Munchausen by proxy cases – Term Paper

What is munchausen syndrome by proxy


Munchausen syndrome is a mental disorder that makes individuals with a dire need for attention to fake injury or sickness. Munchausen syndrome by proxy is where children’s caregivers present false symptoms or trigger real characteristics to make it seem that the child is sick or injured. The prefix “by proxy” is taken to mean via a substitute. Despite MSP being considered as a child abuse, it is also a primary mental disorder.

Many MSP patients exaggerate about their child’s state while others go to the extent of lying to gather attention. The victims are given poisoned food, food is sometimes withheld or an infection being caused intentionally. Some of the caregivers place the children on a dangerous path by allowing tests and procedures that are characterized by pain and an enormous amount of risk just to get sympathy.MSP patients consider to be stronger than them; they may deceive them to get satisfaction.

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This disorder can affect any individual, but mothers with children under the age of six are likely victims. Some people go to risky extends to get recognition. Recent research at Cleveland Clinic establishes a close relation between child abuse and MSP. This paper devotes attention to MSP to the timing and ways through which authorities can intervene upon suspicion.

Munchausen syndrome by proxy in adults

It is crucial for us to acknowledge the existence of MSP. Despite it being rare, it is a risky disorder that affects young, innocent children. After we recognize and seek to identify possible cases is when intervention comes in handy. Caregivers suffering from MSP appear to be attentive and caring, cushioning them against any suspicion. This makes identification of cases an uphill task. Cases that the children show tremendous improvement when under medical observation and exhibit a worsening as earlier stated, this paper focuses on when and how authorities can intervene when a caregiver is suspected of Munchausen by Proxy. Relatives, family, and friends can be a good link for discovery and early intervention in cases. This paper focuses on doctors as authorities of intervention

In earlier points, it was seen that the perpetrator, usually the mother, likes to notify the relatives and other family members of the sickness of the child (Alexander, Smith and Stevenson 583). Since they enjoy the sympathy and attention given, they willingly share the information. The family members should get involved once the reports of illnesses have become frequent within a short span of time or if the child seems to be having medical illnesses constantly.

According to Roesler and Jenny (80), an example is give of a four month old girl whose name was Annie. Her mother took her to hospital claiming that she was vomiting and was turning blue. The doctors managed to stabilize her and placed a nurse in the room to watch her as she recovered. However, when the nurse stepped out to attend to a different matter, she came back and found the baby had turned blue. They suspected that the mother had contributed to the child’s discomfort by smothering her. They, therefore, separated her from the baby, after which the child’s vitals went back to normal.

Medical intervention in cases of Munchausen

The next level of intervention in cases of Munchausen by Proxy can be the doctor and medical staff (Kinschereff and Famularo 42). The ideal time for their intervention is when there are numerous doctor or hospital visits, yet the victim lacks any medical history associated with the alleged symptoms. In addition to the frequency, the medical personnel can also look out for bizarre signs that appear to have no correlation. Data on cases of Munchausen by Proxy shows that most perpetrators have vast knowledge in medicine and are open to the victims undergoing any treatment including those that can cause excruciating pain. These are all indicators of the condition and once identified, they signal that it is now time for the medical staff and doctors to intervene in protection of the victim’s welfare.

An example is given of a six-year old who was taken to hospital by his mother. She claimed that he had been coughing and wheezing for six days. Further, she told the doctors that he had a fever of up to 103.9 degree Fahrenheit. Other symptoms described included a reduction in his oral intake for three days and a decreased urine output for two days. The doctors quickly admitted him given his history of pneumonia (Roesler and Jenny 14). His blood sugar was also low and given his mother’s history with diabetes the medical staff began injecting him with insulin. However, they noticed that the transmission tube was leaking and began suspecting the mother. They, then, placed water into the tube marking it as insulin and watched. His blood sugar level remained normal since the mother assumed she was disrupting his insulin intake. After isolating her, they monitored him and realized that his blood sugar level remained normal

The intervene in the cases of munchausen

Physicians and other medical personnel can intervene in the cases of Munchausen by Proxy through a stepwise method. Focusing on the example presented above, doctors can first observe the medical history of the patient. Every hospital keeps patients records for future reference (Meadow 385). The information on the files helps to clarify on current symptoms. In some hospitals, the history encompassed that of the close families such as the mother, father and other siblings. If a child is frequently brought into the doctors or hospital with alleged symptoms that cannot be explained, the doctor is better equipped to diagnose Munchausen by Proxy.

