Primary care increasingly depends on hybrid environments that integrate artificial intelligence, clinical decision-support systems, digital infrastructures, and distributed information flows. These forms of non-biological agency generate clinically relevant actions but fall outside the traditional life-centered foundations of bioethics. This results in responsibility gaps in areas such as algorithmic triage, automated alerts, digital diagnostic systems, and human–machine shared decision-making. A framework capable of grounding ethical relevance in agency rather than biological life is needed to support safer and more accountable practice in general medicine.This study aimed to develop and evaluate Agenoethics, a conceptual framework that grounds ethical responsibility in agency (agens) rather than life (bios). The primary objective was to assess whether this model offers clearer responsibility attribution in primary care contexts involving human, technological, and hybrid actors.Structured conceptual analysis conducted using: – historical clinical ruptures (e.g., transplantation, IVF, genome editing) to test the limits of life-based ethical models; – philosophical analysis drawing from action theory, responsibility theory, and autonomy; – cross-domain case analysis involving artificial intelligence, digital infrastructures, and distributed decision-making in primary care; – construction of an Ethical Continuum Model tracing responsibility through decision, action, effect, self-realisation, and reassessment; – development of two operational tools applicable to general practice: the Concentric Responsibility Map and the Responsibility Index Matrix.Findings indicate that ethical salience arises from agency with causal or probabilistic influence, regardless of whether the agent is biological. Vulnerability functions as a horizon that scales ethical weight but does not ground it. Responsibility in primary care emerges as a recursive process rather than a single event. The mapping tools identified responsibility gaps in algorithm-assisted diagnostics, telemedicine infrastructures, and distributed clinical workflows of contemporary general practice.Re-grounding ethics in agency clarifies responsibility relationships in environments where clinical reasoning is shared between humans and technological systems. This approach complements existing bioethical principles while addressing modern challenges such as automation, opacity, and distributed agency.Agenoethics offers a coherent and operational ethical foundation for primary care in technologically mediated environments. By centering ethics on agency rather than biological life, the framework enhances accountability and supports safer and more transparent clinical practice.