Munchausen Syndrome

[Mighty_Emperor]

blimey emps you have been doing your home work,
ive had a good read through all the sites and some that ive found as well, they all seem to say the say thing "attention seeking" , now i dont agree 100% with that, although i can only talk about my own case.

ive said before that there are a number of reasons for my attacks but unless i am in denial i dont feel attention seeking is a major factor. i see it as an escape from reality even though if i were to be honest reality isnt that bad.

i would also like to point out to any body joining this thread at the tail end that i do not harm others especially my own children to gain the same effect.

cheers emps

Sorry to hear about your loss

I didn't really do much homework - I signd up to the Google news alert with the keyword Munchausen and the info sorted itself out (that plus a couple of searches and some odd luck breaks in Amazon while shopping for some other stuff).

I was also thinking that 'attention seeking' seemed a bit of a glib 'dismissal' - I would have assumed that that there are a range of causes - the Munchausens being more of a symptom than the actual problem. Then again they have to go on reported cases so perhaps you are helping t change people's perceptions too

Emps

 

[Mighty_Emperor]

Tue 2 Mar 2004


5:37pm (UK)

Doctor Tells Peers of Child Gassing Case

By Andrew Evans, Lords Staff, PA News


A senior doctor, defending a controversial diagnosis, today told how a mother gassed her four-year-old son when he was noisy or naughty.

Munchausen’s Syndrome by Proxy – sometimes referred to as “factitious or induced illness” – was involved in some cases where mothers were convicted, but recently cleared, of murdering babies.

Crossbencher Lord Walton of Detchant, former General Medical Council president, said that years ago “a child of four was referred to my neurological department in Newcastle”.

He had been admitted to hospital in Cumbria on six occasions for undiagnosed attacks of coma.

“It was only when he was able to tell us that when he was noisy or naughty his mother put a tube on the gas pipe and put it to his mouth and turned the gas on until he calmed down that we realised that this was such a case.”

Lord Walton added: “There are such cases and a recognition of these depends upon the most careful assessment by paediatricians and others.

“It is important to recognise that this does exist and that the protection of children is one of the most crucial parts of this problem.”

Junior health minister Lord Warner earlier stressed the Government had not initiated a review of the scientific validity of Munchausen’s Syndrome by Proxy or the protocols by which such conditions were diagnosed.

He told Lord Walton the key issue was “how we protect children”.

http://news.scotsman.com/latest.cfm?id=2600332

Seems like MBP isn't currently at threat but we know the way the government works so........

I'm still unsure of the MBP link with cot death other than the same scientist is invovled. If someone was using cot death to cover up their child killing (I assume that, while rare, it may happen) it seems like a much more furtive activity which would not really want too much interest focused on their activities while MBP seems to aim for hospital trips and medical attention.

Emps

 

[Mighty_Emperor]

MBP has really hit the new after the cot death decision:

Munchausen's Syndrome by Proxy

The term Munchausen's Syndrome by Proxy was first coined by paediatrician Professor Sir Roy Meadow, whose evidence has been challenged in several high profile cot death cases.

It is a highly controversial condition, which some doubt even exists.

What is Munchausen's Syndrome by Proxy (MSbP)?

MSbP is parenting disorder that comes in two forms. The children of people with MSbP will either have a fabricated illness or an induced illness.

In fact, both the Royal College of Paediatrics and Child Health and the Department of Health now use the term FII for the condition rather than MSbP.

Fabricated illness involves a parent claiming that their child is ill, when they have actually made up the symptoms.

This can involve a high degree of deception. For instance, a parent may claim that their child has passed blood in its urine, and will present samples suggesting this is the case.

However, following tests, it will become apparent that the parent has actually pricked their own finger and dropped blood into the sample.

Another example would be a parent claiming their child is having frequent epileptic fits - even when simultaneous observation by video and by EEG (a measure of brainwave activity) shows no such events are occurring.

Induced illness is the more sinister form of the condition. This involves the parent inflicting damage on their child.

For instance, this may include injecting unsterile fluids such as dishwater into a child, or putting a caustic solution into a child's eyes to make them sore.

What causes it?

The exact psychological basis for MSbP is not known. Some people believe it is a complex way of seeking attention, but this only remains a theory.

Some experts believe that there is such a wide variation in symptoms that it is unlikely that everybody diagnosed as having MSbP is actually suffering from the same condition.

Currently, it covers cases as severe as parents who kill their children and cover up the fact, and as mild as those who knowingly exaggerate real symptoms simply to get medical care.

Does it really exist at all?

It has been suggested that MSbP is only a theory. However, a spokesman for the Royal College of Paediatrics and Child Health told BBC News Online: "There have been too many documented cases were illness has been fabricated.

"However, nobody quite knows how common or rare it is."

Is it more common among certain groups?

An analysis of 300 cases has shown that the condition is more common among mothers.

Suffers often have a history of mental health problems, and may have been abused as children.

There is also some evidence to suggest many people who fabricate or induce illness in their child - although still a minority - have some basic paramedical training.

Do doctors face difficulties in diagnosing it?

Yes. Paediatricians rely heavily on history taken from parent of what happened to a child.

If the parent is lying, it makes hard for doctors to get to the truth.

Doctors also have to bear in mind that concerned parents have a tendency to over-dramatise or exaggerate symptoms - and in the over-whelming majority of cases this in no way means that their child has FII.

How common is MSbP?

It is pretty rare. However, data is fairly sketchy. There has only been one national survey into MSbP, which was carried out in the mid-1990s.

It was very thorough, every paediatrician in the UK being asked every month for 18 months if they had diagnosed a new case.

The results suggested that there are only about 50 new cases of MSbP each year, about 20 of which involve children under one year.

This means the average paediatrician will either never see a case, or only see one very rarely.

There has been no repeat survey so any claim that the rate is going up or going down is spurious.

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/medical_notes/3528517.stm

Published: 2004/03/03 10:10:02 GMT

© BBC MMIV

GMC probes Munchausen's doctor

A leading doctor faces investigation into allegations he wrongly diagnosed child abuse, BBC News has learned.

Professor David Southall is facing a GMC investigation after complaints by at least six parents dating back at least seven years.

Some say their children were taken into care after they were wrongly diagnosed with Munchausen's Syndrome by Proxy.

Adults with the condition may induce or exaggerate illness in children to attract attention to themselves.

Professor Southall is a consultant paediatrician based at the North Staffordshire Hospital at Stoke on Trent.

He is one of the country's main experts on Munchausen's Syndrome by Proxy, also known as Fabricated or Induced Illness.

Contradictions

The BBC's Andrew Hosken has spoken to four women who have complained to the General Medical Council that Professor Southall wrongly diagnosed abuse in their cases.

Only a public inquiry will sort the matter out
Earl Howe, Conservative health spokesman
At least three other parents are believed to have complained to the council.

Some of the parents say their children were wrongly taken into care as a result of Professor Southall's diagnoses.

They say other doctors' opinions contradicted his diagnosis of child abuse.

The first allegations are expected to be considered by the GMC in the summer.

In the late 1980s and early 1990s, Professor Southall was involved in a controversial study where covert video surveillance to detect child abuse.

More than 30 women were taken to court as a result.

But some critics were concerned there was the possibility that children could be exposed to abuse as a result - in one case, a mother was filmed breaking her child's arm.

'No evidence'

A statement from the University Hospital of North Staffordshire Trust said Professor Southall had been advised by lawyers not to comment on the cases before they are considered by the GMC.

It added that independent experts who had examined Professor Southall's child protection work had found he had: "always acted in a way that promoted the best interests of children in his care and he took decisions in collaboration with colleagues from other agencies.

"They did not find evidence of inappropriate diagnosis."

The trust added that other investigations completed to date have found no evidence to support claims of incompetence or serious professional incompetence.

The General Medical Council said its preliminary procedures committee had considered two complaints related to Professor Southall.

A spokeswoman said: "After examination of the evidence, they have decided not to proceed with one of the cases. The other has been referred to the professional conduct committee (PCC).

"The PCC is considering a separate matter relating to Professor Southall in the summer."

The PCC has the power to strike doctors off the medical register.

One mother, who didn't want to be named, who has complained to the GMC, told the BBC: "It didn't only destroy me, it destroyed a lot of other people in the process."

Richard Nicholson, editor of the Bulletin of Medical Ethics said: "There is something about the way a few people amongst paediatricians working in child protection have become almost obsessive, and are far too willing to make a diagnosis of child abuse.

"It should be a diagnosis of last resort. But for too many paediatricians, its become a diagnosis of almost first resort."

Conservative Health spokesman Earl Howe called for a public inquiry into the issue of Munchausen's diagnoses.

