Munchausen by Any Other Name
Munchausen Syndrome by Proxy (MSBP) continues to be a theory of prosecution for parents around the country and in Michigan. The concept, flawed since its inception, is that you can diagnose a parent by looking at the medical care provided to a child. The diagnosis has gone through the same type of evolution that Shaken Baby Syndrome has gone through. The process is familiar to parent defense attorneys: Medical and psychological practitioners, in their zeal to protect children, advance scientifically unsupportable theories that do not hold up to scrutiny. When enough parents are prosecuted, child abuse defense attorneys expose the underpinnings of the diagnosis and parents are exonerated in the legal system. The reaction amongst the advocates of the troubled theories is generally the same: Change the name of the flawed theory and press on.
In this way, Munchausen Syndrome by Proxy has transmogrified into Pediatric Condition Falsification, Factitious Disorder by Proxy, Caregiver Fabricated Illness in a Child and Medical Child Abuse. Yet regardless of the evolving names used to describe this condition, the theory behind Munchausen is significantly flawed. For one thing, you can’t diagnose a parent by looking at the medical records of someone else. In that sense, the focus on the child’s medical needs rather than the psychological condition of the parent makes sense.
At the outset, Munchausen was used to describe situations where seriously mentally ill parents would intentionally injure and then come to the aid of their own child. This is both insidious and rare. As the application of the theory progressed, the focus became something vastly broader. Now any parent seeking medical attention can come under the scrutiny of CPS and a Child Abuse Pediatrician when someone is challenging the need for medical attention.
In today’s world, a child with an undiagnosed illness or allergy, illusive symptoms or frequent trips to the family doctor are likely to come under quiet scrutiny for medical child abuse.
In most of the “Munchausen” cases that I have handled, parents relied on the guidance of medical doctors and made medical decisions consistent with the medical recommendations. It always amazes me how quick those doctors are to retreat from their own recommendations when they get a call from CPS. This makes sense, however, in the litigious world we live in. A recommendation that results in an unnecessary procedure is classic malpractice, for which a doctor can be sued. It is almost impossible to sue a doctor for malpractice after CPS successfully brings a neglect petition against the parent alleging Munchausen. Doctors seem to figure out quickly that throwing the parents under the bus is good for business.
Parents need to be careful when making medical decisions for their children. Here are some general tips that I often give my clients, some of which may apply to you. However, you should not rely on these tips but should rely on your own attorney for specific guidance.
- Don’t doctor shop. The more doctors you have, the more likely you are to be accused of Medical Child Abuse. This is especially true when the medical records look like you shared different information with the various doctors.
- Seek a qualified physician to offer a second opinion, especially before agreeing to an invasive procedure.
- Employ a gatekeeper. If there are complicated medical issues, it is good to have one physician who controls and monitors the medical care. This doctor should always know what everyone else is doing and saying. This can be the family physician or the child’s pediatrician, as long as she is comfortable with the role. Don’t keep secrets from your gatekeeper.
- Get legal help early. When a Munchausen investigation is going on, it is likely that some person holding themselves out as a Munchausen expert is reviewing all of a child’s medical records going back to birth. The evaluation is usually a process of second guessing every medical appointment and every medical decision made looking for a pattern of seeking unnecessary care. When this is happening, you should get an attorney working with you.
At Cronkright law, our focus is helping parents. If we can help you, don’t hesitate to call. Our initial screen and consultation will be at no charge to you.