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factitious illness by proxy will be used under another name. Earl —_ proceedings. In this regard, Pragnell argues that munchausen Howe said it would be a development he'd "watch closely". syndrome by proxy or factitious illness theory should not be used. Hayward-Brown said that doctors are also moving towards He agrees that this is a wider interpretation than the Cannings "somatisation", where they allege that a young child has a decision, but is a position that should be used; it would prevent psychiatric illness where the child makes him/herself sick or the use of any child abuse theory while it was the subject of believes he/she is ill. "This is often combined with MSBP. It is considerable professional dispute. already known that usage of 'somatisation' has led to the death of one child who did not receive correct medical treatment." Professional denial of problems with MSBP charges As a result of the Cannings judgement—where the Court of There is a high degree of opposition to anti-MSBP forces as Appeal stated that if the outcome of the trial depends "exclusively influential doctors champion a colleague who has made false on the serious disagreement between...reputable experts, it will be | MSBP allegations. Other doctors, academics and those who unwise and therefore unsafe to proceed"—the UK Government speak out against the use of the munchausen syndrome by proxy ordered official reviews of both criminal and civil cases involving theory are discovering a "corrupt" system that is rejecting any Meadow's MSBP and cot death theories. The UK Attorney- change. General, Lord Goldsmith, reported to the Commons on 22 July In 2001, the UK Department of Health issued new guidelines in 2004 that, in checks to date, about one case in eight is potentially an attempt to give a form of validity and authenticity to MSBP, unsafe. and introduced a new title of "fabricated and induced illness in The UK Children's Minister Margaret Hodge also ordered child children". But Pragnell claims these guidelines were produced protection agencies to review care cases and determine if there are without any independent and scientifically based research or "doubts about expert evidence". Solicitor-General Harriet inquiry into the existence of munchausen syndrome by proxy/FII Harman told Parliament on 20 January 2004 that mothers who (fabricated and induced illness). The department merely regurgi- have had children removed would have their cases reviewed. tated the unsubstantiated opinions of MSBP/FII proponents, in However, Earl Howe said the government is just looking at a complete disregard for conflicting opinions. restricted group of court cases where At Professor David Southall's profes- the verdict may have gone the wrong sional misconduct hearings before the way. "It is disappointing that the British General Medical Council government is not addressing the Doctors, academics and those (GMC) on 6 August 2004,"! Professor VSBr or ett nes 1° |_who speak out against the use fe" ats Meiderto he Ro problem. They are not looking at of the munchausen syndrome Health, supported Southall. The GMC vm aaunitan, Teas | By proxy theory are 2s aC ped Sal These policies decline to state that discovering a "corrupt" system important ground-breaking research and the consequence of getting it | tat is rejecting any change. FR ins: pabies and children have been Surah Harman is disappointed that GMC sad of other submissions tha the UK Government is watering down they all "testify to Southall's clinical its review of MSBP cases. Commons Shadow Children's Minister skills and unparalleled commitment to the welfare of children all Tim Loughton attacked the decision to allow child protection over the world". agencies to review their own cases, as it would not inspire Liverpool University academic Dr Lynne Wrennell, who confidence that justice was being done where questionable attended the Southall hearings, said the case hinged on what was evidence was used. Other MSBP opponents have said the review accepted practice in child protection cases. "Southall's support of cases is not independent, as so-called experts are known or was cautious and carefully worded," Wrennell noted. professionally related to each other. In Australian states such as New South Wales, Victoria and London's Guardian newspaper of 14 July 2004 reported that Queensland, MSBP allegations are still being made against Scotland Yard is transforming the way suspicious baby deaths are = mothers. In Queensland, according to Edmond, the Appeal Court investigated; this is in response to miscarriages of justice involv- _ judgement is binding on lower courts, but the Children's Minister ing mothers wrongly accused of killing their children. Senior Mike Reynolds does not acknowledge that there have been legal detectives said they are responding to criticism of failings in and civil problems with MSBP's continued usage. In NSW, infant death investigations after the cases of the wrongly accused | Meadow's evidence is still being used in a court case, despite the mothers Angela Cannings, Sally Clark and Trupti Patel.’ Director of Public Prosecutions Nicholas Cowdrey's being aware BBC News on 17 June 2004 reported that the UK Government __ of the UK situation and the professional misconduct charges is undertaking a review of the way expert witnesses have been Meadow is facing. The NSW Department of Community used in child abuse cases. Children's Minister Margaret Hodge Services continues action against mothers, despite clear told the BBC that this action is in response to widespread concern knowledge of the problems that the MSBP charge has caused in about the quality and validity of evidence given by medical expert the UK. The NSW Attorney-General's office will take no action witnesses.'” in the matter. According to Hayward-Brown, there is no Pragnell suggested that the Cannings judgement on expert indication of any body in NSW or Australia showing concern evidence should be used in all MSBP cases, as these have been about the need for review of current and previous cases involving the subject of serious disagreement in the medical profession and Meadow's evidence, diagnoses and theories. in social work for many years. Any case involving MSBP will be Australia's federal government, through its Institute of Family the subject of disputes between experts, even before court Studies and its Child Protection Clearing House, promotes MSBP proceedings. In this regard, Pragnell argues that munchausen syndrome by proxy or factitious illness theory should not be used. He agrees that this is a wider interpretation than the Cannings decision, but is a position that should be used; it would prevent the use of any child abuse theory while it was the subject of considerable professional dispute. Doctors, academics and those who speak out against | the use ~fab NEXUS = 41 of the munchausen syndrome OCTOBER — NOVEMBER 2004 www.nexusmagazine.com