He told the BBC: "Only a public inquiry will sort the matter out."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/3528479.stm

Published: 2004/03/03 10:30:40 GMT

© BBC MMIV

Battling a 'psychological theory'
Outside the Appeal Court on London's Strand a small group of protesters gathers in support of two mothers who claim their children were wrongly taken into care after false accusations of abuse.

Off to one side a lone man, wearing the same pale yellow ribbon as the others, stands handing out flyers he has printed himself.

"John" has being fighting against Munchausen's Syndrome by Proxy (MSBP) since his wife was accused of having the syndrome some 10 years ago.

He has come to London from Scotland to show his support for the two women whose appeals are being heard inside.

"I can't do anything in court - the lawyers will do the work inside - so I'm here to show support for another family and trying to help them through this.

"I was in the same position years ago and I've come out the other side.

"I'm saying: 'We're here for you.'"

'Taken away'

John says two of his children were taken from him after his wife was accused of giving one of them an overdose in hospital.

"My children were taken from me - one for two and a half years and one for six months - on the 'balance of probability' and one phone call from Roy Meadow."

Sir Roy is the cot death expert whose evidence helped convict mothers Angela Cannings and Sally Clark of murder. Both were later cleared.

John says he and his wife had to give up their jobs and lost their house "just so I could see my kids two times a week".

The criminal charges laid against John's wife were not proven in court so both children were returned to the family, but what concerns John now is the civil "probability charge", which restricts his wife's contact with children.

How do you prove you're innocent of something that doesn't exist?
'John'

He is convinced she does not suffer from MSBP and questions its very existence, emphasising that it is a psychological theory rather than a recognised psychological condition.

It is John's belief that doctors are scared to dismiss the theory because of the possible ramifications of cases like his.

Proving innocence

Experts willing to testify in court, he says, are hard to find, and even then, proving someone does not have MSBP is difficult.

"The day social workers take your children away, you're 'guilty'.

"How do you prove you're innocent of something that doesn't exist?"

"You can't just accuse somebody and walk away. And this is why we thank Angela Cannings and Sally Clark."

John is preparing to lodge a review of the original decision in his wife's case within the next few weeks.

He says he wants to take the matter to court in order to have the charge against his wife lifted and to force the doctor in question to apologise to her.

"I'm not interested in his money or the hospital's money."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/3529489.stm

Published: 2004/03/03 16:38:30 GMT

© BBC MMIV

 

[Mighty_Emperor]

And people accussed of MBP are also appealing against the decision:

'Why I joined families' fight'

Angela Cannings explains how her fight against allegations of killing her babies drove her to help families fighting to get their children back.

Two families who claim their children were wrongly taken into care after false accusations of abuse have taken their cases to the court of appeal.

They dispute diagnoses of Munchausen's Syndrome by Proxy (MSBP), meaning they allegedly caused or exaggerated their child's illness.

Mrs Cannings joined a protest at court by those with children in care.

She said: "I have had the tragedy in my life. I have had to deal with trying to prove my innocence."

Terry and I feel [we can help] today just to support the families that are going through heartache
Angela Cannings

Mrs Cannings said her successful battle against convictions for murdering seven-week-old Jason in 1991, and 18-week-old Matthew in 1999, had raised issues about the way expert's opinions are treated in court.

Despite MSBP not playing a major part in her trial, Mrs Cannings said she could empathise with families, saying: "We've lost children through cot death but also we had the threat of our daughter going into care.

"Terry and I feel [we can help] today just to support the families that are going through heartache."

She said the main danger to justice in the family courts, where the standard of proof is lower than in criminal courts, came from experts' opinions and assumptions.

Challenge experts "In the past, the experts' advice has been so heavyweight that the authorities have acted on that."

But she did concede that it was important to distinguish genuine abuse cases from those where there was no concrete medical evidence.

"What we have to be careful with and what we realise is that there are genuine child abuse cases going on. Obviously those investigations and cases have to be brought forward.

"In cases where there doesn't seem to be any proof, evidence, clear-cut evidence, initially there should be an investigation but then leave it at that."

She said her aim was to challenge experts where this had been impossible previously.

"On the broader issue I would like to now see questions brought against experts who actually bring these accusations in the first place.

"Our lives were torn apart for four years and we don't want to see this happening to other people, to other families."

Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/uk_news/politics/3530233.stm

Published: 2004/03/03 16:35:47 GMT

© BBC MMIV

Wednesday, 3rd March 2004

Parents fight to win back children

THE first appeals by parents whose children were taken from them after medical experts diagnosed Munchausen's syndrome by proxy began today.

The condition can cause a mother to harm her children to attract attention to herself.

The hearings, before a panel of judges headed by the President of the High Court family division, Dame Elizabeth Butler-Sloss, follow the Angela Cannings ruling in the Court of Appeal criminal division in December

That court, which cleared Mrs Cannings, 40, of murdering two of her children, called for a halt to the prosecution of parents in cases where expert evidence points to the possibility of "cot death".

Today's hearings involve two separate appeals in the civil division of the Court of Appeal and are expected to last two days.

Andrew McFarlane, representing the mother of one of the children, told the three judges that the Angela Cannings judgement caused a complete re-evaluation of the approach that had been taken thus far.

He said: "The message from the Cannings judgment was: if you have a series of unexplained medical traumas, you have three sudden deaths, it does not mean child abuse, it means three unexplained events."

Tragedies

Dame Elizabeth opened the hearing with a warning that there should be no identification of any of the parties involved, including the local authorities and doctors.

Mrs Cannings, who was joining her first protest since her conviction was quashed, said it felt "a bit strange" to be back at the High Court.

"We wanted to support and help families as best we can, having been through this experience ourselves," she said. "If we can help the families who are going through these tragedies then we will do that."

Mrs Cannings continued: "We've heard from the government that they're going to review cases but that was in January and we're now into March. I would like to see a decision now.

"I understand that there are a lot of cases and it's going to take a lot of time and effort.

"But there's so much sadness, and families have been separated and children have been taken away - and it's on a medical assumption."

Mrs Cannings said being back with her family was "just absolutely brilliant".

"But we've had four years of being apart and it's going to take a long time to sort out," she added.

http://www.manchesteronline.co.uk/news/stories/Detail_LinkStory=83028.html

Wed 3 Mar 2004


11:26am (UK)

Parents in Court Protest over Children in Care

By John Aston, PA News


Parents and campaigners gathered outside the Court of Appeal today in support of two families who were challenging decisions to take their children into care after medical experts diagnosed Munchausen’s syndrome.

Lawyers for the families argue that the children, referred to as B and U for legal reasons, were removed on the basis of flawed medical evidence.

The two cases are the first to reach the courts after Government ministers announced a review in the wake of the Angela Cannings appeal.

Outside the Royal Courts of Justice in The Strand, parents whose children had also been taken away spoke of their own trauma.

One, “Sarah Mitchell” – not her real name – said: “I am here to show support for these families and for all the children wrongly removed from their care on the basis of dustbin medical diagnoses.

“We who are here today know what they are going through, and we are going to fight to the bitter end.”

Sarah, 39, said she had had four children taken away in 1996 because of flawed medical diagnoses after her children fell ill.

Pointing to the Royal Courts behind her, she said: “This is where it all happened. It is a scary place to be. I am back to the beginning where it all ended.”

Sarah added that that the medical reports dogged her when she went to live in New Zealand, where two other children were also taken away.

Davina McClean, 47, from Swansea, described how her son Ben was taken into care in 1991 on the basis of a medical diagnosis. Her son was returned in July 1992.

She said: “It was terrible. Traumatic. What we are protesting about is that this issue has continued for decades, and the medical profession has gone unchallenged in the courts.”

http://news.scotsman.com/latest.cfm?id=2603103

The problem is that, as with just about every other crime, some innocent people will have been convicted of this but this shouldn't be used to suggest this kind of thing doesn't occur and we areally can't throw the whole thing out or we are going to be in a terrible position where children are being abused but not believed because MBP has been 'discreditted'.

Anyway I'm sure this will run and run - as I said above I have set up a Google news alert for "Munchhausen" so I should be able to stay on top of this.

Emps

 

[Mighty_Emperor]

Now I didn't know this (or missed it in earlier reports) but Canning was accused of having MBP after the cot deaths - I think that is an odd diagnosis:

Mothers appeal over children in care

Wed 3 March, 2004 13:38

By Michelle Green

LONDON (Reuters) - Two women whose children were taken into care following allegations of abuse have launched a court battle for their return, three months after appeal judges cleared a mother of killing her two babies.

Angela Cannings, 40, had her life sentence quashed in December after three judges at London's court of appeal ruled the expert evidence that led to her conviction was unsafe.

