Muchausens By Proxy Speak out on Mothers Day

I'm being poisioned by Mother's Day references this week. As a survivor of Munchausens by proxy I must use this opportunity to speak out.

In Münchausen syndrome by proxy, an adult caregiver makes a child appear mentally or physically ill or impaired by either fabricating symptoms or actually causing harm to the child, in order to gain the attention of medical providers and others. In order to perpetuate the medical relationship, the caregiver systematically misrepresents symptoms, fabricates signs, manipulates laboratory tests, or even purposely harms the child (e.g. by poisoning, suffocation, infection, physical injury). Studies have shown a mortality rate of between 6% and 10% of MSbP victims, making it perhaps the most lethal form of abuse.

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Also unique to this form of abuse is the role that health care providers play by actively, albeit unintentionally, enabling the abuse. By reacting to the concerns and demands of perpetrators, medical professionals are manipulated into a partnership of child maltreatment.

Article
The cause of Munchausen syndrome is not known, according to the National Institutes of Health. “This syndrome almost always involves a mother abusing her child by seeking unneeded medical attention for the child,” according to its website. “It is rare and poorly understood.”

Warning signs of the disorder include:

A child who has one or more medical problems that do not respond to treatment or that follow an unusual course that is persistent, puzzling, and unexplained. Caused and/or portrayed/brought on by caretaker; particularly mother.
Physical or laboratory findings that are highly unusual, discrepant with patient's presentation or history, or physically or clinically impossible.
A parent who appears to be medically knowledgeable, fascinated with medical details and hospital gossip, appears to enjoy the hospital environment, and expresses interest in the details of other patients' problems.
A highly attentive parent who is reluctant to leave their child's side and who themselves seem to require constant attention.
A parent who appears to be unusually calm in the face of serious difficulties in their child's medical course while being highly supportive and encouraging of the physician, or one who is angry, devalues staff, and demands further intervention, more procedures, second opinions, and transfers to other more sophisticated facilities.
The suspected parent may work in the health care field themselves or profess interest in a health-related job.
The signs and symptoms of a child's illness do not occur in the parent's absence (hospitalization and careful monitoring may be necessary to establish this causal relationship).
A family history of similar or unexplained illness or death in a sibling.
A parent with symptoms similar to their child's own medical problems or an illness history that itself is puzzling and unusual.
A suspected emotionally distant relationship between parents; the spouse often fails to visit the patient and has little contact with physicians even when the child is hospitalized with a serious illness.
A parent who reports dramatic, negative events, such as house fires, burglaries, or car accidents, that affect them and their family while their child is undergoing treatment.
A parent who seems to have an insatiable need for adulation or who makes self-serving efforts for public acknowledgment of their abilities.
A patient who inexplicably deteriorates whenever discharge is planned.

Caution is required in the diagnosis of MSbP/FII/FDP. Many of the items above are also indications of a child with organic, but undiagnosed illness. An ethical diagnosis of MSbP must include an evaluation of the child, an evaluation of the parents, and an evaluation of the family dynamics. Diagnoses based only on a review of the child's medical chart can be rejected in court.