The second step of intervention by physicians and hospitals would involve interviewing the other parent and family members in the absence of the suspected perpetrator. There is plenty of information that can be obtained from interviewing the family members. An individual may shed light on instances when they have found the perpetrator handling the victim in a questionable manner (Meadow 8). Furthermore, if the family has older children, there is a possibility of one or more of them having encountered the same in their earlier ages. Testimony from a sibling or the partner can solidify the doctor’s diagnosis of the Munchausen syndrome.

Admitting the child can be a third step of intervention by the medical personnel. Doctors are nurses able to monitor the health of the patient in the hospital closely. Regular checks by the doctors could dissuade the perpetrator from carrying out any harmful activities. If the individual does not have the opportunity to induce the symptoms or exaggerate them, the doctors can identify the effect of the Munchausen by Proxy (Rosenberg 551). Furthermore, the staff can observe the interaction between the caregiver and the victim. Any suspicious activity by the caregiver would draw the attention of the medical personnel and explain the occurrence of the bizarre symptoms.

The other way through which the hospital can intervene is by separating the child from the suspect. It would involve obtaining the consent of the family members and the local law enforcement. If doctors have good reason to believe that one parent is harming the child or inflating the symptoms observed, they can appeal to the relatives to take the child for a predetermined period to follow their health progress within that timeframe. Doctors could also call to the other parent to remove the child from the current home setting and take him or her away from the perpetrator as they strive to determine if the child’s symptoms is a result of Munchausen by Proxy (Rosenberg 553).

Recommending a psychological and psychiatric evaluation for both the child and the perpetrator is another method of intervention by the doctors. I believe that this technique could be the most useful. Its success will allow the medical personnel to confirm their diagnosis of the perpetrator. If the child grows to an expressive age, the manner in which the caregiver inflicts harm, psychiatric and psychological evaluation is the best approach for encouraging them to speak (Alexander, Smith and Stevenson 583). The probing questions can assist the child to remember events that he or she would, otherwise, never share. Furthermore, through the evaluation, the caregiver might be inspired to reveal the truth.

Child and family services agency

The last means through which doctors and hospitals can intervene is by informing child protective services and the local law enforcement (Hanon 9). It is the responsibility of the child services agency to act for the good and safety of the child. There has been reported deaths as a result of Munchausen by proxy. The caregiver is a threat to the security and safety of the child. Instances that appear harmless such as lying about the symptoms still pose a risk. It can lead to a misdiagnosis and the medicine prescribed contributes to poor health. It becomes worse when the perpetrator induces symptoms since such an action directly contributes to the deterioration of the health of the child. Notifying the child protective services and the local law enforcement gives the state the legal right to remove the child from harm. In my opinion, this is the best route to be taken in any suspected cases of suspected Munchausen by Proxy.

As earlier mentioned, one way to which the school can intervene is by talking to the student. Teachers can, in the course of the day, hear a student confess to another student of mistreatment at home. Furthermore, a change in the behavior of a student such as an increase in violent behavior or desire to harm others acts as an indicator for problems (Meadow 8). Teachers can follow up by calling the student aside and talking to them about the source of their current violent behavior. Opening the channels of communication could assist in gathering information that could save the child’s life and ensure their safety.

Their intervention can involve taking the child from the current home and placing him or her into a safer environment. Although, some researchers and therapists have argues that removing the child from a place they consider home can be detrimental in the long run, the change of environment can also be beneficial for their healing process. The child requires an environment that exposes him or her to love and care. It is essential that the children who were previously under the care of an individual suffering from the Munchausen by Proxy syndrome understand that they can be safe (Hanon 9). This belief will help with them as they undergo treatment. In my opinion, once child protective services see signs of Munchausen by Proxy, they should keep the children a ward of the state even if the child is to return home so that there is constant oversight to prevent a relapse in abuse.