Medical Intelligent Systems (MIS) are increasingly integrated into healthcare workflows, offering significant benefits but also raising critical safety and ethical concerns. According to the European Union AI Act, most MIS will be classified as high-risk systems, requiring a formal risk management process to ensure compliance with the ethical requirements of trustworthy AI. In this context, we focus on risk reduction optimization problems, which aim to reduce risks with ethical considerations by finding the best balanced assignment of risk assessment values according to their coverage of trustworthy AI ethical requirements. We formalize this problem as a constrained optimization task and investigate three resolution paradigms: Mixed Integer Programming (MIP), Satisfiability (SAT), and Constraint Programming(CP).Our contributions include the mathematical formulation of this optimization problem, its modeling with the Minizinc constraint modeling language, and a comparative experimental study that analyzes the performance, expressiveness, and scalability of each approach to solving. From the identified limits of the methodology, we draw some perspectives of this work regarding the integration of the Minizinc model into a complete trustworthy AI ethical risk management process for MIS.