Ethical considerations and challenges in the use of artificial intelligence in pediatric surgical practice: a national survey of Nigerian pediatric surgeons

Abstract

Background Use of artificial intelligence (AI) in surgical practice is gaining attention globally, but the ethics of use in pediatric surgery within low-resource settings remains unexplored. This study assessed the experiences of Nigerian pediatric surgeons, their ethical concerns, perceived challenges, and training needs regarding integration of AI. Methods A cross-sectional questionnaire-based survey was conducted among consultant pediatric surgeons and senior residents in Nigeria using KoboToolbox. The survey explored demographics, AI use, ethical concerns, and regulatory preferences. Data were analyzed descriptively. Results Of 140 eligible participants, 88 responded with a response rate of 62.9%. Sixty-seven (76.1%) respondents were consultant pediatric surgeons. Most respondents ( n =41, 46.6%) were aged between 40 and 49 years. The majority ( n =71, 80.7%) were males . Only one-third ( n =29, 33%) of the respondents reported having personally used AI in their pediatric surgical practice. Among those who had used AI, the most common area of application was research and literature review ( n =27, 30.7%). The majority of participants expressed significant ethical concerns related to AI use in pediatric surgical care. Accountability in adverse outcomes ( n =85, 96.6%), complexity of consent ( n =84, 95.5%), and equity of access to AI ( n =79, 89.8%) were among the ethical concerns. The majority ( n =70, 79.5%) of participants reported that they were not confident in the adequacy of existing Nigerian laws to regulate AI use in healthcare. Over half ( n =45, 51.1%) of participants chose the Medical and Dental Council of Nigeria as the body that should lead ethical regulation of AI in Nigeria. Conclusions The use of AI in pediatric surgery in Nigeria is uncommon and mostly academic. Key ethical concerns include accountability and consent requiring clear regulation and structured training programs.

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