The autonomous vehicle (AV) is one of the first commercialized AI-embedded robots to make autonomous decisions. Despite technological advancements, unavoidable AV accidents that result in life-and-death consequences cannot be completely eliminated. The emerging social concern of how an AV should make ethical decisions during unavoidable accidents is referred to as the moral dilemma of AV, which has promoted heated discussions among various stakeholders. However, there are research gaps in explainable AV ethical decision-making processes that predict how AVs’ moral behaviors are made that are acceptable from the AV users’ perspectives. This study addresses the key question: What factors affect ethical behavioral intentions in the AV moral dilemma? To answer this question, this study draws theories from multidisciplinary research fields to propose the “Integrative ethical decision-making framework for the AV moral dilemma.” The framework includes four interdependent ethical decision-making stages: AV moral dilemma issue framing, intuitive moral reasoning, rational moral reasoning, and ethical behavioral intention making. Further, the framework includes variables (e.g., perceived moral intensity, individual factors, and personal moral philosophies) that influence the ethical decision-making process. For instance, the framework explains that AV users from Eastern cultures will tend to endorse a situationist ethics position (high idealism and high relativism), which views that ethical decisions are relative to context, compared to AV users from Western cultures. This proposition is derived from the link between individual factors and personal moral philosophy. Moreover, the framework proposes a dual-process theory, which explains that both intuitive and rational moral reasoning are integral processes of ethical decision-making during the AV moral dilemma. Further, this framework describes that ethical behavioral intentions that lead to decisions in the AV moral dilemma are not fixed, but are based on how an individual perceives the seriousness of the situation, which is shaped by their personal moral philosophy. This framework provides a step-by-step explanation of how pluralistic ethical decision-making occurs, reducing the abstractness of AV moral reasoning processes.