Abstract
Machine learning-based artificial intelligence (AI) chatbots are increasingly used to promote health and encourage individuals to adopt healthier behaviors. Chatbots driven by generative AI (genAI) simulate human interactions through text or voice to generate personalized content with guidance on topics such as smoking cessation, nutrition, managing stress, and sleep improvement. The use of AI chatbots for health promotion and wellness has been growing since 2023. While empirical evidence suggests their effectiveness in supporting behavioral change and mental health, the legal, ethical, and societal implications remains largely unexplored. This article presents a qualitative case study of S.A.R.A.H. (Smart AI Resource Assistant for Health), a genAI chatbot developed by the World Health Organization (WHO), analyzed against the six ethical principles outlined in the WHO's 2021 Guidance on Ethics and Governance of AI for Health. We also gathered exploratory insights from adolescent focus groups. These findings are descriptive and not based on formal thematic analysis. Drawing on this analysis, we identify key gaps between high-level ethical principles and practice and offer policy recommendations to guide responsible use of AI chatbots for health promotion.