Munchausen's Sydrome

A recent case in Hobart has brought a rare and controversial mental illness, Munchausen's by proxy syndrome, back into the spotlight.

The Medical Journal of Australia said the term "Munchausen by proxy syndrome" is best applied to cases of child abuse in which a parent, usually the child's mother, fabricates symptoms or induces illness in a child, usually to draw attention to themselves.

Dr Kieren Moran, a paediatrician in the Child Protection Unit at Sydney Children's Hospital, said although the condition was extremely rare, it did exist.

"It's not a disease, it's a behaviour where the parent, usually the mother, feigns illness in the child," Moran said.

"In a study we did, in three years we found just 45 cases in the whole of Australia."

Moran believes that where cases of Munchausen's by proxy are found, treatment for the behaviour is more suitable than jail.

However, some experts claim the disorder does not really exist.

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The first diagnosis of Munchausen's was made in 1977 by Sir Roy Meadow in the United Kingdom.

Meadow has since been struck off the medical register causing thousands of Munchhausen by proxy cases in the UK to be reviewed.

In Australia, Munchausen's is still regarded as a plausible disorder.

In the 1980s, Munchausen's by proxy sufferer Donna Bowker killed one of her children and seriously disabled a second and was sent to jail for her crimes.

"I didn't want to murder my babies and it wasn't easy way out," Bowker said.

"I love my babies in my own way I had no intention of murdering them and that's one thing I can say for sure."

It is alleged Bowker gave her daughter an overdose of sedatives because she wanted to give credence to her claims the child was ill.

"I didn't poison her," Bowker said.

"I tried to calm her down to try and stop her fitting.

"No one listens to you to you you're expected to be a super mum, but I couldn't be."

Bowker's first baby, Chloe, ultimately died of heart failure.

She is alleged to have twice given her newborn second daughter, Rebecca, salt and to have injected her with insulin on nine separate occasions to make her look sick.

"I gave Rebecca some insulin to keep her in hospital," Bowker said.

"It sounds weird, I know."

"The doctor said if her sugar levels were low they'd keep her there and that otherwise she'd have to go home."

"I made Rebecca sick to get attention for and for me to get myself out of this mess because I couldn't cope with the situation."

Bowker served time in prison.

History of Munchausen's by proxy syndrome:

Munchausen Syndrome was named after a German cavalry officer Baron von Munchausen (1720-1797), a man who travelled widely and was known for his dramatic but untruthful stories.

In 1951, Richard Asher described a pattern of self-abuse, where individuals fabricated histories of illness.

These fabrications most often led to complex medical investigations, hospitalisations, and needless surgery.

Remembering Baron von Munchausen and his mythical tales, Asher named this condition Munchausen Syndrome.

In an article for the Australian Institute of Family Studies, called "A new name for Munchausen Syndrome by Proxy: defining Fabricated or Induced Illness by Carers", authors Ellen Fish, Leah Bromfield and Daryl Higgins said the syndrome was a term coined by paediatrician Professor Roy Meadow in 1977.

The term refers to the circumstance where the child is the subject of the fabrication of an illness by the parent.

"It was thought that the parent 'with MSbP' was motivated by trying to gain attention from medical professionals by inducing or fabricating the sickness in their child," the authors said.

"The emphasis on the motivation of the parent or carer was tied to the classic definition of Munchausen Syndrome by Proxy."

However, the older Munchausen Syndrome by Proxy label is now undergoing intense scrutiny worldwide.

MSbP as a syndrome diagnosis has been called into question in recent criminal court cases in the United Kingdom.

Meadow gave evidence in three high-profile child murder trials.

His 'expert testimony' in these trials meant that some mothers were convicted and children removed from their families and taken into out-of-home care because they were seen as 'at risk'

On June 21, 2005, Professor Roy Meadow was struck off the medical register after he gave misleading evidence in a child murders trial.

This has created doubt about Meadow's evidence regarding Munchausen's as a diagnosis.

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