Cannings had been diagnosed with Munchausen's Syndrome by Proxy, which suggests that mothers harm their children to draw attention to themselves. Judges subsequently called for all criminal cases that relied on similar evidence to be reopened.

Lawyers for the two mothers at the centre of Wednesday's hearing, who were also diagnosed with the syndrome but who have denied harming their children, argue that non-criminal cases should also be reviewed.

"What I seek to do is highlight what the court in the Cannings case said about the approach to evidence," Andrew McFarlane QC, representing one of the women, told the court.

He said that the Cannings case was not about one or two named paediatricians getting it wrong but about how the courts should approach such cases.

"The message from the Cannings judgement was: if you have a series of unexplained medical traumas, you have three sudden deaths, it does not mean child abuse, it means three unexplained events," he said.

That message should be applied to non-criminal cases taking place in family courts where the stakes for family life are just as high, McFarlane added.

"The consequence for many families is the move of the child for adoption, which is the local authority's plan in this case," he said.

"There is no more draconian order than an adoption order in the family field and it is in a real sense a life sentence for the parent who loses a child through adoption."

The case is the first to reach appeal since the Cannings' murder conviction was overturned.

It also follows the successful appeal against conviction by Sally Clark and the acquittal of Trupti Patel, two other women wrongly accused of murdering their babies.

The case is expected to last two days. Reporting restrictions prevent identification of any of the parties, local authorities or doctors involved.

http://www.reuters.co.uk/newsPackageArticle.jhtml?type=topNews&storyID=468987&section=news

 

[Mighty_Emperor]

Another MBP eport:

Mom abused hospitalized infant

Mother is to appear in court today

Wednesday, March 3, 2004

BY AMALIE NASH
News Staff Reporter





A 30-year-old Lodi Township mother was scheduled to appear in court today on charges that she intentionally sickened her infant son by tampering with his feeding tube and oxygen tank while he was hospitalized last fall.

Jennifer Sexten is charged with first-degree and second-degree child abuse in a case that began last October when her 1-year-old son, Magnus, was a patient at Mott Children's Hospital at the University of Michigan.

Sexten was later ordered by a Washtenaw County Family Court referee to move from the family's home, while her 3-year-old son remained with his father and Magnus was placed in foster care, according to juvenile court documents. A trial is scheduled for March 22 on a petition to terminate Sexten's parental rights.

At prior custody hearings, a prosecution witness discussed Munchausen by proxy, a medically recognized syndrome in which an adult - usually the mother - deliberately harms a child to gain attention. But it's unclear at this point whether either side is arguing the role of the syndrome in the case.

A felony criminal complaint filed against Sexten in December charges that she caused serious harm to Magnus by "failing to provide food to the infant and/or tampering with the infant's medical treatment and/or by reporting false medical symptoms to the infant's treating medical team."

A preliminary hearing on the criminal charges was scheduled to be held today in District Court.

A petition filed last month in Family Court outlines allegations against Sexten involving Magnus, who was hospitalized last year from Sept. 15 to Nov. 3. The petition to take the children away from Sexten also discusses the older son, but she was not accused of harming him.

Washtenaw County Chief Assistant Prosecutor Joseph Burke refused to discuss the case this week. The University of Michigan Department of Public Safety investigated the matter, and Lt. Robert Neumann also would not comment.

Attorneys representing Sexten in the criminal and custody cases declined Tuesday to discuss specifics, but said their client will be vindicated in court. Sexten was released on personal bond after her arraignment and now lives in Milan.

"In no way did she intend or cause any harm to her infant child, and criminal charges are totally unfounded in our view," said criminal defense attorney Douglas Mullkoff. "There are definitely two sides to every story, and that's what the courts are here to sort out."

Attorney Sheryl Manning, who represents Sexten in the custody case, concurred with Mullkoff, but declined further comment.

The petition filed in Family Court alleges:


Sexten told hospital staff that Magnus experienced frequent vomiting and seizures, but that was inconsistent with what the medical staff saw. The infant has been hospitalized several times since birth, court records show.


Sexten was observed on Oct. 24 using a syringe to remove liquid food from Magnus' feeding tube, then squirted the contents of the syringe around his head and sheets. When a nurse entered the room, the mother acted as if he had just vomited.


The same day, Sexten was seen injecting two syringes of an unknown substance into Magnus' feeding tube right after a nurse left the room.


On Oct. 25, after a nurse hung a "flush" bag in Magnus' room, Sexten was observed lifting the blanket and touching her son in the area where a Broviac line, an IV catheter, was inserted. Shortly afterward, the child started bleeding profusely from the site of the line, but Sexten denied being in the room at all during that time.


Sexten on several occasions turned up the oxygen level Magnus was receiving despite repeatedly being told not to touch the machine. Magnus was receiving oxygen, which medical staff didn't think he needed, but Sexten insisted on its use.

"Jennifer Sexten's false reports that Magnus was unable to tolerate food by mouth led to the medical staff's decision to insert a feeding tube and central line," court papers said. "Magnus' primary medical problem during his most recent hospitalization was a serious infection to the site of the Broviac. Infection is a common risk with central lines and Magnus' life was placed in risk due to his mother's behavior."

Once Sexten was barred from the room beginning on Oct. 25, Magnus improved and was ready to be released from the hospital a few days later, according to the documents.

The children's father, Jeff Sexten, was also at the hospital during that time, but there was no evidence that he had any knowledge of his wife's actions, court papers said.

Kim Moore, who is representing Jeff Sexten in the custody matter, said he is prepared to care for the children. His parental rights are not in question, but since he is married to Jennifer Sexten, the outcome of her case could affect his ability to see the children, Moore said.

"He is seeing his children and trying to expand that," Moore said. "He's very interested in having the children."

While their son is in foster care, Jeff Sexten can visit Magnus unsupervised for no more than five hours a day on weekend days, and Jennifer Sexten is allowed visitation one night a week supervised by staff from the Family Independence Agency, according to court records.

Nationally, cases of suspected Munchausen by proxy rarely lead to criminal prosecution, said Dr. Marc Feldman, an expert whose book titled "Playing Sick" will be released in May. Feldman said most cases are handled in family court, where officials believe terminating parental rights will address the situation without involving police and prosecutors.

"This is not a mental disorder - it's a form of abusive behavior," Feldman said. "These people are fully aware of what they're doing, considering the planning and difficulty involved. They just may not know why they're doing it."

The first-degree child abuse charge is punishable by up to 15 years in prison, and the second-degree child abuse charge carries a maximum four years in prison.

http://www.mlive.com/news/aanews/index.ssf?/base/news-7/107832869566960.xml

 

[Mighty_Emperor]

A rather 'emotive' report:

This man devastated my family

By Keith Dovkants, Evening Standard
4 March 2004

On a landing in Holloway prison, with a razor blade being held at her neck and whispered threats in her ear, Sarah Grey experienced a moment of liberating anger. It was not directed at the hard-case prisoner holding her by the hair and threatening to cut her throat, nor even the prison staff she believes set her up for this violent confrontation. Rather, her fury was aimed at the people she blames, to this day, for the disintegration of her life. Among them she numbers Professor David Southall, the eminent paediatrician who is being investigated by the General Medical Council over allegations that he wrongly accused parents of harming their children.

Sarah's son was taken away from her after Professor Southall became involved in his case and she is pursuing her own, separate, complaint against him. According to her, his actions triggered a series of devastating circumstances that led to her, her closest family and a friend being sent to jail. Then, both her children were taken into care and her entire existence was taken over by the battle to get them back.

At the heart of her story is a diagnosis of Munchausen's Syndrome by Proxy, the theory that proposed some mothers harm their children to draw attention to themselves. The acceptance of the theory, first advanced by Professor Sir Roy Meadow, led to murder charges against innocent mothers and the suspicion that thousands of children may have been needlessly taken into care. Sarah joined the demonstration outside the High Court yesterday when the first appeal hearings were launched by parents who believe their children were wrongly taken away from them on the basis of Munchausen evidence.

The Children's Minister, Margaret Hodge, has announced a review of such cases, but an Evening Standard investigation into Sarah Grey's case and others like it suggests the Government's action is unlikely to produce positive results.

Indeed, we can reveal that Ms Hodge could soon face a judicial challenge to her plans. And mothers who have lost their children to the Munchausen scourge are already saying Ms Hodge's initiative is merely an attempt to whitewash a grave national scandal.

Sarah Grey comes from a loving, law-abiding family which was torn apart when the Munchausen theory was visited upon them. She, her husband and her elderly mother were given substantial prison sentences in circumstances that appear to belong to some dark Kafkaesque dictatorship rather than modern Britain.

