>Bakkali</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Khalid</FirstName>
          <LastName>Ennibi</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>El Arbi</FirstName>
          <LastName>Bouaiti</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
        </Author>
      </AuthorList>
      <DOI/>
      <Abstract>Introduction: Health 4.0, integrating artificial intelligence (AI), the Internet of Things (IoT), and big data into healthcare, offers opportunities to transform medical practice and improve patient care. However, its development raises ethical concerns involving privacy, autonomy, equity, accountability, and human oversight. Methods: We conducted a conceptual narrative review and ethical analysis based on peer-reviewed literature and authoritative governance documents identified through a targeted search completed on 31 December 2025. The analysis examined informed consent, data governance, cybersecurity, health equity, transparency, accountability, and human oversight. Results: Several interconnected ethical challenges were identified. Extensive collection and secondary use of health data may compromise privacy, autonomy, and meaningful informed consent. AI- and IoT-driven healthcare may also widen existing inequalities because of unequal access to digital infrastructure and technological resources. Increasing automation raises concerns regarding transparency and responsibility when technological systems contribute to errors or adverse outcomes. Based on these findings, we propose CyberEthics H4.0, an integrative framework encompassing cybersecurity, data governance, dynamic consent, equity, transparency, human oversight, and distributed accountability across the technology lifecycle. Discussion: These challenges require coordinated rather than isolated responses. Consent should become dynamic and continuous, while cybersecurity and data governance should be embedded throughout the technology lifecycle. Equitable access, digital literacy, transparency, and human oversight are essential to prevent exclusion and clarify accountability among healthcare professionals, developers, institutions, and regulators. Conclusion: Responsible Health 4.0 requires technological innovation to be accompanied by robust ethical governance. CyberEthics H4.0 provides a conceptual framework for integrating ethical principles throughout the technology lifecycle. Continuous ethical deliberation and adaptive regulation will be essential as digital healthcare continues to evolve.</Abstract>
      <AbstractLanguage>English</AbstractLanguage>
      <Keywords>Ethical issues,Health 4.0,Technological tools,Informed consent,Human rights,Confidentiality</Keywords>
      <URLs>
        <Abstract>https://journal-jmsr.net/ubijournal-v1copy/journals/abstract.php?article_id=16353&amp;title=Health 4.0: Balancing Technological Innovation and Ethics through the CyberEthics H4.0 Framework</Abstract>
      </URLs>
      <References>
        <ReferencesarticleTitle>References</ReferencesarticleTitle>
        <ReferencesfirstPage>16</ReferencesfirstPage>
        <ReferenceslastPage>19</ReferenceslastPage>
        <References/>
      </References>
    </Journal>
  </Article>
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