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Munchausen Syndrome by Proxy: Clinical Review and Legal Issues

NCJ Number
129542
Journal
Behavioral Sciences and the Law Volume: 9 Issue: 1 Dated: (Winter 1991) Pages: 73-83
Author(s)
B Kahan; B C Yorker
Date Published
1991
Length
11 pages
Annotation
This article presents a case study of Munchausen syndrome by proxy, an underrecognized form of child abuse in which a parent feigns or creates an illness in a child with the specific objective of subjecting that child to unnecessary diagnostic tests and treatments. The syndrome ranges from false reports of allergies to life-threatening abuses such as poisoning.
Abstract
Boys and girls are equally victims of this syndrome; the average age of the victim is four or five years at the time of diagnosis and the perpetrator is almost always the mother. Older children often actively participate in the deception. Some of the warning signs of Munchausen syndrome by proxy include recurrent illnesses with no clear explanation, discrepancies between medical histories and clinical findings, parents who welcome invasive testing and have a good deal of medical knowledge, and symptoms that disappear when the parent is absent. Temporary custody orders, psychiatric evaluation of the child and family, and ongoing support and therapy are components of syndrome management. The difficulty of procuring evidence of this type of child abuse is perhaps the greatest legal obstacle to intervention by medical practitioners. Constitutional issues involved in Munchausen syndrome by proxy include the parents' right to privacy, due process, and probable cause needed to conduct a search. 3 tables and 40 references (Author abstract modified)