Dr James Schaller
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When Physicians are Divided, and Child Protection Workers, Who Know Nothing About Medicine, are Involved with Their "Experts," Ignorant Accusations of Munchausen by Proxy Emerge

Munchausen by Proxy is a new fad diagnosis used by ignorant and impotent clinicians living in "little box medicine" that should be reserved for very clear and certain situations, and not considered common in mill medicine that misses as much as it discovers.

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I have seen mothers brought into court who simply needed assistance. For example, a primary-care pediatrician testified that he felt overwhelmed by the complexity he faced in the management of two siblings with congenital disorders. He described the mother as honest and forthright, and he had no concern about abuse, but he contacted child protective services to help support the family and the child. However, child protective services hired a psychiatrist to review the mother's records after they discovered that MSBP had once been considered as a possibility. Without interviewing the mother, the psychiatrist told the judge that she was reckless, aggressive, and relentless. He said he would not be able to sleep at night unless these children were removed from their mother. The judge eventually cleared the mother, delivering some harsh words to the psychiatric expert, child protective services, and the primary-care pediatrician who failed to stand up on behalf of the mother. However, the process disrupted more than a year of the mother's life, ended her marriage, and consumed over $100,000 in attorney's fees.

I have seen mothers accused of MSBP simply because physicians disagreed about the medical management of their child. For example, the more aggressive professors at the state medical school, where he had sent his young patient for consultation, distressed a pediatrician in a small community. Instead of telling the professors that they had usurped control of his patient or that he disagreed with their treatment, he accused the mother of providing excessive care. Despite the absurdity of his accusation, child protective services took custody of this mother's only child for several months.

In addition, mothers are often blamed for the tests, procedures, and consultations even though this is common practice, especially in larger medical centers.

J Am Acad Psychiatry Law 34:1:90-95 (2006)

Persistent Problems With the Munchausen Syndrome by Proxy Label

Loren Pankratz, PhD


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