By Proxy

Craig McGill. Do No Harm: Munchausen Syndrome by Proxy. Vision Paperbacks, 2002.

Munchausen syndrome by proxy is the syndrome, or alleged syndrome, whereby parents, mainly mothers, are accused of harming their children in order to gain the attention of medical personnel. The syndrome has been increasingly in the news, and received much publicity in the case of Beverly Allitt. However the diagnosis has now been withdrawn in Allitt's case, and Craig McGill enquires as to whether the syndrome exists at all.

The scepticism has been reinforced in Britain by the rapid decline in public trust in the medical profession following recent scandals and alleged scandals (some of which are simply to due to the medical profession not keeping up with major and rapid changes in social values). McGill examines the argument around the English speaking world. Much of the presentation is of disguised case histories of false accusations (or alleged false accusations) in Britain, the US , Canada and Australia. As is always the case, the truth in the these cases can never be known. Those accused and their advocates argue that court injunctions often prevent them from passing critical comment on the actions of the “professionals”. Equally the accusations that are made against the professionals cannot be answered for legal and ethical reasons. As the saying goes, one story is good till the other one is told.

We have in the past suggested that MSP may play some sort of role in the production of children’s abduction narratives, but that assumed MSP exists. Reading the “case histories” or sob-stories told here, I was however struck by some similarities to abduction narratives - the same theme of the lone battler against an uncomprehending world, all the professionals being against you, the failed relationships (always the exclusive fault of the other partner, you understand), or the insensitive and uncomprehending partner. Everyone else is to blame for their problems. The children are presented to doctors as suffering from a wide variety of poorly characterized and ambiguous “illnesses” which can never be pinned down. The sort of illness, one suspects, that past societies would have attributed to witchcraft.

Faced with mysterious protean disorders which may or may not exist, everyone starts looking for blame; mothers blame the doctors for being unable to magic a 'cure' or provide a neat little diagnosis, doctors have a tendency to blame parents, especially mothers, for syndromes that they cannot comprehend, because they too need someone to blame for their 'failure'. Both sides take up positions, and antagonize the other.  Perhaps a few of these mothers are physically harming their children, but the diseases might still be largely a product of their imaginations, interpreting perhaps normal phenomena of growing as “diseases”, a tendency accentuated by the notion held by sections of Western opinion that normalcy equals perfection. If a child’s health is therefore less than perfect, this becomes an enormous abnormality requiring constant medical attention. In a small number of cases parents may be tempted to “produce symptoms to order” in their child to convince the doctors that their interior terrors have some bases in reality.   -- Peter Rogerson.