Munchausen Syndrome by Proxy

FBI Law Enforcement Bulletin,The, August, 1995 by Kathryn A. Artingstall

In order to reduce the possibility of further abuse to the child, investigators must work toward a swift conclusion to the case once they have confronted the suspected offender. Accordingly, case parameters and guidelines regarding evidence collected should be established prior to informing the subject of the investigation. Careful planning and caution in this area can be critical; research indicates that from 9 to 31 percent of all MSBP victims die at the hands of their perpetrators.(5)

Some confronted offenders might react more passively by relocating with the victim and other family members. If the courts do not enact protective measures to preclude a suspect from relocating with the child, the cycle of MSBP probably will continue in a new locale.

To avoid this scenario, investigators should ensure that adequate measures to protect the victim are in place via social services or judicial avenues before informing subjects that they are under suspicion. These measures should remain in place until the case is concluded.

If not arrested, offenders who believe they are under suspicion might become more cautious, but only temporarily. The child's apparent illness might subside until the offender believes it is safe to resume the abuse. Offenders also may wait until a reasonable time elapses and then re-admit the child into the hospital.

In either case, it appears that as offenders continue their abuse, the danger to the child increases. The needs-oriented behavior of such offenders has been compared to that of drug addicts. Through cycles of abuse and nurturing, MSBP offenders seek to satisfy an ever-increasing need for attention and self-validation. However, some experts believe that - unlike most drug addicts - MSBP offenders cannot be rehabilitated.(6)

False Allegations

Despite seemingly strong circumstantial evidence present in some cases of apparent MSBP abuse, law enforcement officers must make every effort to refrain from making false allegations. Accusations based on insufficient investigation and absent forensic analysis can have disastrous consequences.

In one such case, a mother in Missouri was falsely accused of the death of her infant son. The child died as a result of apparent ethylene glycol poisoning. However, upon the birth of a second baby, doctors found that the infant had a rare disease, methylmalonic acidemia, which in fact, had caused the death of the first child. The mother subsequently initiated legal action against the State.

Such cases reinforce the need for investigators to explore all avenues when suspicion of MSBP arises. The importance of medical evaluation cannot be overstated. In fact, without properly collected medical documentation to support the thesis of MSBP abuse, it is unlikely that prosecutors can establish probable cause to support custodial arrest.

Child Custody Cases

The manner in which charges of MSBP originate must be considered in the total course of an investigation. Highly disputed child custody cases often generate charges of child abuse. Sometimes, MSBP offenders accuse the other parent of abuse in order to mask their own wrongdoing and to keep custody of the child.