Bad Medicine Parents the State and the Charge of “Medical Child Abuse”

224 University of California, Davis [Vol. 50:205
inquiry required in MSBP, the MCA inquiry gives the doctor the
power to make more subtle distinctions of gradation regarding the
parent’s behavior — whether, given the child’s expected symptoms
from a genuine medical condition, the parent instigated overtreatment.
Allowing doctors to make such fine distinctions places parents of
children with complicated medical issues in a continually vulnerable
position.
In all this, the terminology of “medical child abuse,” and its
association with MSBP, function to tar a vast range of parents as
psychopaths intent on hurting their children. This is despite the fact
that a large portion of behavior that falls within the broad definition of
MCA might more accurately be considered simple differences of
opinion between mothers and doctors, differences of opinions between
two sets of doctors, or slight, within-the-bell-curve-of-normal
exaggeration by a concerned parent. 80 (This is not to say that the
evaluating physicians always recognize the potentially broad possible
range of motives a parent may have; instead, they often leap to
assuming such a psychopathic motive exists based on scant
evidence. 81 ) Rather than refer to this entire spectrum of behavior as
Syndrome by Proxy: A Literature Review and Four New Cases, 7 HARV. REV. PSYCHIATRY
94 (1999) (describing seven cases in which an undiagnosed illness was falsely
described as MSBP). There were attempts to define MSBP more broadly as time wore
on in order to include pervasive exaggerations of a child’s symptoms, rather than the
complete fabrication of an illness. See, e.g., Morley, supra note 71, at 529 (criticizing
extension of MSBP to a broader range of cases). Nevertheless, the basic pattern still
generally held. See Rosenberg, Medical Diagnostic Criteria, supra note 45, at 424
(describing MSBP diagnosis by exclusion in terms of credibly excluding “all other
possible explanations for the child’s condition”).
80 See Meadow, Hinterland, supra note 33, at 344-45 (“We recognise that parents
sometimes exaggerate their child’s symptoms, perhaps to obtain faster or more
thorough medical care of their child.”); Morley, supra note 71, at 529 (“[M]others
frequently exaggerate their child’s symptoms, not through any malignant desire to
mislead the doctor but as part of common language: ‘he hasn’t eaten a thing all week’,
‘he vomits up all the feed’. Such phrases are part of everyday life and experienced
paediatricians do not take the mother’s story at face value but take a careful history to
find out exactly what has been happening.”).
81 As Lisa Ludwig, the attorney for Katherine Parker, who was charged with
criminal child abuse stated, “There are two possibilities here: One is that a high-school
educated, stay-at-home mom tricked literally dozens of medical professionals into
doing literally dozens of unnecessary medical procedures — including brain surgery
— on three different children . . . . The other possibility is the doctors made errors.”
Aimee Green, Stay-at-Home Mom Accused of Fooling Doctors into Medicating, Operating
on Kids Gets Probation, OREGONIAN (Feb. 23, 2016, 3:04 PM), http://www.oregonlive.
com/portland/index.ssf/2016/02/stay-at-home_mom_accused_of_fo.html. This same
leap to psychopathic motives occurs with MSBP charges. See Pankratz, MSBP Label,
supra note 46, at 91 (“I am repeatedly amazed when experts who have not interviewed