Medical Child Abuse

Medical child abuse is the updated terminology to more accurately describe what was previously referred to as Munchausen syndrome by proxy. Medical child abuse refers to situations in which a child receives unnecessary and harmful or potentially harmful medical care that is instigated by a caregiver’s actions, which may include exaggeration, lying, and inducing illness.

Both healthy children and those with underlying medical conditions can be victims of medical child abuse. Multiple clinicians (often specialists) — who may not communicate effectively with each other — participate in a child’s care, and the possibility of medical child abuse may be overlooked. Similarly, multiple clinicians may miss previous or current organic diagnoses.

A diagnosis of medical child abuse should include the following:

• thorough evaluation of all medical records

• clear communication among present and past treating physicians across institutions

• multidisciplinary collaboration including information from other medical sources (e.g., nurses in hospital or at home)

• caregiver understanding of completed evaluations and medical risk of additional intervention