Designing chatbots that can be trusted for patients with delusional infestation in the age of artificial intelligence

This Perspectives article explores the ethical and clinical implications of integrating artificial intelligence (AI) chatbots into psychodermatology, focusing on patients with delusional infestation. We raise the central ethical question of whether chatbots should be designed to withhold or reframe certain facts in sensitive clinical contexts, acknowledging the intricate and unresolved tensions between the ethical principles of autonomy, nonmaleficence and medical paternalism. By integrating insights from dermatology, psychiatry and digital ethics, we highlight the importance of designing patient-centred AI tools and aim to spark interdisciplinary dialogue regarding this complex issue.