Disordered Mother or Disordered Diagnosis? : Munchausen by Proxy Syndrome

The diagnosis of Munchausen by Proxy Syndrome (MBPS) conjures up an eerie spectacle: a disturbed mother, while ostensibly seeking medical assistance, secretly induces physical illness in her helpless child in order to receive attention from a caring, even loving physician.

This putative "syndrome", which horrifically combines the elusiveness of the classic Munchausen Syndrome patient seeking care for nonexistent illness with the evils of child abuse, has been the subject of numerous books, television dramas, and recent court cases.

Yet, despite the widespread conviction among legal and psychiatric experts that Munchausen by Proxy Syndrome actually exists, the "syndrome" is specious, the evidence sustaining it insubstantial and logically flawed.

If the diagnosis is an artifact, it is not without serious social implications.

In their final chapter, Allison and Roberts review the celebrated case of Yvonne Eldridge to show how the application of this specious diagnostic category may lead to the forcible removal of children from the home over the protests of already disempowered mothers. Seeking to regain custody of their children, mothers accused of MBPS face long, uphill battles in which they are confronted by "expert witnesses" who rely on a wholly circular and self-justifying literature.

For Allison and Roberts, this extraordinary situation invites comparison with the grievous institutional follies of other eras, to wit, the accuser's power of attribution in the prosecution of witches in early modern history and the physician's authority to diagnoze and treat hysteria in the 19th century.