Munchausen By Proxy Syndrome

Munchausen’s Syndrome is a type of child abuse, and it is not easy for the healthcare personnel to prove the abuse as the perpetrator of abuse is mostly the parent of the victim.

Most of the time, the perpetrator is the “mother” who fabricates a disease regarding the child and seeks medical assistance for the child. The children being left vulnerable makes them an easy target for violence and abuse. Particularly children around the age of 2 mostly become the target for physical abuse as they cannot easily resist the act of violence and they are still dependent on their minders. The physical abuse of the child has a wide range of forms, including beatings, sexual abuse, and even causing the death of the child.

What is Munchausen by Proxy Syndrome?

German Baron Karl von Munchausen, a former officer, used to travel from town to town, city to city, and tell fabricated stories; when this was exposed, he was dubbed “Baron of Lies” and took place in the literature in time.

In Munchausen by Proxy Syndrome, the individual attracts the attention of medical experts and healthcare workers by fabricating unreal stories about his mental or physical state, and misleads the healthcare workers by being exposed to improper treatment. In advanced stages, the parent may deliberately harm the child (giving the wrong drugs, suffocating, poisoning etc.). During the abuse, MBP victims may have various symptoms of physical diseases; however, the symptoms may result in death as a consequence of misguidance and mistreatment.

Diagnosing Munchausen by Proxy Syndrome

Due to the fact that the cases of Munchausen by Proxy Syndrome (MBPS) cannot be easily diagnosed by medical personnel as a form of child abuse, it may not be commonly known by the public. One of the most fundamental reasons of this is the fact that the perpetrator is mostly the mother of the child, and that mothers are naturally perceived as the protectors of the children.

Another issue is the requirement for a medical doctor to prove the situation with evidences and give assurance to the authorities even though he suspects that the child has a fabricated story of sickness; in this sense, it is of critical importance that collaboration is made with other healthcare personnel for the credibility of the medical story told by the mother of the sick/victim child.

According to Sheridan (2003), in 57.2% of the cases analyzed, the parent caused the symptoms of the child. Pieces of research show that the biological mother of a child is the abuser in MBP cases. On the other hand, it was determined that the fathers abused the children by means of MBP in 7% of the cases. Moreover, it was found that the perpetrators generally had professional training on healthcare. The most common professions of the MBP perpetrators are nursing and nurse assistantship respectively.

Diagnosing Munchausen by Proxy Syndrome at early stages is of critical importance in terms of saving the victim from the abuse, and healthcare personnel must pay attention to the MBP indicators and be vigilant.

Symptoms of Munchausen by Proxy Syndrome

According to Artingstall (1998), the MBP indicators are as follows:

A long-term sickness which cannot be diagnosed or explained by experienced physicians. The sickness(es) is/are usually defined so uniquely that doctors say they have never seen anything like this before.
Repetitive admissions to hospital and/or medical visits.
Comprehensive medical tests that fail to make a diagnosis.
Symptoms that do not make any medical sense.
Permanent failure of the victim to respond to treatment.
Symptoms and signs that disappear only when the victim is moved away from the perpetrator.
Minders who do not seem concerned about the sickness of the child though being constantly with the child when in hospital.
Mothers who have unusually close relationships with the healthcare personnel.
A history of Sudden-Infant-Death Syndrome in the family.
Mothers who have previous medical or healthcare experiences and who have the same type of medical history as their child.
A parent who is content with his child going through a medical test, even though it is painful.
They try to convince the healthcare personnel that the child is still sick when it is advised that child be discharged from the hospital.
A model family that raises suspicions normally.
A minder with a previous history of Munchausen’s Syndrome.
A minder who persistently denies the recommendation that the diagnosis is not medical.
Minders who talk in a way that the child’s sickness is their own sickness.
Minders who speak on behalf of the child when the speech is particularly directed at the child.

It is quite important to be familiar with the profiles of the victim and perpetrator, as it is difficult for the healthcare personnel to diagnose MBP cases. In conclusion, early diagnosis of Munchausen by Proxy Syndrome cases is of critical importance in terms of preventing the abuse as soon as possible and saving the victim from a possible death.

REFERENCES:
– Akpınar, A. Munchausen By Proxy Syndrome. Journal of Scientific Perspectives, 5(2021), 199-209.