title: Munchausen Syndrome by Proxy/Fabricated and Induced Illness: does the diagnosis serve economic vested interests, rather than the interests of children?
abstract: The discourse of Munchausen Syndrome by Proxy/Fabricated and Induced Illness posits the widespread incidence of a highly dangerous form of child abuse in which illness and developmental delay in children, is caused by their parents or carers. The discourse has been linked to false allegations of child abuse, hostile adoptions and miscarriages of justice. It has also stimulated concerns that the children's real medical and developmental needs are neglected when their conditions are misdiagnosed as child abuse. This study examines the critical claims that have been levelled against the Munchausen discourse. They provide explanations of the children's problems that compete with the discourse. The claim of the discourse to scientific validity is thereby shown to be questionable. The explanations have been distilled into specific hypotheses, to stimulate further research. The literature from which the hypotheses were derived, identifies problems in the MSbP/FII discourse in five broad areas of science, regarding: the test validity of techniques; construct validity; statistical methods; evidentiary standards and adverse impacts. The main conclusion is that the detailed critical hypotheses, cohere around the central claim that the discourse of Munchausen Syndrome by Proxy/Fabricated and Induced Illness serves economic vested interests, rather than the interests of children. The hypotheses predict adverse health and social outcomes, as a result of the discourse. Consequently, the continued deployment of the discourse would probably be "unsafe and therefore unwise".
authors.affiliation: Public Health Research Group, Criminology Programme, School of Social Science, Liverpool John Moores University, Clarence Street, Liverpool L3 5UG, United Kingdom. L.Wrennall@ljmu.ac.uk
authors.forename: Lynne
authors.initials: L
authors.lastname: Wrennall
mesh_terms: D002648:Child; D004467:Economics; D019317:Evidence-Based Medicine / Q000379:methods*; D006801:Humans; D008962:Models, Theoretical; D016735:Munchausen Syndrome by Proxy / Q000175:diagnosis*