A response to 'factitious disorders by proxy: A trap for the unwary' Parent induced illness,factitious illness by proxy (Munchausen by proxy)

Abstract

Introduction This form of child abuse is quite rare but perhaps not as unusual as the figures imply. The name itself and the recent changes confirm that there is increasing awareness of its significance; Munchausen Syndrome by proxy has been changed to factitious illness by proxy or parent induced illness. Roy Meadow (1977, 1982, 1990), first drew attention to this form of abuse where parents present their child with an organic illness. Bools et al (1994) has developed the work and there has been a recent important article from Gray and Bentovim (1996), based on work at Great Ormond Street Hospital. The complexity and diversity of these cases and the range of presentations seem to be part of the problem in recognition. An outline of the emergence of awareness of this form of child abuse and a review of the literature is well covered in the article 'Factitious disorders by proxy' (Randall & Parker, 1997). While drawing this difficult and complex form of abuse to the attention of professionals, what we would suggest is also needed is both an outline of the various forms of presentations and some thoughts about the processes that are present both within the professional system, intrafamilially, and intraphysically.     

A Child Wanted by Two,Conceived by Several: Lesbian-Parent Families Negotiating Procreation with a Known Donor

This article presents procreation agreement negotiations and the role played by men taking part as known donors in the parental project of lesbian mothers in the province of Quebec, Canada. Thirty-six individuals were interviewed: 10 female couples, 11 donors, and 5 of the donors’ life partners. The results show that the donors’ contribution takes place within a deliberative process during which the adults involved discuss 5 elements, namely (a) the procreation method selected, (b) the issue of future donations, (c) the forms of address and the role of the donor in the life of the children issuing from his donations, (d) the possible involvement of the donor's loved ones in the life of the lesbian-parent family, and (e) responses to various scenarios that might arise in the future. The negotiation also addresses concerns that those involved might have regarding the children's needs, resulting in a complex web of interpersonal relationships. Our findings show that dialogue is the key unifying factor, ensuring that everyone is in agreement and that the donor's role with respect to the child is in line with the expectations of everyone involved.