Lynne Wrennall
Dr Lynne Wrennall is Senior Lecturer in Criminology with the
Public Health Research Group, Criminology Programme, School of Social Science, Liverpool John Moores University
Lynne has written on the subject of the use of false allegations of MSBP made against women in the past - attracting the attention of America's leading supporter of MSBP - Dr Louisa J. Lasher with particular regard to a previous article of Dr Wrennalls - Munchausen Syndrome by Proxy/Fabricated and Induced Illness: Does the diagnosis serve economic vested interests, rather than the interests of children? http://linkinghub.elsevier.com/retrieve/pii/S0306987706007547 (note this is a chargeable-download paper.)
Lynne has now written a new paper, entitled Misdiagnosis of Child Abuse Related to Delay in Diagnosing a Paediatric Brain Tumor and made it available through a free PDF download through a new academic publisher - Liberatas Academica.
http://la-press.com/article.php?article_id=803
Title: Misdiagnosis of Child Abuse Related to Delay in Diagnosing a Paediatric Brain Tumor
The title perhaps provides a substantial indicator about the content.
Although rumours abound that medical staff routinely accuse parents, notably women, of MSBP, as a means to distract from a proper medical diagnosis...it's unlikely that such a comprehensive - and damning example of such behaviour committed by paediatricians has been so well documented as in this paper. There can be no greater condemnation of medical staff who have so comprehensively failed both their patient - a little girl eventually diagnosed with a brain tumour, and their profession than the paragraph;
Some nine months elapsed between symptom onset and eventual accurate diagnosis. When the symptomatology of the case is assessed against the available knowledge, the delay is found to have been avoidable.
Abstract
Conflicting opinion regarding the relative weight that should be allocated to the investigation of organic causes of child illness, compared to the pursuit of suspicions of child abuse, has generated considerable public debate. The discourse of Munchausen Syndrome by Proxy/ Fabricated and Induced Illness is at the centre of contention. In particular, concern has arisen that children’s medical needs are being neglected when their conditions are misdiagnosed as child abuse.
This paper documents a case study in which the use of Child Protection procedures was linked to the belief that the child’s illness had “no organic cause.” The case study is contextualised in a review of literature relevant to the diagnostic process.
The deployment of the Child Protection perspective resulted in significant delay in the diagnosis of the child’s brain tumour. The child was ultimately found to be suffering from an optic chasm mass lesion involving the hypothalamus and the medial temporal regions, resulting in Diencephalic Syndrome. The evidence in this case is that erring on the side of suspecting Munchausen Syndrome by Proxy/ Fabricated and Induced Illness, was not “erring on the side of the child.”
Several lessons need to be learned from the case. The importance of ensuring that the Child Protection perspective does not displace adequate assessment of alternative explanations for the child’s condition is emphasised, as is the need for good communication in medical relationships. Strategies involving empathy, mediation, negotiation and conflict resolution may provide a more appropriate and therapeutic alternative to the use of Child Protection procedures in cases where the diagnosis is contentious. The need to re-write relevant policy, protocols and guidance is imperative.
