title: First, do no harm: the use of covert video surveillance to detect Munchausen Syndrome by Proxy--an unethical means of "preventing" child abuse.
abstract: Since it was first identified in 1977, Munchausen Syndrome by Proxy has uniquely affected the way in which the medical and legal communities deal with the issue of child abuse. Inherent in the medical response to the disease are issues of suspicion, investigation, identification, confrontation, and, of course, the health of an innocent child. Given the deceptive dynamics of this disease, however, denial and disbelief naturally overshadow every action taken by medical professionals in pursuing these issues. Fortunately, as medical knowledge about the dynamics of the disease continues to develop, medical professionals become more willing and better able to identify the disease and focus their response on the safety of the child. The greatest problem in prosecuting Munchausen Syndrome by Proxy is that judges and juries remain unwilling to accept the reality of the disease. Consequently, in an effort to confirm medical suspicions and quell legal doubts, the medical community has resorted to covert video surveillance of the abuse while it is being perpetrated in the hospital. In this Article, Flannery argues that this response is an unnecessary and unethical, means of preventing Munchausen Syndrome by Proxy and protecting the child. Flannery supports the approach taken by the Family Court of New York in addressing Munchausen Syndrome by Proxy cases. The Family Court of New York recognizes the unique dynamics of this bizarre disorder, and, therefore, considers all cumulative circumstantial evidence in a Munchausen Syndrome by Proxy case, comparing the facts of the subject case to the commonly accepted features of confirmed cases. Part of the circumstantial evidence that should be considered, Flannery argues, is the dissipation of the child's condition upon temporary separation from the alleged perpetrating parent. As is done by the Flannery Court of New York, a res ipsa loquitur standard should then be applied, and an appropriate disposition for the child should be determined. By employing this standard, the court may confirm suspicions of Munchausen Syndrome by Proxy while avoiding the unnecessary harm to the child inherent in the covert video surveillance of Munchausen Syndrome by Proxy.
authors.affiliation: Villanova University School of Law, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Flannery
mesh_terms: D002648:Child; D002649:Child Abuse / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D002655:Child Custody; D002669:Child Welfare / Q000331:legislation & jurisprudence*; D008192:Deception; D006801:Humans; D009035:Mothers / Q000523:psychology; D016735:Munchausen Syndrome by Proxy / Q000175:diagnosis*; D009518:New York; D010564:Personnel, Hospital; D018907:Privacy / Q000331:legislation & jurisprudence; D014741:Video Recording / Q000941:ethics*