Do children need to know? Clinical and ethical concerns With caregivers not telling children about surgery

jpedsurg.org

On the morning of surgery, the mother of a 5-year-old child scheduled for G-tube placement after several months of NG-tube use due to inadequate nutritional intake, informed the clinical staff that she had not discussed the procedure with the child, expressing concern about his reaction. The patient was known to exhibit anxiety in medical environments, with particular distress when faced with unexpected procedures or changes in routine. He had no prior knowledge of the planned G-tube surgery. Members of the clinical team suggested that they help the mom provide developmentally appropriate preparation to the child while in the pre-op area, emphasizing the importance of honest, trauma-informed communication and noting that the child would wake with the tube and might experience confusion or distress if unprepared.

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Article · Oct 2025 · 1 min read

In brief

This case examines the ethical and clinical challenges when a caregiver chooses not to inform a 5-year-old child about planned G-tube surgery on the day of the procedure. The clinical team advocates for developmentally appropriate preoperative preparation to minimize postoperative confusion and distress, highlighting the importance of trauma-informed communication in pediatric surgical care.

Preoperative disclosure to pediatric patients is ethically important even when parents prefer nondisclosure due to anticipated anxiety.
Children who wake from surgery with unexpected devices (e.g., G-tubes) may experience confusion, distress, and erosion of medical trust.
Developmentally appropriate preparation in the preoperative area can mitigate trauma while respecting parental concerns about timing.
Trauma-informed communication balances parental authority with the child's right to honest information about their own body and care.
Clinical teams should proactively address parental hesitancy about disclosure to prevent postoperative psychological harm to the child.

Written by the GCMD Library team from the article.

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