When Caregivers Kill: Understanding Child Murder by Parents and Other Guardians
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MSbP may be more prevalent in the parents of those with a learning difficulty or mental incapacity, and as such the apparent patient could, in fact, be an adult. These men play a passive role in MSbP by being frequently absent from the home and rarely visiting the hospitalized child. Usually, they vehemently deny the possibility of abuse, even in the face of overwhelming evidence or their child's pleas for help. Overall, male and female children are equally likely to be the victim of MSbP.
In the few cases where the father is the perpetrator, however, the victim is three times more likely to be male. The name "Munchausen syndrome by proxy" MSbP is derived from Munchausen syndrome , a different though related condition. People with Munchausen syndrome have a profound need to assume the sick role , and exaggerate complaints, falsify tests, or inflict illnesses on themselves directly. These proxies then gain personal attention and support by taking on this fictitious "hero role" and receive positive attention from others, by appearing to care for and save their so-called sick child.
In , writer and con artist Rudolf Erich Raspe anonymously published a book in which a fictional version of "Baron Munchausen" tells fantastic and impossible stories about himself, establishing a popular literary archetype of a bombastic exaggerator. Asher in  as when someone invents or exaggerates medical symptoms, sometimes engaging in self-harm , to gain attention or sympathy. Two cases   to describe the abuse-induced and neglect-induced symptoms of the syndrome of abuse dwarfism. According to other sources, the term was created by the British pediatrician Roy Meadow in According to Meadow, one had poisoned her toddler with excessive quantities of salt.
The other had introduced her own blood into her baby's urine sample. This second case occurred during a series of Outpatient visits to the Paediatric Clinic of Dr. Bill Arrowsmith at Doncaster Royal Infirmary. He referred to this behavior as Munchausen syndrome by proxy MSbP. The medical community was initially skeptical of MSbP's existence, but it gradually gained acceptance as a recognized condition.
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There are now more than 2, case reports of MSbP in the professional literature. Reports come from developing countries, as well as the U. Meadow was knighted for his work for child protection, though later, his reputation, and consequently the credibility of MSbP, became severely damaged when several convictions of child killing, in which he acted as an expert witness, were overturned.
The mothers in those cases were wrongly convicted of murdering two or more of their children, and had already been imprisoned for up to six years. The pivotal case was that of Sally Clark. Clark was a lawyer wrongly convicted in of the murder of her two baby sons, largely on the basis of Meadow's evidence. As an expert witness for the prosecution, Meadow asserted that the odds of there being two unexplained infant deaths in one family were one in 73 million. That figure was crucial in sending Clark to jail but was hotly disputed by the Royal Statistical Society , who wrote to the Lord Chancellor to complain.
Those odds in fact range from a low of 1: In , Lord Howe , the Opposition spokesman on health, accused Meadow of inventing a "theory without science" and refusing to produce any real evidence to prove that Munchausen syndrome by proxy actually exists. It is important to distinguish between the act of harming a child, which can be easily verified, and motive, which is much harder to verify and which MSbP tries to explain. For example, a caregiver may wish to harm a child out of malice and then attempt to conceal it as illness to avoid detection of abuse, rather than to draw attention and sympathy.
The distinction is often crucial in criminal proceedings, in which the prosecutor must prove both the act and the mental element constituting a crime to establish guilt. In most legal jurisdictions, a doctor can give expert witness testimony as to whether a child was being harmed but cannot speculate regarding the motive of the caregiver. In all, around cases resulting in conviction in which Meadow was an expert witness were reviewed, with few [ citation needed ] changes, but all where the only evidence was Meadows' expert testimony were over turned.
In July , the GMC declared Meadow guilty of "serious professional misconduct", and he was struck off the medical register for giving "erroneous" and "misleading" evidence.
Justice Collins said that the severity of his punishment "approaches the irrational" and set it aside. In addition to the controversy surrounding expert witnesses, an article appeared in the forensic literature that detailed legal cases involving controversy surrounding the murder suspect. It also briefly describes the importance of gathering behavioral data, including observations of the parents who commit the criminal acts. The article references the work of Southall , Plunkett, Banks, Falkov, and Samuels, in which covert video recorders were used to monitor the hospital rooms of suspected MSbP victims.
In 30 out of 39 cases, a parent was observed intentionally suffocating their child; in two they were seen attempting to poison a child; in another, the mother deliberately broke her 3-month-old daughter's arm. Upon further investigation, those 39 patients, ages 1 month to 3 years old, had 41 siblings; 12 of those had died suddenly and unexpectedly. In most legal jurisdictions, doctors are allowed to give evidence only in regard to whether the child is being harmed.
They are not allowed to give evidence in regard to the motive. Australia and the UK have established the legal precedent that MSbP does not exist as a medico-legal entity. As the term factitious disorder Munchausen's Syndrome by proxy is merely descriptive of a behavior, not a psychiatrically identifiable illness or condition, it does not relate to an organized or recognized reliable body of knowledge or experience.
Reddan's evidence was inadmissible. The Queensland Supreme Court further ruled that the determination of whether or not a defendant had caused intentional harm to a child was a matter for the jury to decide and not for the determination by expert witnesses:. The diagnosis of Doctors Pincus, Withers, and O'Loughlin that the appellant intentionally caused her children to receive unnecessary treatment through her own acts and the false reporting of symptoms of the factitious disorder Munchausen Syndrome by proxy is not a diagnosis of a recognized medical condition, disorder, or syndrome.
It is simply placing her within the medical term used in the category of people exhibiting such behavior. In that sense, their opinions were not expert evidence because they related to matters that could be decided on the evidence by ordinary jurors.