And Sarah lost her two children. They were taken into care three years ago, when she was thrown into prison, and she has not seen them since. This is the hurt that prompted the angry despair in Holloway and led Sarah to tell the woman threatening to cut her throat to "just go ahead and do it".

"I meant it," she said. "I just didn't care any more. Everything had been taken away."

How did it come to that? She is 38 now, a slim, attractive woman who talks intelligently and without hysteria-about the tragedies that came to dominate her life. Her memory is uncannily accurate and appears to concur precisely with the documents she stores in more than 40 ring-binder files.

The files tell their own story. They begin with letters, some photocopied and fading reports, assessments and then papers on the court case and prison.

The record begins in 1990 when her son James had an MMR jab at just over two years old.

"I became aware something was wrong quite quickly," she said. "He became unsteady on his feet, he wouldn't sleep and although he had been speaking quite well, he stopped communicating." James's sister Emma was born around this time, and she grew normally and thrived, but James became worse.

He wasn't eating properly and he was shutting himself off from everyone around him. By the time he was five his left leg had begun turning inward and he was diagnosed with cerebral palsy. It was also suspected that he was autistic.

The family moved across Britain so James could attend a special- needs school. Sarah had to abandon the designer babywear company she had launched; her mother and father moved to be close by.

The school was not a success. "He was very unhappy there," Sarah said. "He would cry for hours when he got home and repeated over and over 'no school, no school ...' I'd persuade him to go in the morning, but he'd break my heart when he said goodbye. He'd be choking back the sobs, tears running down his face."

Eventually, she said, she could stand it no more and began educating James at home. He was eight years old at the time and still needed a great deal of care. He was attending hospital regularly and underwent a serious operation on his leg to try to correct the growing deformity. It didn't work.

In November 1997 she took James for an examination by Professor Southall. He was an advocate of Professor Sir Roy Meadow's Munchausen theory, but when Sarah took her son to see him she knew nothing of this. Indeed, after years of frustration, he seemed like their last hope. She could not have known how it was to turn out.

Her files contain a letter written by Professor Southall to her local hospital. In one letter he expressed the view that a full examination of James's case would probably reveal Munchausen's Syndrome by Proxy. "I suspect ... we should be looking for child-protection proceedings," he added.

During Professor Southall's examination of James he asked about family history. Sarah revealed that her twin brothers and one of her two sisters had died in infancy.

"He changed completely," she said. "He became very interested. He kept firing questions at me about the babies. I couldn't answer him - I was 12 months old when that happened - so he said he wanted to see my mother."

She made the trip back to Professor Southall's hospital in Stoke-on-Trent with her mother, Mary. The documents in Sarah's file reveal that after this meeting Professor Southall began to investigate the infant deaths in her family.

They further disclose, in letters he wrote, that he believed Mary had suffered from Munchausen's Syndrome by Proxy and may have killed her own babies. She, he suspected, had passed on the " syndrome" to her daughter.

As Sarah's mother, Mary, related this part of the story she held up the documents in disbelief.

"How could anyone believe such a thing?" she said. "My babies died because they had cystic fibrosis. They were in hospital. He has tried to turn a family tragedy into a crime."

On 25 September, 1998, James was taken into care. Sarah and her mother were allowed to see him for an hour a day. Even that contact was soon to be stopped. Professor Southall had warned that it could be dangerous for the two women to be with the children. Within a few months the local social services department made moves to take James's sister Emma into care.

"There were three court hearings in quick succession," Sarah recalled. "We were in a panic. We didn't know what to do."

She sought the help of Penny Mellor, a vigorous campaigner for mothers who had fallen victim to the Munchausen theory.

"I was terrified they were going to take Emma away," Sarah said. "James was showing signs of abuse at the care home - he had a black eye and fingertip bruising on his arms - and I couldn't face both my children suffering like that."

So her mother, Mary, took Emma on a long holiday. It lasted four weeks and ended in Scotland when dozens of police raided the flat they were staying in.

"It was a major police operation - they had been scouring the country for them - they even gave it a name, Operation Neptune. It seemed they had been told Emma had been abducted by a mass murderer."

Emma, who was found hiding from the police in a wardrobe in the borrowed flat, was immediately taken into care. Sarah, her husband, her mother and Penny Mellor were arrested. They came to court in the spring of 2001. Ms Mellor and Mary were charged with conspiracy to abduct Emma. Sarah and her husband were charged with aiding and abetting them.

Mary, then aged 62, was sentenced to nine months' jail. She served almost three months in a prison where the adjoining wing contained at least one mass killer and longterm prisoners called her "nonce" because staff told them she had been convicted of child abuse.

"That happened to both of us," Sarah said. "The prison staff seemed to take delight in saying we were in for a child offence." Sarah also served almost three months; most of the time was spent sharing a cell with her mother but one month was spent in Holloway so she could attend court hearings that decided the fate of her children.

Her husband was sentenced to six months' jail and Penny Mellor was given a two-year sentence. This was later reduced to 18 months on appeal and she was released after serving eight months.

By the time Sarah and her family left prison, her children were lost to her. Her marriage, which she said had been a happy one, ended. She and her husband are separated, although they are on amicable terms.

"The children are both in foster homes," she said. "I haven't seen either of them for three years." A DVD she put together with a poem for them last Christmas was returned to her because it was judged to be "inappropriate".

She tells the story calmly, but there can be no disguising the hurt. Each day that passes, she said, seems to move her children further and further away from her.

When Margaret Hodge announced an urgent review of care proceedings involving Munchausen cases there was a moment of hope: "I thought, thank God! I thought that if someone just looks at our case they'll know straight away that a wrong has been done. But then I looked at what was being proposed more closely. I realised all the Government was doing was referring cases back to the local authority. It was just a whitewash."

Sarah's reasons for saying this are based on a sound judgment that may yet embarrass Ms Hodge. Sarah is one of more than a dozen parents who have instructed the London law firm Leigh Day and Co to act for them over the placing of their children in care. The firm is currently looking at the possibility of applying for a judicial review of the Government's decision to turn the suspect cases back to local authorities.

Solicitor Bozena Michalowska says: "There is no provision for an independent review. The local authorities will be judging themselves in their own court. And there is no mechanism for truly objective monitoring."

Sarah believes that this will prevent new scrutiny of her case. She said: "The local authority is not going to provide legal ammunition that could be fired back at them."

As the Munchausen story continues to unfold, the list of parents joining the action being prepared by Bozena Michalowska and her colleagues grows almost daily. And there is a growing confidence that when the battle is joined in earnest, there will be no shortage of ammunition.

Family names have been changed for legal reasons

http://www.thisislondon.co.uk/news/articles/9473403?source=Evening Standard

 

[Anonymous]

Sounds like it's going the way of Satanic Ritual Abuse.

 

[nikoteen1]

2nd visit to shrink tomorrow at 9:30, quite looking forward to it actually, will keep you informed.

 

[Anonymous]

nikoteen... good news there, hope it goes well and im sure it will.

 

[Mighty_Emperor]

nikoteen: Good luck - it has to be a good thing that you are feeling so positive about it.

Emps

 

[stonedog3]

yes! go nik!

kath

 

[Mighty_Emperor]

And so it begins

Doctors wary of child abuse probes

Mon 8 March, 2004 12:25

LONDON (Reuters) - Doctors are increasingly unwilling to take on child protection work because of a soaring number of complaints against them by parents, a survey says.

As a consequence, children could be put at risk, the report's author said on Monday.

Nearly 14 percent of paediatricians questioned by the Royal College of Paediatrics and Child Health said they had been the subject of complaints, sometimes threatening, after becoming involved in child abuse investigations.

Of those doctors, almost one-third -- 29 percent -- said they were reluctant to deal with such cases out of fear for their professional reputations and, in some cases, the potential of personal threats.

The results show doctors are thinking twice about sounding the alarm in potential child abuse cases, said the study's author Dr Neil McIntosh.

"It is a shame but if there is any suggestion of doubt, maybe the child will be in danger," McIntosh said.

The survey found the number of yearly complaints against doctors had increased from less than 20 in 1995 to more than 100 in 2003.

Of the 11 percent of complaints that were referred to the General Medical Council, the doctors' regulatory body, none had been upheld.

McIntosh said a number of Web sites were to blame for convincing parents they should target doctors whom they believe have wrongly accused them of harming their children.

"There is now a coordinated campaign against paediatricians coming from a number of Web sites and when child protection issues come up, there is a group who gets hold of parents and says you should complain -- and sometimes this is not just complaining, this is threatening," he told Reuters.

The survey of 4,776 paediatricians comes three months after a mother had her life sentence quashed in a landmark ruling in which an appeals court ruled the expert evidence that led to her conviction of killing her two children was unsafe.

