Tuesday, February 03, 2004
By Wendy McElroy

Munchausen Syndrome by Proxy (MSBP) is the psychiatric diagnosis by which a parent -- almost always a mother -- is believed to intentionally harm or kill a child in order to garner attention.

Diagnosing a mother as having MSBP is a tool often used by the state to remove children from the care of the parent, terminate parental rights or in the case of a child's death, charge the parent with murder. Now, due to a raging scandal in Britain, that diagnosis is being discredited.

According to British newspapers, over the last decade, thousands of British women who sought medical treatment for their children were in fact risking being diagnosed

with MSBP -- a diagnosis that could lead to the termination of parental rights but also to imprisonment. Perhaps as many as tens of thousands of children have been taken by the state from their parents on the basis of  "expert" testimony that the parent had MSBP. 

But with MSBP’s originator -- pediatrician Sir Roy Meadow -- under government investigation, British authorities are being forced to re-examine cases dating back to 1996. The Guardian comments: "[T]he fallout from the Meadow affair is set to go global. Thousands of families around the world who have had their children taken into care are to demand their cases be re-examined."

In recent years, a slew of articles on MSBP have appeared in American medical journals. An August, 2003, FBI Law Enforcement Bulletin included an article entitled "Munchausen Syndrome by Proxy: the importance of behavioral artifacts." Some American doctors, such as Dr. Marc Feldman, advertise online their availability to testify as expert witnesses in MSBP trials.

According to the Chicago Sun-Times, Feldman estimates there are more than 1,200 new cases of Munchausen's by Proxy annually in the United States. Organizations like Mothers Against MSBP Accusations (MAMA) have sprung up in "response to the fast growing number of false allegations" of MSBP. MAMA claims "families across America, Britain, Australia, Canada and New Zealand are being destroyed by doctors and other professionals who make false and even malicious allegations against desperate mothers of chronically/critically ill children."

The London Times points out that, this week, "the first anti-Munchausen’s conference will take place in Australia."

How will the furor impact North America? The best indication may be the unfolding events across the Atlantic.

The scandal in Britain was sparked by a High Court review that revealed three mothers had been wrongly accused based on his testimony. In one case, where a family had lost two children to unexplained infant deaths, Meadow assessed the odds of this happening at one-in-73 million; that figure sent the mother to jail. In that case, Meadow’s math was rejected by the Royal Statistical Society, which issued a press release advising the government of a misconduct of justice.

The three cases are not isolated. Attorney General Lord Goldsmith has announced an investigation into 258 other verdicts. With the High Court’s reversal of "Meadow’s cases," the news magazine The Economist aptly stated in its Jan. 24 issue, "an entire medical and legal edifice collapsed." It is not merely Meadow’s credibility but also the research upon which MSBP rests -- research inexplicably shredded by Meadow -- which is under attack.

The anxiety of anti-MSBP campaigners, who have been vocal since 1996, now revolves around one question: what happens next?

Parents cry out "return our children!" But Margaret Hodge, the British minister for children, says it may be wrong to do so. Admitting that tens of thousands of children could be involved, Hodge maintains: "If an adoption order was made … 10 years ago, what is in the real interest of the child? … [I]f the child was adopted at birth the sensible thing to do is to let it stay."

At least three factors strongly contributed to this sustained debacle in Britain.

First, medical advances and educational campaigns have caused a marked decrease in "cot deaths" that is, unexplained deaths of babies in Britain. Over the last decade, The Economist explained that the number of such deaths "halved … and has since fallen to around 300." But the fact that fewer babies die mysteriously casts greater suspicion upon those who do. Someone must be to blame.

Second, in both Britain and North America, there has been a great willingness some would say a great eagerness to place legal blame upon parents for any problem concerning children. Every bruise seems to raise the specter of child abuse. The Economist reports, "As early as 1995, the Canadian government was encouraging investigators in cot death cases to ‘think dirty’ a slogan later picked up in other countries where infant deaths had fallen." Parents were considered guilty until proven innocent.

As one Web site claims, "It's been estimated that as many as one in five cot deaths is really … Munchausen Syndrome By Proxy." (The "murdering" mother is said to bask in widespread sympathy even as she poses a threat to her other children.)

Third, there has been a lack of accountability.

The Guardian pointed to high-level negligence: Prime Minister Tony Blair and key officials ignored warnings from "a leading child psychologist and former government adviser" regarding several cases in which parents had been wrongly separated from children because of MSBP accusations. The British child welfare system seems to be systemically flawed.

The parallels between Britain and North America are too strong for the scandal not to ripple over. Soon, courts over here may be reversing verdicts; officials may be weighing whether to return children to parents who are strangers. The facts of MSBP -- is it a valid psychiatric condition and, if so, what is the prevalence? -- may be lost in the emotional explosion.

Wendy McElroy is the editor of ifeminists.com and a research fellow for The Independent Institute in Oakland, Calif. She is the author and editor of many books and articles, including the new book, "Liberty for Women: Freedom and Feminism in the 21st Century" (Ivan R. Dee/Independent Institute, 2002). She lives with her husband in Canada.


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