Munchausen Syndrome by Proxy/Fabricated and Induced Illness: Does the diagnosis serve economic vested interests, rather than the interests of children?

[Note: Parents of children with ME/CFS often struggle against accusations among medical professionals dubious of the condition’s reality that they fabricate and/or induce their child’s ills.]

Journal: Medical Hypotheses. Volume 68, Issue 5, 2007, Pages 960-966

Author and affiliation: Lynne Wrennall. Public Health Research Group, Criminology Program, School of Social Science, Liverpool John Moores University, Liverpool, UK. [E-mail: L.Wrennall@ljmu.ac.uk ]

PMID: 17141423

The discourse on Munchausen Syndrome by Proxy/Fabricated and Induced Illness posits the widespread incidence of a highly dangerous form of child abuse in which illness and developmental delay in children is caused by their parents or carers. The discourse has been linked to false allegations of child abuse, hostile adoptions and miscarriages of justice. It has also stimulated concerns that the children's real medical and developmental needs are neglected when their conditions are misdiagnosed as child abuse.

This study examines the critical claims that have been leveled against the Munchausen discourse. They provide explanations of the children's problems that compete with the discourse. The claim of the discourse to scientific validity is thereby shown to be questionable. The explanations have been distilled into specific hypotheses, to stimulate further research.

The literature from which the hypotheses were derived identifies problems in the MSbP/FII discourse in five broad areas of science, regarding:

  • The test validity of techniques,
  • Construct validity,
  • Statistical methods,
  • Evidentiary standards,
  • And adverse impacts.

The main conclusion is that the detailed critical hypotheses cohere around the central claim that the discourse of Munchausen Syndrome by Proxy/Fabricated and Induced Illness serves economic vested interests, rather than the interests of children.

The hypotheses predict adverse health and social outcomes, as a result of the discourse. Consequently, the continued deployment of the discourse would probably be “unsafe and therefore unwise.”

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