Munchausen by Proxy: Five Core Principles - Abstract
To effectively identify, assess and manage suspected cases of Munchausen by Proxy abuse, clinicians, legal professionals and the public need to incorporate five core principles into their understanding of this life-threatening form of maltreatment. To successfully protect a MBP victim requires a focus on the presence of harmful deception, regardless of underlying health status. It requires appreciation for of the web of individuals who support the ongoing abuse by failing to recognize it and, sometimes, by participating in the false story of illness or impairment. It requires knowledge of the ways in which clinicians can be successfully misled and pressured to provide unneeded assessment and interventions, especially given the limitations of existing diagnostic tools. Finally, it requires understanding that this behavior is compulsive and addictive, likely to require clinical and social assistance for the abuser to refrain from engaging in their harmful behaviors and to become a safe caregiver. Health providers, legal professionals and family members who grasp these principles will be better able to use the available guidelines effectively to identify and protect victims, and to facilitate
appropriate treatment of abusers.