Munchausen Syndrome by Proxy Can Inflame Needless Fears 6 June 2004
Craft and Hall(1) suggest that we must not forget everything we have learned over the past 40 years about child abuse. But do not forget that we fall off both sides of the horse.

To his surprise, Roy Meadow(2) admitted in 1995 that Munchausen syndrome by proxy had become so popular that it was being overused and misunderstood by some social workers and legal professionals. Since then, many have tried to define the disorder in a way that avoids over-inclusion and diagnostic error. However, the medical literature does not convey the prevalence of these misunderstandings or the devastating consequences, especially as they unfold in juvenile courts across the country. In my experience, most of these mothers have problems that should have been solved clinically, but instead they became entangled in a confrontational legal system.

I have written 22 reports on mothers accused of Munchausen syndrome by proxy, and I offer them to any institutionally approved committee investigating this disorder. Although some describe tragic child abuse, the majority illustrate how quickly this diagnosis can enflame needless fears.

1. Craft AW, Hall MB. Munchausen syndrome by proxy and sudden infant death syndrome. BMJ 328:1309-1312.

2. Meadow R. What is, and what is not, "Munchausen syndrome by proxy?" Arch Dis Child 1995;72:534-538.

Competing interests: I provide consultations on MSbP.


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