{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:17:08Z","timestamp":1789993028601,"version":"4.0.1"},"reference-count":106,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Artif. Intell."],"abstract":"<jats:p>\n                    Digital Twins for Health (DT4H), defined as dynamic, data-driven,\n                    <jats:italic>in silico<\/jats:italic>\n                    representations of individuals, organs, medical devices, clinical workflows, or healthcare systems, are emerging as a promising paradigm for transforming healthcare. DT4H systems have the potential to advance personalized medicine, treatment optimization, disease prediction, drug discovery, clinical trials, and health system planning. However, their real-world development and deployment also raise important ethical, legal, and social implications (ELSI). Because DT4H systems rely on sensitive longitudinal health data and may directly inform clinical decision-making, they introduce significant concerns related to their development, use, and ongoing governance. Many of these concerns are not entirely new, as they are grounded in established bioethical principles and substantially overlap with ELSI frameworks developed for AI for healthcare (AI4H). Accordingly, rather than examining DT4H-related ELSI issues in isolation, this survey situates them within existing bioethical and AI4H frameworks while identifying the distinctive challenges that arise from the unique characteristics of DT4H and must be addressed to support their ethical, responsible, and trustworthy development and deployment.\n                  <\/jats:p>","DOI":"10.3389\/frai.2026.1875471","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:56:43Z","timestamp":1789991803000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A survey on ethical digital twins in healthcare"],"prefix":"10.3389","volume":"9","author":[{"given":"Chaw","family":"Maung","sequence":"first","affiliation":[{"name":"Information Systems Department, University of Maryland Baltimore County","place":["Baltimore, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nia","family":"Richard","sequence":"additional","affiliation":[{"name":"Information Systems Department, University of Maryland Baltimore County","place":["Baltimore, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimei","family":"Pan","sequence":"additional","affiliation":[{"name":"Information Systems Department, University of Maryland Baltimore County","place":["Baltimore, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1159\/000543483","article-title":"Digital twins: the future of personalized nutrition and health?","volume":"18","author":"Abrahams","year":"2025","journal-title":"Lifestyle Genomics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1109\/SIEDS69358.2026.11540317","article-title":"\u201cDigital twins in healthcare: creating a framework for ethical use,\u201d","author":"Acevedo","year":"2026","journal-title":"2026 Systems and information engineering design symposium (SIEDS)"},{"key":"B3","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1109\/SDS64317.2024.10883917","article-title":"\u201cA novel model for digital twins in mental health: the biopsychosocial AI-driven digital twin (badt) framework,\u201d","author":"Alimour","year":"2024","journal-title":"2024 11th International conference on software defined systems (SDS)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1080\/15265161.2023.2237456","article-title":"In their own image: ethical implications of the rise of digital twins\/clones\/simulacra in healthcare","volume":"23","author":"Amram","year":"2023","journal-title":"Am. 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