Munchausen by Proxy Syndrome
Roy Meadow first defined Munchausen by Proxy Syndrome (MBPS) in his 1977 paper "Munchausen Syndrome by Proxy - the hinterland of child abuse". He used it to describe the case of two children; one of who had suffered repetitive salt poisoning that later became fatal while the other underwent several investigative procedures for renal disease, which turned out to be fabricated by the mother. The cases seemed to correspond with Munchausen syndrome in that the children incurred many painful hospital procedures and admissions because of false stories and factitious signs but in these cases, the deception was not caused by the alleged patient themselves but by another person i.e. a proxy. This thus led to the term Munchausen by Proxy Syndrome. It is also known as Munchausen Syndrome by Proxy (MSBP) or Factitious Disorder by Proxy (FDP). By 1987, in a review by Rosenberg, the definition was listed as a syndrome cluster characterised by: -* Illness in a child that is faked or produced by a parent or caretaker* Persistent presentation of the child for medical assessment and care, usually resulting in several medical procedures* Denial of knowledge by the perpetrator of the cause of the illness in the child
Since it is, by nature, only circumstantially evidenced, it makes it difficult to understand the motivation behind MBPS perpetrators. Some mothers, when questioned after they have been revealed to be causing the factitious illness, claim that they did it as a cry for help. Libow's study of adult victims found that most of them had developed long-lasting and severe consequences. Doctors who already cannot resolve the illness of the child would feel very hesitant bout placing the blame on the sick child's mother. The accuracy of this diagnosis is important, not only to reduce the trauma suffered by the child, but to prevent a misdiagnosis. There might be a period of separation between mother and child, the legal expenses can be very high and the shame experienced by the family hard to overcome even after justification has been reached. The most recent revision of DSM-IV from the American Psychiatric Association (DSM-IV-TR, 2000) considered that there was insufficient information to warrant its inclusion as official categories or axes. Most patients never fully admit their role in their child's illness and seek to blame others e. MBPS involves parents, mainly mothers in a powerful controlling relationship whose goal is working through past humiliations with a powerful parental representative. It is a very significant minority of mothers/caretakers that have engaged in by-proxy activities that have also manifested symptoms of Adult Munchausen syndrome, either simultaneously or following public realisation of the child's factitious illness. A diagnosis of MBPS can only be made when a cluster of symptoms is present as earlier documented by Rosenberg in 1987. Despite all the evidence against her (including the testimony of 12 nurses!), all six members of the jury said that they believed she loved her daughter. This might be true in many other cases.
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Acceptance Essays