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The essential issue as to whether the appellant reported or fabricated false symptoms or did acts to intentionally cause unnecessary medical procedures to injure her children was a matter for the jury's determination. The evidence of Doctors Pincus, Withers, and O'Loughlin that the appellant was exhibiting the behavior of factitious disorder Munchausen syndrome by proxy should have been excluded.
Principles of law and implications for legal processes that may be deduced from these findings are that:. In his final conclusions regarding Factitious Disorder, Ryder states that:. I have considered and respectfully adopt the dicta of the Supreme Court of Queensland in R v. LM  QCA at paragraph 62 and I take full account of the criminal law and foreign jurisdictional contexts of that decision but I am persuaded by the following argument upon its face that it is valid to the English law of evidence as applied to children proceedings.
The terms "Munchausen syndrome by proxy" and "factitious and induced illness by proxy " are child protection labels that are merely descriptions of a range of behaviors, not a pediatric, psychiatric or psychological disease that is identifiable. The terms do not relate to an organized or universally recognized body of knowledge or experience that has identified a medical disease i.
In reality, the use of the label is intended to connote that in the individual case there are materials susceptible of analysis by pediatricians and of findings of fact by a court concerning fabrication, exaggeration, minimization or omission in the reporting of symptoms and evidence of harm by act, omission or suggestion induction.
All of the above ought to be self evident and has in any event been the established teaching of leading pediatricians, psychiatrists and psychologists for some while.
That is not to minimize the nature and extent of professional debate about this issue which remains significant, nor to minimize the extreme nature of the risk that is identified in a small number of cases. I cannot emphasis too strongly that my conclusion cannot be used as a reason to re-open the many cases where facts have been found against a carer and the label MSBP or FII has been attached to that carer's behavior.
What I seek to caution against is the use of the label as a substitute for factual analysis and risk assessment. In his book Playing Sick , Marc Feldman notes that such findings have been in the minority among U. Pediatricians and other physicians have banded together to oppose limitations on child-abuse professionals whose work includes FII detection.
Wendi Michelle Scott , a mother accused of harming her child.
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The book Sickened , by Julie Gregory , details her life growing up with a mother suffering from Munchausen by proxy, who took her to various doctors, coached her to act sicker than she was and to exaggerate her symptoms, and who demanded increasingly invasive procedures to diagnose Gregory's enforced imaginary illnesses. Lisa Hayden-Johnson of Devon was jailed for three years and three months after subjecting her son to a total of medical actions — including being confined to a wheelchair and being fed through a tube in his stomach.
She claimed her son had a long list of illnesses including diabetes, food allergies, cerebral palsy, and cystic fibrosis, describing him as "the most ill child in Britain" and receiving numerous cash donations and charity gifts, including two cruises.
In the mids, Kathy Bush gained public sympathy for the plight of her daughter, Jennifer, who by the age of 8 had undergone 40 surgeries and spent over days in hospitals  for gastrointestinal disorders. The acclaim led to a visit with first lady Hillary Clinton , who championed the Bushs' plight as evidence of need for medical reform.
However, in , Kathy Bush was arrested and charged with child abuse and Medicaid fraud, accused of sabotaging Jennifer's medical equipment and drugs to agitate and prolong her illness. The prosecutors claimed Kathy was driven by Munchausen Syndrome by Proxy, and she was convicted to a five-year sentence in In , year-old Lacey Spears was charged in Westchester County, New York , with second-degree depraved murder and first-degree manslaughter.
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She allegedly fed her son dangerous amounts of salt after she conducted research on the Internet about its effects. Her actions were allegedly motivated by the social media attention she gained on Facebook, Twitter, and blogs. She was convicted of second-degree murder on March 2, ,  and sentenced to 20 years to life in prison.
Dee Dee Blancharde was a Missouri mother who was murdered by her daughter and a boyfriend after having claimed, for years, that her daughter, Gypsy Rose, was sick and disabled, to the point of shaving her head, making her use a wheelchair in public, and subjecting her to unnecessary medication and surgery. Feldman said it is the first case he is aware of in a quarter-century of research where the victim killed the abuser.
Factitious disorder imposed on another
Rapper Eminem 's mother, Debbie, has Munchausen by proxy. He mentioned it frequently in interviews, and even in his song Cleanin' Out My Closet. She would frequently take him to hospitals to receive treatment for illnesses he did not have. His mother's illness also caused Eminem to receive custody of his younger brother Nathan. In the series, Saga's mother suffers from Munchausen by Proxy, abusing Saga and her younger sister Jennifer, who commits suicide at age 14 due to the abuse. The consequences and long-term, wide-ranging effects of the condition on the victims are explored in depth, especially in the third and fourth final series.
In the American television crime drama True Detective , detective Rustin Cohle played by Matthew McConaughey confronts a woman in custody and questions her actions revolving around her child's recent death in her care, as evidence suggests her behavior is indicative of this disorder. Checkout Your Cart Price. Description Details Customer Reviews From mothers who kill their children in post-partum fugues, to fathers who murder their kids for revenge against an estranged wife, the stories in this book are chilling yet real, and bring home the message that children are vulnerable to violence even inthe care of those who should love and protect them the most.
Sadly, child murder by parents and caregivers happens more frequently than one might guess, and while each case is different, there are often warning signs that something might be amiss. Signsof physical abuse may precede the ultimate act of murder. A mother's mental state after the birth of a child may signal true distress and the potential for extreme actions. No one can predict with certainty when a parent or other caregiver may snap, but here Alt and Wells examine many cases of child murder to find out what they have in common, how we might prevent such violence, and what more we can do to protect children in potentially explosive situations.
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