Artificial intelligence (AI) is increasingly influencing various sectors of healthcare, but its integration into pediatric surgery faces significant ethical challenges. A comprehensive survey conducted by a national team of pediatric surgeons from the Federal Medical Centre in Umuahia, Nigeria, reveals that while there is recognition of AI’s potential to enhance diagnostic accuracy and improve clinical decision-making, practical application remains limited.
The study, published on October 20, 2025, in the World Journal of Pediatric Surgery (WJPS), assessed the perceptions and experiences of 88 pediatric surgeons across six geopolitical zones in Nigeria. Although AI’s capabilities are advancing globally, only one-third of respondents reported ever using AI, primarily for non-clinical tasks such as literature searches. Very few utilized AI for diagnostic purposes or surgical planning, highlighting a disconnect between technological advancements and everyday practice in pediatric surgery.
Concerns regarding ethics and accountability emerged as predominant themes in the survey findings. Surgeons expressed apprehension about the implications of AI-related errors, the complexities surrounding informed consent for minors, and the risks associated with patient data privacy. Additionally, the potential for algorithmic bias and reduced human oversight raised alarms among practitioners.
Many surgeons viewed transparency with families as critical but opinions varied. Some advocated for informing parents about AI’s role in care, while others believed disclosure was unnecessary when AI did not directly influence clinical decisions. A significant proportion of respondents indicated low confidence in existing legal frameworks governing AI use in healthcare, emphasizing the need for stronger regulatory leadership and clearer guidelines.
The research team noted, “The results show that pediatric surgeons are not opposed to AI—they simply want to ensure it is safe, fair, and well regulated.” They highlighted the urgent need for structured governance to address ethical concerns, including accountability, informed consent, and data protection, before AI can be confidently employed in pediatric settings.
In addition to ethical considerations, the study pointed out challenges unique to pediatric surgery. The limited autonomy of children complicates decision-making, necessitating parental involvement, which adds layers of complexity to informed consent processes. In low-resource environments, issues such as inadequate infrastructure and data representativeness further hinder the adoption of AI technologies.
As AI continues to evolve, the study underscores the necessity for pediatric-specific ethical frameworks and clearly defined accountability mechanisms for AI-assisted care. Strengthening data governance, enhancing digital infrastructure, and expanding AI literacy among clinicians and families are essential steps toward fostering trust in AI technologies.
The findings advocate for clear national guidelines and practical training programs to prepare pediatric surgeons for future AI integration. By addressing these ethical and practical challenges, the medical community can work towards making AI a valuable tool in pediatric surgical care while safeguarding the interests of vulnerable patients.
