Artificial intelligence (AI) is increasingly being explored for use in emergency medical dispatch systems (EMDS), where rapid and reliable decision-making is essential. While AI has the potential to support dispatchers by improving risk assessment and triage consistency, its application in this high-stakes and emotionally charged context raises significant ethical questions. To provide guidance for responsible implementation, this study follows a design science research (DSR) approach combining a systematic literature review and expert interviews as grounding. This process resulted in the identification of nine design requirements (DRs) and the development of six design principles (DPs) that emphasize human oversight, transparency, privacy, bias mitigation, communication support and professional competence. The results offer actionable guidance for designing AI-supported EMDS that enhance decision processes while preserving ethicality.