Angela Cannings, 40, had been diagnosed with Munchausen's Syndrome by Proxy, in which parents harm their children in order to call attention to themselves.

Last week, a mother also diagnosed with the same disorder lost a court battle for the return of her daughter from care after judges unanimously decided she had tried to harm the child.

http://www.reuters.co.uk/newsPackageArticle.jhtml?type=topNews&storyID=471550&section=news

 

[nikoteen1]

sorry guys, wimped out, couldnt face it when the time came for my appointment. feel like shit now.

 

[Anonymous]

hay nik... no problem.. you did the most dificult one. You just gota gather it up again a little to go further, youll make it.

PS..u aint no wimp.

 

[Anonymous]

Nobody said it was going to be easy and you have every right to 'wimp out', don't be so hard on yourself..make another appointment and see how you feel when the times comes.

You've come this far and it's all forward from now on :likee:

 

[Beakmoo]

But then again, if you don't go Nik, nothing will ever change, and your unhappiness will have taken charge of you, rather than the other way round.

 

[Mighty_Emperor]

Yep there is nothing wrong with being scared of going but read through the article I link to above - there isn't a cure but they can give you a great deal of help in coping with things so the first couple of steps will be the hardest but try and focus on things beyond that like your getting happier and healthier and not hurting yourself.

Do you not have someone who could go with you? Not for any kind of support but if you arrange to go with someone else then it is much harder to back out - you have virtually commited to it before the day

Better luck next time - just cut off your escape routes while you are feeling more positive

Emps

 

[nikoteen1]

there arent any people for me to go with because i havent told any body apart from you guys. i have been beating myself up this week about missing my aappointment so feel more determined to stick with it next time. strange thing though, after calling to cancel my appointment i i actually felt very faint whilst in the town and had to battle with myself headto stay upright. i dont know if ithe stress had actually made me ill or if my mind was believing the fake illness that i used as an excusenot to go to my appointmentbut if i

 

[Anonymous]

stick with it Nik.. im sure itll get easier as it goes along.

 

[stonedog3]

Nik - check your PMs and PM me!

Kath

 

[Mighty_Emperor]

'Mothers Against Munchausen's is not the innocent group it seems'

By Jeremy Laurance
15 March 2004


The paediatrician averted her gaze as she asked me about my six year old son's swollen, bruised and lacerated ankle. I wondered why. Then, with a sickening lurch, I understood. How could I prove I had not hit or kicked him myself?

The worst of it was that I felt guilty. I had been taking him to school seated on the crossbar of my bike when his foot caught in the spokes, sending the two of us soaring gracefully over the handlebars.

Seventeen years later the incident remains vivid in my mind because, even though I had only glimpsed it, no parental horror can compare with the prospect of losing your child. And when you read the Heart to Heart discussion on the Mothers Against Munchausen's website it is impossible not to be moved by the pain of families whose lives have been torn apart by the decisions of paediatricians like the one who interviewed me.

Mothers Against Munchausens is a campaigning group that is fighting for justice against what it sees as a witch-hunt by paediatricians whom, they say, found abuse where it did not exist and removed children from loving families without justification.

Its campaign has been extraordinarily successful - if by success you mean scaring the professionals off the beat. One third of districts in England are now said to be without a paediatrician covering child protection because doctors do not want the hassle, threats and intimidation that go with the job.

But when you look closer you see that Mothers Against Munchausen's is not quite the innocent group it appears.

This month the appeal court rejected an appeal by a mother whose child was taken away after three doctors decided she had deliberately tried to smother the child on four occasions. Known as case U, it was the first in the series of reviews ordered by the attorney general after the appeal court overturned the conviction of Angela Cannings, who was jailed following the deaths of her two babies.

In the Cannings case, the judges made it clear that the courts must in future accept that it is better that guilty parents go free than that one innocent parent is locked up. In that context, it is unlikely the appeal court would have rejected the appeal in case U unless the judges were very sure indeed that the conviction was safe.

Yet messages on the Mothers Against Munchausen's website after the decision were wholly supportive. "Terribly disappointed," said one. "How many oaths were broken today?" said another. Mothers Against Munchausen's appears to be a movement which anyone, including child killers, can join.

The group has denied there is any campaign against paediatricians but admitted a few senior doctors were in their sights. Among them is Professor David Southall, of the North Staffordshire Hospitals Trust, who is to appear before the General Medical Council next June charged over an intervention he made in the Sally Clark case, the solicitor convicted and later cleared by the appeal court of killing her babies.

Professor Southall is alleged to have submitted a report to the police accusing Sally Clark's husband, Stephen, of the crime after watching a TV programme in which Stephen Clark described his 11-week-old baby son having a nosebleed. Nosebleeds in young babies are very unusual and Professor Southall apparently thought this grounds for suspecting Mr Clark of killing the baby.

Was it appropriate for a doctor to intervene in a case with which he had no involvement on the basis of something he had seen on television? One way of looking at this is as unwarranted meddling. The other way is as the action of a concerned citizen using his expert knowledge to assist police.

It will be for the GMC to decide on Professor Southall's actions. But in the eyes of some of the press he is already guilty. In their eagerness to convict him they display a wilful blindness that continues to dominate our attitude to child abuse.

Children are murdered, mostly by parents or carers, at the rate of one or two a week. Children are sexually abused, often by parents, much more frequently. But these are facts we seem unwilling to confront, despite a string of scandals in which gross child abuse was missed or ignored, stretching back 30 years to Maria Colwell in 1974.

It is barely a year since the report on Victoria Climbie, the latest case in this grim litany, described the prolonged torture of a child because professionals, and paediatricians in particular, failed to act.

Now we seem determined to string the paediatricians up because they had the temerity to act.

http://news.independent.co.uk/uk/health/story.jsp?story=501406

 

[lemonpie3]

Nikoteen, stick with it pal, we're all rooting for you. :yeay:
Let us know how your next appointment goes ok?

 

[Mighty_Emperor]

Woman cleared of involvement in baby's death

09 March 2004

A woman who police suspect may suffer from a condition where she harms her own children, has been cleared of any involvement in the death of her baby.


Giving evidence at an inquest yesterday, Detective Sergeant Kevin Tiernan said police had insufficient evidence to show a 34-day-old boy who died seven years ago was a victim of Munchausen syndrome by proxy.

Nelson Coroner Ian Smith suppressed the name of the Nelson mother and child and ruled the baby died of irreversible hypoxic injury to the heart.

Parents who suffer from Munchausen syndrome by proxy generate an illness or a near-fatal "episode" in their children.

Mr Tiernan said on many occasions the parent, almost always the mother, resuscitated the child.

It was suspected the parent did this to gain sympathy and attention and often the children of someone suffering from the syndrome died.

Mr Tiernan said there were several reasons police were suspicious of the mother in this case.

The baby's death was considered suspicious because he was the second child of the woman to die.

The woman had a daughter who died when she was 19 days old, two years earlier. An inquest into the baby girl's death found she died of perinatal asphyxia.

Life-threatening events that happened to the boy occurred only in the presence of the mother and almost immediately after her son's discharge from hospital. This resulted in further admissions.

"Individually each of these specific factors are not in themselves conclusive of an unnatural death but combined, form a strong suspicion that (the mother) may have been involved in the baby's death," Mr Tiernan said.

The mother was talked to by detectives in 1998 and again last year and denied smothering her baby or in any other way contributing to his death.

After the baby was born he was admitted to Nelson Hospital twice over the next few weeks after being found by his mother blue and cold.

He was discharged a few days after each hospital admission, but on the third occasion was again found blue and not breathing in his cot. He was taken to Nelson Hospital before being transferred to Wellington Hospital, but died the following day.

The Wellington doctor who performed an autopsy on the baby was unable to determine the cause of death.

Reports police obtained as part of their investigation showed concern from Palmerston North doctor Jeff Brown about emergency medical treatment given to the baby.

Dr Brown said the baby received an excessive electric shock from ambulance officers. However, he did not believe this would have had any effect on the outcome.

http://www.stuff.co.nz/stuff/0,2106,2839397a10,00.html

 

[Mighty_Emperor]

Disturbing developments

Tue 9 Mar 2004


Children's doctors receiving hate mail


TANYA THOMPSON HOME AFFAIRS CORRESPONDENT


DOCTORS are receiving hate mail and death threats amid mounting anger over their role in child-abuse investigations, a survey has revealed.

Research suggests that experts in the field of paediatrics are increasingly afraid to become involved in child- protection work following a backlash from parents wrongly accused of harming their children.

A BBC poll found that almost a third of doctors from the Royal College of Paediatrics voiced serious fears about continuing to take part in the work.

Professor Alan Craft, the college president, said: "This is a big problem.

