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