Your concerns are typically addressed by:
1. Reserve pricing - if no ad is 'good enough', e.g. no advertiser is willing to bid above a certain threshold for you, then no ad is shown
2. ePCM pricing - Adsense predicts what the likelihood of clickthrough/conversion is for a given ad and user, and includes that in its auction algorithm. Roughly, eCPM bid = cost per click / probability of click. This addresses the typical problem of high CPC/CPA bid but low engagement probability ads crowding out otherwise good CPM-based ads.
In general responsible advertisers have aligned incentives with viewers. Intrusive or obnoxious (or malicious) advertisements hurt viewers, who are less likely to return.