Child abuse in the medical guise: Munchausen Syndrome by Proxy.
Item
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Title
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Child abuse in the medical guise: Munchausen Syndrome by Proxy.
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Identifier
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AAI9618095
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identifier
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9618095
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Creator
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Rister, Esther S.
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Contributor
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Adviser: Carl F. Wiedemann
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Date
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1996
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Language
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English
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Publisher
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City University of New York.
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Subject
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Sociology, Criminology and Penology | Health Sciences, Mental Health | Health Sciences, Public Health
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Abstract
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Child abuse in the medical guise (CAMG) has been identified as Munchausen Syndrome by Proxy (MSBP). It involves the interaction of a parent who willfully distorts the medical condition of a child, presenting him/her for treatment with factitious symptomatology and a pediatrician who is coopted into providing (or making referrals to other providers for) excessive and unnecessary invasive diagnostic and treatment protocols for the child.;This study was designed to investigate the role of the pediatrician in CAMG.;It was hypothesized that: (1) pediatricians will be unable to differentiate sophisticated MSBP child abusers from pathetic non-abusing Help Seekers (HS) and aggressive non-abusing Health Care Addicts (HCA); and that: (2) pediatricians will be unwilling to report incidents of CAMG to the appropriate authorities within the criminal justice system because they perceive the CAMG perpetrators as "good" and well-intentioned people.;438 practicing pediatricians responded to one of 6 randomly selected case vignettes (about low intensity HS, HCA and CAMG/MSBP cases and about high intensity HS, HCA and CAMG/MSBP cases) involving parents/mothers who brought their infants to the hospital for emergency care. The Questionaire provided for the objective diagnosis of each case and included a checklist of potential medical, mental health and criminal justice referrals. Ss subjective responses to parents/mothers and babies were measured on seven-step Semantic Differential scales. Support for these hypotheses was generated at both levels of intensity.;Two separate forms of adult behavior may produce the same types of CAMG outcomes. The first involves homicide, or the desire of an adult to maim and/or kill a child by means that are sufficiently exotic to avoid detection and apprehension. The second involves suicide, or the desire of an adult to test out a death-producing method on a child before applying it to him/herself.;Pediatricians have been described as the linchpins of the child protection system because it is the combination of their diagnostic skills and expert medical testimony that can produce meaningful reporting and effective prosecution.;In order to redress existing cases of CAMG and in order to deter parents from inflicting such abuse in the future, the author recommends that pediatricians receive more meaningful training and continuing medical education designed to both help them better identify cases of CAMG and to encourage them to be more willing to report such cases to appropriate agencies within the criminal justice system.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
