ABSTRACT
Artificial intelligence (AI) is reshaping clinical decision-making in Nigeria, exposing gaps in doctrines built for exclusively human judgment. This article reconstructs medical negligence for AI-driven care by proposing a Nigerian Standard of Reasoned Justification (SRJ) – a unified test that requires empirical competence, logical defensibility, respect for autonomy, and institutional responsibility. Grounded in Okonkwo v MDPDT and read alongside Bolam, Bolitho, and Montgomery, the SRJ is shown to be an inevitable doctrinal articulation of Nigeria’s existing legal and ethical mandates rather than an imported novelty. The paper maps distributed liability across clinicians, institutions, and developers; identifies evidentiary barriers under the Evidence Act 2011 (s 84); and advances targeted reforms: (i) amend the Evidence Act to recognise machine-generated audit trails and metadata; (ii) extend device oversight to Software as a Medical Device (SaMD); (iii) establish a National Health Data and AI Governance Council (NHDAIGC) and a National Health AI Governance Framework (NHAIGF); and (iv) leverage the NHIA Act 2022 so that accreditation and reimbursement are contingent on SRJ compliance, embedding algorithmic safety into routine governance. Situated within African bioethics (ubuntu) and constitutional commitments to dignity, equality, and the right to health, the SRJ offers a legally sound, culturally authentic, and operationally practical pathway for safe, explainable, and accountable AI in Nigerian healthcare.
Elgujja, Abba, Reconstructing Medical Negligence for AI-Driven Care: Toward a Nigerian Standard of Reasoned Justification (October 12, 2025).
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