A MITRE D3FEND guided blockchain based cyber resilient framework for IPv6 based 6G enabled healthcare networks.

The proliferation of Internet of Medical Things (IoMT) devices in 6G-enabled healthcare networks introduces critical cybersecurity challenges, including expanded attack surfaces, device heterogeneity, and real-time security requirements that traditional perimeter-based frameworks cannot adequately address. This paper proposes a Blockchain-Enabled Zero-Trust Architecture (B-ZTA), guided by the MITRE D3FEND defensive ontology, integrating Zero Trust micro-segmentation, a Random Forest-based intrusion detection system, and a lightweight Proof-of-Authority blockchain for deterministic policy enforcement. The framework is validated through MATLAB-based simulations rather than physical IoMT deployment, across 30 independent trials under diverse cyberattack scenarios in a simulated 62-device hospital environment. Under the evaluated scenarios, results indicate a 99.10% Threat Neutralization Rate, mean enforcement latency of 76.68 ms, and 95th percentile latency of 249.86 ms, satisfying 6G eMBB and mMTC latency requirements for IoMT monitoring use cases. Quantitative benchmarking against five state-of-the-art frameworks yields a composite security score of 91.8. These findings suggest promise for the B-ZTA approach within the simulated environment, with physical testbed validation and adversarial robustness evaluation identified as priority directions for future work.