As Artificial Intelligence (AI) continues to play an increasingly pivotal role in medical decision support systems, the ethical implications of its integration into healthcare practices demand comprehensive examination. This review delves into the ethical considerations surrounding AI-enhanced medical decision support systems, aiming to provide insights into the challenges, existing frameworks, exemplary practices, and emerging trends in this rapidly evolving field. The significance of ethical considerations is underscored by the patient-centric focus, emphasizing the impact of AI on patient outcomes and the delicate balance between technological advancements and patient welfare. Trust and transparency emerge as critical pillars, exploring the role of trust in medical decision-making and the imperative of ensuring transparency in AI algorithms to foster confidence among healthcare professionals and patients. Ethical challenges, including privacy and confidentiality concerns, biases in AI algorithms, and issues related to informed consent, are thoroughly examined. Strategies for safeguarding patient data, mitigating biases, and transparently communicating with patients are explored to address these challenges. The role of accountability and responsibility is delineated, defining the ethical responsibilities of both healthcare professionals and AI developers. The review surveys existing ethical frameworks in healthcare AI and evaluates their applicability and effectiveness. Additionally, it highlights recent proposals for ethical guidelines, emphasizing the need to integrate ethical considerations into the entire development life cycle of AI-enhanced medical decision support systems. Case studies and exemplary practices from healthcare institutions implementing ethical AI serve to illustrate real-world applications and offer insights into best practices. The evolving landscape of ethical AI research is explored, showcasing ongoing initiatives and potential innovations that hold promise for addressing ethical challenges in the future. This review underscores the paramount importance of ethical considerations in the integration of AI into medical decision support systems. It provides a comprehensive overview of current challenges, existing frameworks, exemplary practices, and emerging trends, emphasizing the ongoing need for vigilance and ethical governance to ensure the responsible and beneficial deployment of AI in healthcare.