Munchausen Syndrome by Proxy

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

The offender commonly substitutes a younger sibling for the initial victim. In rare cases, both children might share the abuse simultaneously, but it is more likely that the offender will concentrate on one victim at a time. Because offenders revel emotionally in the attention derived from MSBP, it seems reasonable to assume that only one child would be necessary to gain such attention. However, investigators would be remiss to assume singular victimization because MSBP offenders maintain their own peculiar index of rationalization.

MSBP as a Homicidal Agent

Unfortunately, MSBP has become a popular means to "dump" cases when agencies seek to establish a link between this syndrome and maternal homicide. Not all women who kill their children are afflicted with Munchausen Syndrome or MSBP, just as not all women who kill their children are insane.

With MSBP, offenders crave the attention gleaned from events surrounding their child's illness or death. Thus, investigators should consider the possibility of MSBP if they believe there to be some secondary gain - in the form of attention or notoriety - afforded the offender at the expense of the victim. If investigators find no warning signs associated with MSBP cases or no secondary gain in the form of attention, then they should consider the possibility of homicide without the association of the MSBP factor.

Conclusion

Despite the evolving understanding of Munchausen Syndrome by Proxy within the medical and law enforcement fields, police investigators still might find it difficult to believe that a child's caregiver, someone who appears sincerely concerned about the victim's health, could be the cause of a child's symptoms. However, a growing list of cases involving Munchausen Syndrome by Proxy confirms that this disorder represents a substantial challenge to the criminal justice system. By understanding the motivations, needs, and methods of MSBP offenders, the law enforcement community can better identify perpetrators and protect innocent victims.

Endnotes

1 R. Alexander, W. Smith, R. Stevenson, "Serial Munchausen's Syndrome by Proxy," Pediatrics, vol. 86, 1990, 581-585.

2 R. Meadow, "Management of Munchausen Syndrome by Proxy," Archives of Disease in Childhood, 1985, 385-393.

3 H. Schreier and J. Libow, Hurting for Love: Munchausen by Proxy Syndrome (Guilford, Connecticut: Guilford Press, 1993), 103.

4 K. Hanon, "Child Abuse: Munchausen's Syndrome by Proxy," FBI Law Enforcement Bulletin, December 1991, 8-11.

5 D.A. Rosenberg, "Web of Deceit: A Literature Review of Munchausen Syndrome by Proxy," Child Abuse and Neglect, November 1987, 547-565; R. Meadow, "Fictitious Epilepsy," Lancet, vol.25, 1984, 8; supra note 1.

6 R. Kinschereff and R. Famularo, "Extreme Munchausen Syndrome by Proxy: The Case for Termination of Parental Rights," Juvenile and Family Court Journal, vol. 5, 41-49.

RELATED ARTICLE: Profile of MSBP Offenders

* Are most often biological mothers of the victims, but potential offenders are not limited to this group; fathers and persons outside the family also have been identified