THE
presumption of innocence is a cornerstone of the rule of law. You
cannot be convicted without trial. Or can you? A denial can never be a
confession, can it? Without a trial you can’t be dragged from your home
before dawn, in 21st-century Britain, never to be seen again — or can
you?
Munchausen’s syndrome by proxy
(MSbP, but now called fabricated or induced illness) is diagnosed when
an adult — usually the mother — fabricates symptoms of sickness in a
child to draw attention to herself. One can imagine a woman with mental
problems doing it, but the idea that thousands of mothers are at it is
surely barking mad. In America 1,200 cases are officially recorded
every year. If it is a proper diagnosis why is it not listed in the
World Health Organisation’s international statistical classification of
diseases and related health problems?
Munchausen’s began life in 1951 as a catchphrase for an overanxious
mother, phantom-suffering her child’s pain. In 1977 a clever
paediatrician, Dr — now Professor Sir Roy — Meadow mutated it to
describe two healthy children whose mothers had fabricated their
illnesses. It made his name. He thought it rare. It provoked
controversy, not least because a mother’s denial was proof of MSbP. Two
questions demanded answers: what exactly was it and how prevalent? The
Government’s Griffiths inquiry recommended “an expert and
multidisciplinary panel to review methods of identification”. A working
party with only two doctors on it, neither a paediatrician, focused not
on identification, but on how to translate suspicion of it into proof.
Confirmation duly came to pass. The guidelines of the working party
were validated.
Since then, hundreds have claimed irreparable damage to their
families by false allegations of MSbP For years the incidence of
violent abuse of children has fallen consistently; by more than 50 per
cent since 1996. Yet in response to just one case — the horrifying
killing of Victoria Climbié, who was let down by social and medical
services — the Government is creating the Children’s Index containing
explicit details of every child from every source. Such a pharmacy of
intimate information could provide many more MSbP prescriptions with
tragic outcomes.
Any of the following may put a mother in the MSbP “frame”: if the
doctor can find nothing wrong with the child; if tests are negative; if
mum demands other opinions; if she has an “unhealthy” interest in
things medical; if she exaggerates the child’s condition; and, of
course, if she denies making it all up. For the health service, MSbP is
a cheap solution to difficult cases. Some doctors call it a sexy
diagnosis.
In Medical Hypotheses, a respected American journal, Dr
Virginia Sherr reports many cases of Lyme disease — notoriously
difficult to diagnose — treated as MSbP, with, sometimes, fatal
consequences for the child. In the BMJ, Charles Pragnell, a
former social worker, cites many stigmatised parents refusing to seek
treatment for their sick children for fear of child abuse allegations;
one doctor diagnosed MSbP 258 times.
The medical establishment justifies MSbP because many mothers
have confessed to it. Would any innocent mother say that she had abused
her child when she hadn’t? Commonly, a social worker, psychologist or
paediatrician will say: “If you deny it you will never see Sandra
again; if you admit it, you will keep her and receive treatment for
your condition.” Mother and her partner may agonise but the loss of
their daughter is unthinkable. So “Sandra’s” mum “confesses”. And that
probably guarantees that they will never be a family again. And the
“confession” goes into the statistics; another “joker” in the MSbP
house of cards.
Accused, a BBC Two documentary, told the shocking story
of a mob-handed, dawn raid in the Scottish island of South Ronaldsay,
in 1988, when nine terrified children were forcibly torn from their
parents on a social services’ fantasy that they had been subjected to
ritual satanic abuse. A family court judge quickly rubbished the
“prosecution” and sent the children home. The social workers involved
are, 17 years later, unrepentant, convinced that the denials — by all
the children and their parents — prove the abuse took place. Welcome to
the witches’ drowning pool.
What should be done? The Children’s Index should be scrapped.
Such a police state measure could multiply miscarriages of justice.
Judges should throw out expert evidence based on MSbP, citing the
judgment of the Queensland (Australia) Court of Appeal, in 2004, that
“it does not form part of a recognised reliable body of medical
knowledge”. The medical establishment should tell all doctors that MSbP
is not a medical condition. When a doctor or social worker is convinced
that a mother is pretending that her child is ill when it is not, she
should be charged with child abuse in a court of law. If the evidence
warrants it she will be “convicted” and any children considered for a
care order. If the evidence is not there, the mother is presumed
innocent.
The author is a solicitor and writer. Stolen Innocence, his story of Sally Clark, is published by Ebury Press