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Thursday, August 19, 1999 Published at 13:18 GMT 14:18 UK


Experts to study controversial abuse syndrome

Beverley Allitt brought MSBP into the public spotlight

Doctors may be given new guidance on how to treat people with a psychological disorder which leads to child abuse.

The Royal College of Paediatrics and Child Health (RCPaed) has recommended to its council that guidance should be issued to members on how to deal with people who are suspected to have Munchausen Syndrome by Proxy (MSBP).

The condition came to public attention following the jailing of nurse Beverley Allitt for the murder of four babies.

Ms Allitt's actions were said to have been linked to MSBP, which was identified by paediatrician Sir Roy Meadow in 1977.

He described it as a form of child abuse in which mothers deliberately induced or falsely reported illnesses in their children in order to draw attention to themselves.

Rare condition

But some parents claim it is a medical invention and has been used to take children into care without firm evidence of abuse.

The RCPaed, which has conducted a detailed survey into the extent of diagnosed MSBP cases, says that because the condition is rare, doctors need more help in identifying it correctly.

Its council will discuss whether further guidance is needed and what form that should take at a meeting on October 14.

"It could involve a working party, a major piece of work or a review of literature on the subject," said secretary Len Tyler.

"It is an area where we realise there has been long-term concern among groups of parents and practitioners."

Paediatrician Dr Harvey Marcovitch, a leading member of the RCPaed, said MSBP was very difficult to diagnose.

"You tend to believe a parent if they say their child is ill. If they are lying to you it is terribly difficult to know what might be wrong.

"If they lie repeatedly it is even more difficult and some who swear blue that they are innocent are later found to be guilty. At some stage you have to become a policeman. It is a different way of thinking."

He added that some people with the condition appeared to believe their fantasy, making them more convincing and more difficult to detect.

Fine line

And he said there was a fine line between child abuse and MSBP.

"If a child has had salt added to their bottle, that, to me, is child abuse, although it has been diagnosed as Munchausen Syndrome by Proxy.

"But if they prick their finger and put the blood in their child's urine they are not directly harming the child and that is Munchausen Syndrome by Proxy.

"However, they might provoke a doctor to harm the child, through conducting test or even doing an unnecessary operation as a result."

But he added that there was a clear overlap.

"Doctors don't want to accuse parents falsely, but they also do not want to miss a Munchausen case.

"For non-experienced paediatricians it is particularly difficult. The College will hopefully make it easier for them."

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Munchausen Syndrome by Proxy

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