Medical Child Abuse

Abstract

Since its initial citing as Munchausen syndrome by Proxy (Meadow, Lancet 2(8033):343–345, 1977), many attempts to bring a consensus among medical professionals on the labeling of the condition have resulted in varied proposed and controversial nomenclatures, including pediatric condition falsification (Ayoub et al., Child Maltreat 7(2):105–111, 2002), child abuse in a medical setting (Stirling and Committee on Child Abuse and Neglect, Pediatrics 119(5):1026–1030, 2007), medical child abuse, and caregiver-fabricated illness in a child (Flaherty et al., Pediatrics 132(3):590–597, 2013). Regardless of the selected term, this is an unusual form of child maltreatment in which harm or potential harm is enacted onto the child by using or manipulating the medical system at the instigation of the caregiver. Medical child abuse (MCA) is a serious and potentially fatal form of child abuse (Roesler and Jenny, Medical child abuse: Beyond Munchausen syndrome by proxy. American Academy of Pediatrics, Elk Grove Village, 2009). The use of direct, clear terminology in the description of this form of child maltreatment is necessary when communication of a complicated medical case to the nonmedical child protective, investigating, and prosecutorial agencies may involve actions necessary to ensure the continued safety and protection of the child.