"We need a different approach. Is it right that people should be complaining against doctors who are only doing their job?"

The poll follows growing concerns about cases involving the controversial diagnosis of Munchausen Syndrome by Proxy, a theory pioneered by Professor Sir Roy Meadow whereby parents fabricate illnesses and deliberately harm their children to draw attention to themselves.

Thousands of children are said to have been taken into local authority care over the past 15 years on the strength of the syndrome. It was Prof Meadow’s evidence which helped convict a solicitor, Sally Clark, falsely accused of murdering her two sons.

The Scotsman understands he has also intervened in cases north of the Border.

At Mrs Clark’s trial in 1999, Prof Meadows said the chances of two members of the same family dying of cot death was "73 million to one". That has been cast into doubt by recent research, and Mrs Clark’s conviction was quashed last year.

The professor’s testimony also helped to imprison Angela Cannings, who was recently cleared of murdering two of her children.

There were calls for an overhaul of the child-protection system last month as a result of concerns about the use of so-called expert witnesses who have diagnosed parents as suffering from the syndrome.

Doctors now fear being made scapegoats or subject to malicious complaints if they become involved in child-protection cases. Just under one third of the college’s 6,000 members expressed concern about being involved in such work.

Almost one in seven of those who have taken part in a child- abuse investigation have been the subject of a related formal complaint, the poll revealed. A total of 71 doctors said they had been referred to the General Medical Council, but few complaints were upheld.

http://news.scotsman.com/health.cfm?id=272862004

Doctors on Child Protection Cases Getting Hate Mail

09 Mar 2004


One doctor has received a death threat, another was threatened with a shotgun and many are getting hate mail. These are doctors who take part in child protection cases in the UK.

There has been growing anger in the UK against doctors when child abuse is suspected. Recently, there have been alleged cases of Munchausen’s syndrome by proxy. Parents are said to have harmed their children in order to attract attention to themselves. Some parents’ children went into care because of a doctor’s testimony.

Many doctors are reluctant to become involved in child abuse cases, according to a survey by the Royal College of Paediatrics and Child Health (UK).

The survey report said 'High-profile cases have destroyed hard-earned reputations based on years of experience.”

One doctor said that he had been threatened with a shotgun. He was told people were going to come and kill his children. This doctor had a complaint made against him to the GMC (General Medical Council, UK) – it was not upheld.

80% of the members of the Royal College of Paediatrics and Child, 6,000 doctors, answered the survey’s questions.

One seventh of them have had a formal complaint lodged against them about their child protection work.

Prof Alan Craft, president of the Royal College, said 'This is a big problem. There is a possibility that paediatricians will not investigate potential injuries and sudden infant death properly and therefore children potentially will die because of it.'

http://www.medicalnewstoday.com/index.php?newsid=6426

 

[Mighty_Emperor]

Its all so very messy - Its clear MSBP exists but the doctor has done himself no favours by seemingly using it as a blanket term for just about anything invloving a mother and child - for example I have no idea how this was diagnosed as MSBP:

Mother cleared of leaving drowned son in duck pond

By Catriona Davies
(Filed: 25/03/2004)


A woman was cleared yesterday of drowning her two-year-old son 13 years ago and dumping his body in a duck pond.

Sallie-Anne Loughran, 40, has always maintained that her son Thomas Hunt left their house in Sutton Bonington, Notts, unnoticed and walked the 150 yards to the duck pond.


Sallie-Anne Loughran after the verdict
Athough an inquest in 1991 concluded that Thomas's death was accidental, Mrs Loughran, who now lives in Ibstock, Leics, was arrested eight years later after the family of her former husband, Paul Hunt, reported suspicions to the police.

After a jury at Nottingham Crown Court found her not guilty of murder and manslaughter by a 10 to two majority, Mrs Loughran said: "This is a case that should never have happened."

She stood outside the court with her third husband Gerard, 46, as her solicitor, Peter Millward, said in a statement: "Sallie would like to thank the jury for listening. It has restored her faith in British justice, and justice has at long last been done for Thomas. It has been a traumatic four years and Sallie is now relieved that it has finally been concluded."


Thomas Hunt
After the verdict, it was revealed that Mrs Loughran, who has two other children, had been diagnosed with Munchausen's Syndrome by Proxy 18 years ago by Sir Roy Meadow, the paediatrician whose evidence was discredited in other child killing cases. The condition, which leads parents to seek attention by harming their children, was not mentioned in the trial.

Mrs Loughran's friend Penny Mellor claimed after the trial that it was the earlier diagnosis of Munchausen's Syndrome by Proxy that led to her arrest. She also claimed the diagnosis had led to Mrs Loughran's first husband securing custody of their daughter Katy, 19, and to Mr Hunt gaining custody of their daughter Emily, 14.

The prosecution claimed that Mrs Loughran drowned Thomas in the bath before carrying him out to the village duck pond to make it look like an accident. Peter Joyce, QC, prosecuting, said Mrs Loughran had confessed to Mr Hunt's father, Peter.

The defence said there was no evidence to suggest that Thomas had not fallen into the pond accidentally, and rejected claims that marks on the boy had been caused by Mrs Loughran holding him down in a bath.

http://www.telegraph.co.uk/news/mai...ond25.xml&sSheet=/news/2004/03/25/ixhome.html

I may have misunderstood what it involves but 'ordinary' child murdering doesn't really strike me as being anything to do with MSBP. I suppose it might happen occasionally but by and large I thought it was for gaining sympathy (not suspiion) and killing your child rather defeats the point.

Emps

 

[Mighty_Emperor]

And this is a case full of dirty dealings - also as far as I can tell the main plank of her appeal is that the doctor who diagnosed MSBP worked with Sir Meadows. She makes other claims about the case but has also been judged as a liar and I can see why the court of appeal is haivng trouble finding out the truth in this one.

Unravelling the Harman case

(Filed: 25/03/2004)


The Court of Appeal must decide if a mother risked her child's life or was a victim of miscarriage of justice, writes Joshua Rozenberg

Did a mother deliberately put her daughter's life at risk two years ago by injecting her with an infected fluid? Or did the mother become the victim of an appalling miscarriage of justice when Kent social services took her little girl into care?

These are the questions at the heart of an extraordinary judgment handed down by Mr Justice Munby in the High Court Family Division last Friday, and reported for the first time in yesterday's Telegraph.

As the judgment revealed, the mother's solicitor, Sarah Harman, sent the case papers to her sister, the Solicitor General Harriet Harman, who in turn forwarded them to the Children's Minister, Margaret Hodge. Each publication was unlawful, and Sarah Harman apologised after accepting the judge's finding that she had been in contempt of court.

Worse still, perhaps, Sarah Harman and her client were found to have misled the judge who dealt with the case last month "by a mixture of suppressio veri and suggestio falsi" - suppressing truth and suggesting falsehoods.

As far as the mother was concerned, that should have surprised nobody. Mrs Justice Bracewell found last year that the mother "is undoubtedly a skilled and persistent liar who, over the years, has sought to and succeeded in conning doctors, teachers and family in respect of illnesses which she claimed to be genuine but which were self-induced".

So, is there any justification for the mother's complaints against the doctors who diagnosed her as suffering from Munchausen's Syndrome by Proxy - an attention-seeking condition first identified by Prof Sir Roy Meadow. At the end of a lengthy ruling in the High Court, Mr Justice Munby said he did not have "the slightest idea".

"It may be that the mother is indeed the victim of a miscarriage of justice. If she is, then she has a powerful argument for saying that she should not be gagged."

But, for all the judge knew, she might not be.

"In that event, there may be a powerful public interest in exposing her for what she is found to be: a woman who falsely cast herself in the role of victim and sought, by use of the media, to persuade the public that she was something which, in truth, she turns out not to have been."

Deciding which of these pen-portraits was true was not a matter for Mr Justice Munby, a well-regarded family judge who is tipped for promotion to the Court of Appeal. All he had been asked to rule upon was whether the mother should be allowed to debate her case in public.

Some facts are undisputed. Her youngest daughter was born in 1999, and when the child was two, Kent social services department began High Court care proceedings.

Mrs Justice Bracewell found in January 2003 that a cannula, or tube, that had been attached to the child in hospital "was deliberately interfered with - removed - by the mother". She also found that the mother had deliberately administered "some unidentified infected substance" to the baby, which caused rigors - or fits - that were "potentially life-threatening".

After a further hearing before Mr Justice Holman last autumn, the child was taken into the care of Kent County Council and placed with family members. In January, her mother decided to challenge the care order in the Court of Appeal. Judgment is awaited after a hearing this month.

At the same time, the mother lodged a complaint with the General Medical Council against two of the doctors who had given evidence against her in the care proceedings.

