A Radiologist's Response to “Ethical Concerns Regarding Time-restricted Intussusception Reduction Policies”

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Mann et al. discuss “standards of care” as if they were static, constant, and evidence-based. Often, however standards of care are not evidence-based and evolve as new data and information becomes available [1]. Sometimes these changes occur subtly without random controlled trials. A great example is the management of intraperitoneal abscesses. Fifteen to twenty years ago, the standard of care was “never let the sun set on an abscess” and surgeons or interventional radiologists and their associated support teams were often summoned in the middle of the night to drain the abscesses.

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Article · Jun 2025 · 1 min read

In brief

A radiologist responds to ethical concerns about time-restricted intussusception reduction policies, arguing that standards of care evolve with new evidence rather than remaining static. The author draws parallels to changing practices in intraperitoneal abscess management to illustrate how clinical protocols adapt over time without necessarily requiring randomized controlled trials.

Standards of care are not static—they evolve as new data emerges, often without randomized controlled trials.
Historical example: intraperitoneal abscess management shifted from urgent overnight drainage to more measured approaches.
Evidence-based practice requires recognizing that 'standard of care' can change subtly over time with accumulated experience.
The 'never let the sun set on an abscess' doctrine has been reconsidered as clinical understanding advanced.

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