The term Munchausen syndrome by Proxy was originally coined by Meadow in (1977), to describe a situation in which a caregiver "creates factitious symptoms or signs in order to mislead the physician into believing the child is ill" (Blumenthal, 106). Meadow (2002) further defines Munchausen Syndrome by Proxy,
The children had incurred numerous needles and painful hospital admissions, investigations, and procedures because of a false story and factitious signs...the falsification was not by the patient themselves but by another person "acting on their behalf" which is a proxy (502).
Under the law, Munchausen's by proxy is considered a form of child maltreatment, as it "entails having inflicted harm upon a child by a caretaker and thus meets the criteria for child maltreatment established by the child abuse and neglect laws" (Perry & Joy, 151). An editorial in The Journal of Child Abuse & Neglect 27 (2003), reports that this form of maltreatment, "almost always manifests as a combination of physical abuse, emotional abuse and neglect...it was identified as a kind of maltreatment only about 25 years ago" (409). Indeed, Munchausen's by proxy is a relatively new form of child abuse, although it most certainly occurred in the past, it was not acknowledged until recently. The Journal of Child Abuse & Neglect (2003), reports that "MBP is no longer considered rare by most leading medical professionals, but rather under-identified due to lack of public awareness and professional expertise" (409). It is of benefit that MSBP is now recognized in the medical field, as "categorization has an important role in medicine and in child protection" (Eminson & Jureidini, 416).
The signs and symptoms
Blumenthal (1994) reports some signs of the Munchausen Syndrome by Proxy include, when the illness of a child is fabricated, persistent medical procedures and assessment, denial of the cause of the illness, and when signs and symptoms of the illness disappear when the child is separated from their parent or caregiver. There are also persistent medical examinations, procedures and surgeries. It is also common that signs and symptoms of the illness disappear when the child and parent are separated (Blumenthal, 107). The perpetrator may go as far as "fabricating or alterating investigation samples." Some examples of this may include, adding salt to a child's blood sample or heating a thermometer to produce a higher fever" (Blumenthal, 107). The parent is often eager to participate in medical procedures such as bringing in food from home, and refusing to leave the hospital (Parrish & Joy, 143).
Goodman (1994) explains that the "illness is the culprit and the patient is the victim" (153). Here he explains that parents often see themselves as a victim fighting against doctors who cannot think of the cause of the illness. This is further complicated because of a "reluctance to pathologize a parent with a potentially genuinely ill child." Medical staffs are...