A new research direction in relation to Generative Artificial Intelligence (GAI) is the use of state-of-the-art technologies in future medical systems, typically, in personalized and predictive medicine. One of the promising areas is the ability to use large models for medical and personalized treatment. Another promising area is the ability to generate synthetic images containing relevant information for the identification of medical conditions. To ensure the responsible use of GAI, a framework is proposed that integrates the ethical dimensions associated with future medical activities. In ophthalmology, the use of GAI for generating Optical Coherence Tomography (OCT) images not only facilitates the expansion of datasets required for training predictive models but also promotes the development of personalized methods for early-stage glaucoma detection. The framework, based on a pyramidal structure, encompasses fundamental principles such as data confidentiality and protection, fairness of access, algorithmic transparency, social impact, ethical responsibility, and, not least, clinical validation. Adherence to fundamental ethical principles serves as a cornerstone in the responsible integration of artificial intelligence-based technologies into medical practice, ensuring their effectiveness.