Her legal action followed successful criminal appeals brought by three other mothers - Sally Clark, Trupti Patel and Angela Cannings. All had been convicted of murdering their children after Prof Sir Roy Meadow - the paediatrician who has been subsequently discredited - had given "expert" evidence for the Crown.

One of the mother's concerns in this case was that a doctor who gave evidence in the care proceedings was said to have based his diagnosis of Munchausen's Syndrome by Proxy on research he had carried out with Sir Roy.

The mother sought permission on Jan 29 to disclose court papers to the GMC in support of her complaint. She also asked if she could hand the papers to Harriet Harman, Mrs Hodge, and to her MP, because she wanted them to be considered as part of a possible Government review of care proceedings following the Cannings case.

In fact, the papers had already been disclosed. A High Court hearing on 5 Feb, at which she sought permission, was a "charade", said Mr Justice Munby.

The first that Kent council knew about what was going on was when Sarah Harman told social workers outside court that she would talk to her sister, the Solicitor General, about the case. If necessary, she told them, the social services department would have to make a contempt of court application against her.

This week, Sarah Harman and her supporters argued that publicity was an essential weapon in fighting miscarriages of justice. And Harriet Harman said in the Commons yesterday that constituents should be not be at risk of contempt proceedings if they discussed their own cases with their MPs. Finally, a Kent MP argued that he could not take up cases with ministers unless he had access to court papers.

But all this misses the point. The judge certainly made an order "against the world", preventing the child and her carers from being approached by the media.

He also refused the mother permission to name the doctor who diagnosed Munchausen's Syndrome in her case - not so much out of concern for the doctor as for other specialists who might, in future, be discouraged from helping the courts in "vitally important child protection cases".

But Mr Justice Munby, who has done more than any other judge to introduce openness in the Family Division, decided that the balance came down in favour of permitting the mother to disclose relevant court papers to the GMC and make her allegations in public.

And the Court of Appeal, Harriet Harman revealed yesterday, was perfectly happy for Margaret Hodge to see the court papers.

So, if only Sarah Harman and her client had waited until permission had been granted, they would not have been in contempt of court. The curious thing is that, by yesterday, we had heard nothing from the mother - even though she knew more than two weeks ago that she would be allowed to talk to her many media contacts.

Although she cannot be named, she is fully entitled, as Mr Justice Munby said, "to participate in the ongoing public debate and to do so essentially in the way she wishes".

She can tell us, for example, that the doctor who worked with Sir Roy Meadow had no experience of fabricated disease, that other experts could find no cause for the child's fits, and that hospital staff thought it unlikely that she would have had an opportunity to administer the unidentified infected substance to her child.

But Mrs Justice Bracewell's findings are that the mother did administer the substance and that she lied about a number of matters.

Who is right? The Court of Appeal reserved judgment three weeks ago. Let's hope it knows the answer.

http://www.telegraph.co.uk/news/mai...25.xml&sSheet=/news/2004/03/25/ixnewstop.html

[edit: And Harriet Harman's response:

http://politics.guardian.co.uk/commons/story/0,9061,1176943,00.html ]

Emps

 

[Mighty_Emperor]

And this is the other side of the coin - it seems (at least from this report) that MSbP is the first thing a lot of modecial professionals consider when a child is brought in (the 'truth' as always probably lies somewhere in between the two extremes):

Seen but not heard

April 3, 2004

Some doctors are too ready to look for psychological problems in the family when diagnosing a sick child. Julie Robotham reports.

The woman thought it should be relatively straightforward to have her son diagnosed and treated - especially given his history of knee injury. The 13-year-old was suffering excruciating pain in the same leg he had damaged three years earlier, and his mother had no reason to expect it was anything other than a recurrence of the old problem when she took him to a Sydney children's hospital last year.

One week after his admission, the teenager's shaken parents removed him from the hospital and drove him home. Doctors had found no explanation for the continuing pain - so bad it made him vomit - and instead of support, the happy family found themselves subjected to a line of interrogation they found simultaneously absurd and disturbing.

"A child psychologist was brought into the picture who asked odd questions about our family," the boy's mother told the Herald. "When I asked why this was required, they advised us they were looking into all possibilities ... [my son] is from a very family-orientated and happy background, but the questions were leading in a different way."

Soon after, a physiotherapist unconnected to the hospital identified and successfully treated the problem - a chronic muscle spasm had developed because the boy had been walking unevenly to compensate for his earlier injury. His treating doctors expressed polite interest, but were unabashed at having called the boy's mental health into question.

Across the country and internationally, parents of sick children are feeling themselves under a microscope of suspicion as doctors weigh the possibility they may have caused unusual symptoms in their children deliberately, or unwittingly by bringing them up in an environment of unbearable psychological stress.

And while it is unarguable that some parents abuse their offspring, - sometimes in bizarre and cryptic ways - concern is growing that the medical profession may be exceeding its remit by too readily attributing illnesses that doctors cannot explain to family circumstances.

Adara Davies fell foul of just such an insidious set of assumptions. The case, revealed by the Herald this week, of the cancer-stricken toddler whose diagnosis was delayed for three weeks while doctors speculated about her parents' relationship, highlights the danger of applying a psychological construction to children's symptoms before possible physical causes have been eliminated.

The Children's Hospital at Westmead has apologised to Mark and Rodna Davies and made a full admission that the delay in identifying their daughter's disease - of which the major symptom was constant vomiting - occurred because pediatricians were hell-bent on a psychological explanation, despite the parents' insistence something was terribly wrong.

"When people fixate on a diagnosis, that should be a warning bell to clinicians to step back a bit, particularly when parents are objecting," says Merrilyn Walton, the University of Sydney medical faculty's associate professor of ethical practice. "There's a growing acceptance that patients are experts in their own right in terms of their experience of their illness and if you're finding yourself discounting this, you should say, 'Hello, I might need help here'."

In the case of children, doctors should regard highly anxious parents not as neurotics who are overstating a trivial illness, but as a potential clue that the child may be very ill. "I would like to see parental concern [regarded as] as important as a temperature," said Walton who, as a former NSW Health Care Complaints Commissioner, investigated a number of instances in which very sick children were left to languish in emergency departments while their frantic parents' intuition that something was seriously amiss was disregarded. Nevertheless, she says, there is strong scientific backing for the notion that psychological stress can cause illness in children, and doctors are right to consider that possibility when a more obvious cause cannot be found.

Don Roberton says illness symptoms in childhood typically give doctors few clues. In adults, a clutch of complaints can set a doctor confidently on the road towards a particular diagnosis; in children they have to consider a much broader spectrum of possibilities, says the president of the pediatrics and child health division of the Royal Australasian College of Physicians. "A three-month-old baby with a severe kidney infection might be crying, potentially not feeding or vomiting," Roberton says, though the same symptoms could be attributable to a vast range of other illnesses or conditions - many of them much more likely than severe infection. The challenge is to keep in perspective the probability the baby will turn out to have something like a gastric virus, while not dismissing the possibility of serious illness.

And it is entirely reasonable - and essential - to look at a child's social circumstances when trying to figure out why they are sick. "Very young children can seem very irritable, there may be failure to thrive, because there are some very complex dynamics elsewhere in the family," says Roberton. Details of the family background "should be part of the history-taking on every contact with children".

Even if that information does not inform a diagnosis, it is still an acknowledgement that "the caring will occur in the family context", and the regime of care and treatment must be comprehensible and acceptable to the family - or else it will not be followed. Poverty and being a single parent are just two factors that can influence how a family is able to care for a sick child.

But Roberton agrees parents can feel threatened and intruded on when a doctor subjects them to scrutiny, and it can be a factor in the breakdown of the relationship between the two parties. "It's relatively rare to be in direct conflict like that, and sometimes a health professional needs to offer the parents the chance of second, third or fourth opinions." Pediatricians who found themselves in deepening opposition to a child's parent should urgently "seek help from others - not to recruit them to our cause but the child's cause", says Roberton.

A difficulty, says Terry Donald, is that doctors in such a situation may not understand their own motivation. Donald, the head of child protection at Adelaide's Women's and Children's Hospital, says many doctors are unhappy with the medical compromises they may have to make to maintain a constructive relationship with parents - for example, ordering tests a parent insists on but the doctor believes are not needed.

Donald has witnessed instances where doctors up the ante on parents they disagree with over a child's diagnosis by suggesting Munchausen's syndrome by proxy (MSBP) - the psychological diagnosis in which the parent is judged to have fabricated or induced the child's illness.

Such an allegation can help a doctor regain control of a situation that is spinning out of their grasp, but Donald says heavy tactics are never acceptable. Even the most difficult parents have to be brought around so that "they have regard and sufficient trust to allow the doctor to lead the process of diagnosis and management. [Doctors have] a responsibility to push this point of engagement," and not to allow relations with parents to sour, says Donald.

