Current Treatment Options in Pediatrics

, Volume 4, Issue 3, pp 363–372 | Cite as

Medical Child Abuse: What Have We Learned in 40 Years?

  • Thomas A. RoeslerEmail author
Hospital Medicine (A Statile and N Unaka, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Hospital Medicine


Purpose of review

The realization that caretakers could harm children by getting unnecessary and harmful or potentially harmful medical care began 40 years ago with the first paper on what Meadow called Munchausen by proxy. This article reviews the evolving understanding of this form of child abuse and discusses ongoing controversies including as follows: what to call it, whether it is rare or common, who gets the diagnosis, is there a profile of a perpetrator, is the motivation of the perpetrator important, and how treatable is the condition.

Recent findings

Several recent policy guidelines are available detailing current recommendations for evaluation and treatment. Pediatricians tend to conceptualize this phenomenon in child abuse terms and refer to it as medical child abuse (MCA). Mental health professionals continue to use the deceptive behavior of the perpetrator as the organizing principle.


Medical and mental health professionals are working together to develop treatment strategies. Clarity regarding the ongoing controversies suggests avenues for future research.


Medical child abuse Munchausen syndrome by proxy Factitious disorder by proxy Pediatric condition falsification 


Compliance with Ethical Standards

Conflict of Interest

Thomas A. Roesler declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Child and Family Psychiatry, Seattle Children’s HospitalUniversity of Washington School of MedicineSeattleUSA

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