Munchausen's Syndrome and Munchausen by Proxy Syndrome (MBPS)
Munchausen's and Munchausen by Proxy Syndrome (MBPS) - Munchausen's Syndrome is a disorder in which an individual repeatedly fakes or exaggerates their own illness or medical symptoms in order to manipulate the attentions of medical professionals or caregivers. Munchausen by Proxy Syndrome (MBPS) is a similar syndrome in which another individual, commonly a child, is substituted for the patient and made the focus of inappropriate medical attention.
In Munchausen by Proxy Syndrome (MBPS), an individual - typically a mother - deliberately makes another person (most often his or her own preschool child) sick or convinces others that the person is sick. The parent or caregiver misleads others into thinking that the child has medical problems by reporting fictitious episodes. He or she may exaggerate, fabricate, or induce symptoms. As a result, doctors commonly order tests, experiment with medications and, in severe cases, may hospitalize the child or perform surgery to determine the cause.
Typically, the perpetrator feels satisfied when he or she has the attention and sympathy of doctors, nurses, and others.
It should be noted that there is strong controversy over the existence of Munchausen by Proxy Syndrome. The originator of the term, British Pediatrician Roy Meadow was discredited for misrepresenting statistical data in his expert witness testimony in the conviction of mothers of children who died from cot deaths (also known as Sudden Infant Death Syndrome - or SIDS). In a nutshell, he testified that the likelihood of more than one incidence of SIDS in a single family was so remote as to warrant a conviction. Several cases in which he testified have since been overturned in British Courts. Critics of the MBPS theory correctly point out that child abuse is child abuse and the burden of proof must be to reveal objective evidence of abuse prior to removing children from parental custody. For more information regarding the MBPS controversy see the links at the bottom of this page.
In some MBPS cases, since the parent or caregiver appears concerned, wrongdoing is not suspected. Frequently, the perpetrator is familiar with the medical profession and is skilled at fooling medical staff. It is not unusual for medical personnel to overlook the possibility of Munchausen by Proxy Syndrome because of the controversy surrounding it or because it goes against the commonly held belief that a parent or caregiver would never deliberately hurt his or her own child.
Children who are subject to Munchausen by Proxy Syndrome are typically preschool age, although there have been reported cases in children up to 16 years old. There are equal numbers of boy and girl victims of MBPS.
A parent observes symptoms of illness in a child that nobody else can detect, and insists that a battery of tests be performed.
A child contracts a common virus and the mother attributes the symptoms to an undiagnosed chronic condition.
A child is developing normally, but the mother insists she can detect symptoms of a mental disorder.
What it feels like:
For a child of a parent who is exposing them to MPBS - they may be made to feel alarm or discomfort as a series of strangers intrusively examine and interrogate them looking for things that might be wrong. They are frequently receiving the message from grown-ups that something is wrong with them. This can lead to developmental delay, fear of strangers - especially doctors and a distorted world-view .
For third parties - spouses or relatives of people exhibiting MBPS-like behaviors this can be a confusing and frightening experience. You may not have all the facts you need to judge what is really going on. On the one hand - you do not want to keep a child away from critical medical care when they need. On the other hand, you do not want the child to be exposed to unnecessary and intrusive investigations and diagnoses, not to mention the associated psychological and physical damage.
For doctors and health care professionals - it can be disturbing and frightening when confronted with a parent who is possibly manifesting MBPS. There is the underlying fear of a malpractice accusation when facing a parent who will not take "no" for an answer. There can also be the confusion of having to deal other family members who vehemently disagree on what the facts are. Many doctors ultimately err on the side of caution - referring to specialists and ordering additional tests and over-medicating and over-diagnosing just to protect themselves. This succeeds in protecting the doctor but is often not in the best interests of the child.
What NOT to Do:
When dealing with a possible MBPS problem:
Don't get into arguments with the perpetrator.
Don't go it alone or try to solve the problem yourself.
Don't interrogate the child or share with them your disapproval of their parent.
Don't ignore the problem. Don't abdicate the problem to others. A child is possibly being abused. You must act.
What TO Do:
Seek advice from a well-qualified attorney, Guardian ad litem or children's advocate.
Document all that you have observed as thoroughly and candidly as you can.
Report what you have seen. Be honest about what you know AND what you don't know (it will be uncovered anyway). Be objective and sincere - remember - it is a child you are representing and you must put the best interests of the child ahead of your own.
If you have regular contact with the child, assure them of their value, and praise their positive qualities.
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