Munchausen syndrome by proxy. Child abuse in the medical system
T. Donald and J. Jureidini
Child Protection Service, Women's and Children's Hospital, North Adelaide, South Australia.
Munchausen syndrome by proxy often is managed differently from other forms
of child maltreatment, although it is differentiated from them only by the
active engagement with the medical profession in the production of
morbidity. We suggest a more rigorous approach to Munchausen syndrome by
proxy, with explicit acknowledgement that it is abuse and that the medical
system is critical to its genesis. This leads us to question the broadness
with which the label is applied (eg, in cases of imposed upper airway
obstruction) and to argue for management strategies closer to those
accepted for other forms of child maltreatment.