Where psychological or family factors have to be canvassed, it should always be done with the utmost care, and always by a senior doctor with relevant experience. "It's not always presented well to parents. Some doctors do it very badly and that can affect badly the way parents respond," Donald says. Without preamble, some doctors bark out the sensitive family questions in the same tone as they ask about fever and eating patterns, and that gets parents offside, he says.

IF doctors' communications skills fall short, their attitudes to parents may be worse. Michael Fairley, head of child and adolescent psychiatry at Sydney's Prince of Wales Hospital and Sydney Children's Hospital, described to a conference last year the disrespectful way some doctors refer to parents of children with unexplained illnesses. "I'll concede that round corridors people will say, 'Ah, this one seems a bit Munchausen-y'. It does get a bit derogatory," Fairley told the Australasian Conference on Child Abuse and Neglect in Sydney last November.

He acknowledged this was inappropriate but said parents' worst fear - that a child may be removed by child protection authorities if an unfounded suspicion of MSBP gets out of hand - was unjustified. Loose talk "certainly doesn't lead to the removal of children ... the diagnostic criteria prevent this going too far", Fairley said.

In a paper in the Medical Journal of Australia last year, an Adelaide psychiatrist, Jon Jureidini, argued the medical system itself was guilty of perpetuating illness in children, blaming doctors' "excitement at life-and-death scenarios, or fascination with apparently rare and publishable cases". The rise of patient power meant parents were emboldened to seek ever more specialist opinions, and professional rivalry meant doctors would sometimes collude with parents in the quest for an exotic diagnosis if it meant they could dismiss the views of a more pedestrian colleague.

"Doctors may associate more personal status with finding the diagnosis than clarifying that a problem has multiple ill-defined causes," wrote Jureidini, the head of the department of psychological medicine at the Women's and Children's Hospital. "Also they may avoid saying, 'I don't know what's going on here,' perhaps because they fear revealing their ignorance."

http://www.smh.com.au/articles/2004/04/02/1080544688263.html

 

[Mighty_Emperor]

Cot death expert: we were victims of a smear campaign

By Jeremy Laurance, Health Editor
10 April 2004


Their controversial findings have ripped families apart, divided the medical profession and triggered the biggest review of criminal convictions in British legal history. But yesterday a leading paediatrician at the centre of the bitter row about child protection broke his silence to defend the disputed diagnosis of Munchausen's syndrome by proxy and its chief protagonist.

Professor David Southall, a consultant paediatrician at the North Staffordshire Hospital in Stoke on Trent, who faces eight charges of serious professional misconduct before the General Medical Council (GMC) in relation to his use of the diagnosis, hit back at his accusers, sayingthat he and his colleagues had been the victims of a campaign of vilification and misrepresentation.

Speaking to The Independent, Professor Southall said he believed the scale of child abuse by parents who caused illness in their offspring to win medical attention was greater than had been recognised.

He said: "The diagnosis has not been over-used. I think it has been grossly under-used but to prove that needs more research. Cases where parents have fabricated or induced illness in their children have been grossly under-diagnosed and under-reported."

Professor Southall, an expert in child protection, said he was speaking out to defend his colleague, Professor Sir Roy Meadow, whose reputation as an expert witness is in tatters after the collapse of criminal cases in which mothers were jailed for murdering their children. Sir Roy, who is to face a charge of serious professional misconduct before the GMC later this year, gave evidence in the cases of Sally Clark, Trupti Patel and Angela Cannings.

Professor Southall said Sir Roy, a former president of the Royal College of Paediatrics and Child Health, had been "victimised" and his position "grossly misrepresented" by the media. Asked what he thought the outcome of the GMC case against Sir Roy would be, he said: "He will get off. He has done absolutely nothing wrong."

Ms Clark and Ms Cannings were jailed, partly on the evidence of Sir Roy, but later freed by the Appeal Court, and Ms Patel was cleared and did not go to jail. The collapse of the cases, and criticism by the Appeal Court of Sir Roy's evidence in the Cannings case, led the Attorney General to order a review of 258 child protection cases, the biggest in legal history.

Ministers have launched a review of an estimated 5,000 cases where children were taken away from their parents by the family courts.

Professor Southall, who is accused of intervening in the Clark case by making allegations against Ms Clark's husband on the basis of a television programme, said he could not speak about his case, on the advice of his lawyers. But he defended Sir Roy, whom he described as "a colleague, not a friend" whose work he had long admired.

Professor Southall said: "Roy would very much like to speak out but has been advised against it by his medical defence union. He has been victimised over this and it is not fair. He is such a nice person. He is not the kind who complains, he just suffers."

Sir Roy had been criticised for telling the court that the chances of two cot deaths occurring by chance in the same family were one in 73 million, a remark later dismissed by the Appeal Court in the Cannings case as "wholly erroneous".

But Professor Southall said the statistic was not calculated by Sir Roy, as widely thought, but came from a government report, The Confidential Enquiry into Sudden Unexpected Deaths in Infancy 1993-96, published by the Stationery Office.

Professor Southall said: "He was quoting from a government report and if anyone is to be criticised it should be the authors of the report."

Sir Roy had been criticised for suggesting that while one cot death was an accident, two was suspicious and three was murder in what has been dubbed "Meadow's Law". But Professor Southall said the "law" was devised not by Sir Roy but by an American specialist, Professor Dominic Dimaio, who set it out in a textbook, Forensic Pathology, published by Elsevier in 1989.

Professor Dimaio says in the book: "It is the authors' opinion that while a second [cot] death from a mother is improbable, it is possible and she should be given the benefit of the doubt. A third case, in our opinion is not possible and is a case of homicide."

That view was repeated in the standard textbook on child abuse, The Battered Child, edited by Helfer, Kempe and Krugman, published in 1997 (fifth edition). It said: "Should a third infant death without an obvious natural disease process occur in the same family, the cause of death should be identified as asphyxiation, and the manner of death classed as homicide."

But The Battered Child was not cited by the Appeal Court judges in the Cannings case, Professor Southall said. "The Appeal Court did not apprise itself of one of the main publications on child abuse. Roy Meadow was quoting from one of the standard world texts."

Sir Roy's chances of rebutting the charges against him at the GMC will depend on what he said in court and on how he presented it. It is a standard defence for a professional accused of making an error that if he can prove it was accepted professional opinion, even though wrong, he cannot be held liable.

But the Appeal Court judges in the Cannings case observed that, in addition to demonstrating that "even the most distinguished expert can be wrong", it provided a "salutary warning against the possible dangers of an over-dogmatic expert approach".

Professor Southall said: "I cannot comment on Roy's performance in court - I have never seen him give evidence. What I can comment on is the quality of his publications. I am very impressed with his research."

The illness

Munchausen's by proxy was first described by Professor Roy Meadow in 1977 and he became a world authority on it as one of the most eminent paediatricians of his generation.

The diagnosis was applied to mothers who deliberately harmed their children to gain medical attention.

But the Royal College of Paediatrics now prefers the term "fabricated illness", which makes no reference to the motive.

It also encompasses mothers who smother their children in desperation as well as those who induce symptoms to win a hospital appointment.

Cot deaths fell sharply in the past decade but there are still 350 unexplained baby deaths a year. The Foundation for the Study of Infant Deaths believes 22 of the deaths in 2002 aroused grounds for suspicion.

http://news.independent.co.uk/uk/legal/story.jsp?story=510194

 

[Mighty_Emperor]

And the doctors present their case:

DOCTORS IN MEDIA CAMPAIGN


10:18 - 15 April 2004

Leading doctors have accused the media of bias against paediatricians such as Professor David Southall at the University Hospital of North Staffordshire. In a letter in The Guardian today, 38 senior doctors said "they could not remain silent over recent court cases and the media campaign against colleagues".

The 37 signatories - consultant paediatricians and one paediatric radiologist - said media pronouncements that Munchausen syndrome by proxy does not exist "give scant consideration to Department of Health and Royal College of Paediatrics and Child Health (RCPCH) reports".

They pointed out that a recent RCPCH survey found no paediatrician had been found guilty of professional misconduct from 87 complaints made to the General Medical Council (GMC).

The letter follows a claim last month by Professor Southall - North Staffordshire's leading paediatrician - that parents were being handed a "charter to abuse" children because so many doctors were terrified of the consequences of reporting cases.

The consultant is to face a disciplinary hearing by the GMC later this year, investigating eight charges by patients that he wrongly accused them of attacking their children.

http://www.thesentinel.co.uk/displa...layContent&sourceNode=67252&contentPK=9603044