Quotes of the Day

Sunday, Sep. 07, 2003

Open quoteWhen Emma Watson was born in 1996, she seemed at first to be a perfectly healthy, happy baby. But her mother, Lisa, who lives in northern England, soon realized that Emma was reaching developmental milestones later than her three elder siblings had. Then one day the 6-month-old girl's eyes rolled back and she began shaking uncontrollably. Emma was diagnosed with epilepsy. Lisa says that the seizures continued. In 1998, shortly after the family's pediatrician retired, Emma's new doctor admitted her to the hospital for observation. The seizures Watson had reported Emma having at home stopped, but the doctors weren't satisfied. In fact, they became suspicious — the Watsons received a disability allowance because of Emma's diagnosis; had that led Lisa to fake the illness? The doctors began asking her if she'd been abused as a child, or had ever made up stories about her children being sick. When Lisa demonstrated a mastery of Emma's complex medical history, they quizzed her: "How do you know all this?" Her response: "Wouldn't any mother have tried to find out as much as she could?"

The doctors' suspicions were reinforced when Emma balked at removing her clothes for examination. At first Watson was incredulous at the insinuations of abuse. As they turned into accusations, she and her husband threatened to take Emma home. When they attempted to leave with her, police and social services escorted them from the hospital and an emergency protection order was issued. Emma was placed in foster care, and officials told Watson, pregnant with her fifth child, that they would apply to place the baby in care at birth. "Why don't you just admit you like hurting your children?" a case worker urged her. Her voice quavering at the memory of her nightmarish ordeal, Watson insists that she has never harmed any of her children in any way.

And so Lisa Watson (both her and her child's name have been changed) became one of hundreds of parents in the U.K. to be accused in recent years of making their children ill or pretending that they are ill, thereby causing them to be subjected to unnecessary, potentially harmful medical procedures. In July, a Scottish court sentenced Susan Hamilton to four years in prison for assault and endangering her child's life. The court ruled that she had poisoned her now brain-damaged daughter with large doses of salt, prompting hospitalizations and doctors' visits over several years. Hamilton and her family say she was wrongly prosecuted.

This kind of abuse was first given a name by British pediatrician Roy Meadow, who acted as a consultant in Watson's case.
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Meadow coined the term Munchausen Syndrome By Proxy (MSBP) in a 1977 Lancet article to describe the behavior of "parents who, by falsification, caused their children innumerable harmful hospital procedures." (Patients with Munchausen Syndrome, named for a fictional character known for tall tales, fake their own symptoms.) In the U.K. and elsewhere, MSBP has become an increasingly common diagnosis, as medical and law- enforcement professionals became familiar with the catalog of MSBP indicators. The FBI profile of the typical perpetrator, for example, warns that they "are most often biological mothers of the victims ... welcome medical tests that are painful to the child ... and appear to be very knowledgeable about the victim's illness." Such parents seem loving, yet enjoy the attention generated by their child's alleged illness. Meadow, now 70, earned a knighthood for his pioneering work, became the leading authority in the field and has been an expert witness in scores of cases involving allegations of child abuse through factitious illness by proxy.

But now Meadow is under attack. Two high-profile criminal trials in which he was a witness have recently collapsed. Sally Clark of Cheshire and Trupti Patel of Berkshire were both tried for murder, accused of suffocating their children and blaming cot death. Patel was acquitted in June. The case against Clark, a lawyer who served three years in prison after her 1999 conviction for killing two of her three sons, was struck down on appeal in April when it emerged that pathologist Alan Williams, a key prosecution witness, had failed to disclose evidence of an infection that could have contributed to the death of one of the boys.

Meadow was a prosecution witness at both trials. He testified in Clark's case that the chance of two cot deaths in one family was 1 in 73 million, a statistical claim that was outside the scope of his expertise and, the appeals court declared, should never have been allowed into evidence. The Crown Prosecution Service said that in all ongoing cases involving the testimony of Meadow or Williams the defense will be told of the Clark case and the criticisms it prompted. As for past cases, "only those involving Dr. Williams and not those of Professor Meadow are being looked at," says a cps spokeswoman. At least one case involving Meadow's testimony will soon be up for review. A Nov. 22 appeal date has been set for Angela Cannings of Wiltshire, who is serving a life sentence for killing her two infant sons. Cannings' husband has said the couple are not allowing themselves to become "too optimistic," but the controversy surrounding Meadow's cases should bolster her appeal.

Meadow's critics say his belief in the prevalence of MSBP has undermined a fundamental precept of the justice system. "Largely because of Meadow's settled conviction that a high number of parents and mothers are murderers, the presumption of innocence that has always been traditional in English justice is completely reversed," says Sue Stapely, one of Clark's lawyers. Clark and Patel are, in a tragically perverse sense, the fortunate ones, because a murder trial brought the accusations against them into the public realm. Most cases involving allegations of child abuse through factitious illness do not result in death, and the matter is dealt with in family courts, where proceedings are closed and the real names of the families involved, including the Watsons, cannot be published. Family-court confidentiality is a long-standing dilemma in Anglo-American law. "It's a well-intentioned feature, because the overriding concern must be the protection of the child, but this secrecy is part of the problem," says Frederick Howe, the Conservative Party's health affairs spokesman in the House of Lords. Howe expresses "grave concern" about the number of cases involving MSBP allegations. "MSBP is an unproven, pernicious and almost certainly flawed theory that has gained general acceptance," says Howe.

Confidentiality rules bar Meadow from discussing cases or responding to the accusations against him, but his defenders say his ideas are sound. Factitious illness by proxy is rare, admits Harvey Marcovitch, a former president of the Royal College of Pediatricians, but "all pediatricians have come across it." Marc Feldman, a U.S. psychiatrist and MSBP expert, notes that similar controversies have arisen in the U.S., where the incidence of MSBP has also increased steadily over the past two decades. He emphasizes that MSBP takes place everywhere, even if it is reported primarily in English-speaking countries where professionals are familiar with its indicators. "It's not a hypothesis or a theory," he says. "MSBP needs to be discussed as a form of abuse, not as a mental disorder or a personality trait of a parent."

Many parents whose families have been devastated by MSBP allegations continue to insist they are blameless; they have staged recent protests and talk of taking their cases to the European Court of Human Rights, which last year ruled that the rights of a British woman accused of inducing illness in her children were violated when her baby was taken from her at birth. Watson is one of the rare lucky ones. In 1999 she regained custody of Emma, who along with her youngest son remains under a social services care order. Watson's claims of innocence were vindicated after Emma had seizures while in foster care. "It sounds awful, but I was elated because I wasn't anywhere near her and couldn't be blamed," she says. The pleasure she was accused of deriving from her daughter's illness is what led to Watson's troubles. Such unnatural joy indicates how deeply allegations of MSBP can twist the soul, and why the controversy around them will not end soon.Close quote

  • AISHA LABI
  • Parents accused of child abuse say the system regards them as guilty unless proven innocent
Photo: NIGEL HILLIER/UNP FOR TIME | Source: Parents across the U.K. say that false child-abuse claims have destroyed their lives