Cover image for Disordered mother or disordered diagnosis? : Munchausen by proxy syndrome
Disordered mother or disordered diagnosis? : Munchausen by proxy syndrome
Allison, David B., 1944-
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Publication Information:
Hillsdale, NJ : Analytic Press, 1998.
Physical Description:
xxxv, 297 pages ; 24 cm
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Central Library RC569.5.M83 A38 1998 Adult Non-Fiction Central Closed Stacks

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Disordered Mother or Disordered Diagnosis? begins with a thorough review of the original literature on Munchausen patients, from which authors David Allison and Mark Roberts demonstrate in detail how, psychiatric descriptions of this alleged condition have been thoroughly circular. The label "Munchausen Syndrome" never denoted a coherent Syndrome: from its "discovery" it has served as a catchphrase for chronically and disagreeably ill patients who share nothing beyond an ability to confuse and eventually antagonize their physicians. With the new MBPS variant, the unity of a "Syndrome" again follows entirely from medical suspicion about a heterogeneous population of disadvantaged mothers and chronically ill children.
Yet, if the diagnosis is an artifact, it is not without serious social implications. Their final chapter reviews the celebrated case of Yvonne Eldridge to show how the application of this specious diagnostic category may lead to the forcible removal of children from the home over the protests of already disempowered mothers. Seeking to regain custody of their children, mothers accused of MBPS face long, uphill legal battles in which they are confronted by "expert witnesses" who rely on a wholly circular and self-justifying literature. This extraordinary situation invites comparison with the grievous institutional follies of other eras, to wit, the accuser's power of attribution in the prosecution of witches in early modern history and the physician's authority to diagnose and treat hysteria in the 19th century.
Passionately written and possessed of rare historical breadth and intellectual clarity, Disordered Mother or Disordered Diagnosis? is a powerful wake-up call for the medical, psychiatric, and legal professions. It is essential reading for clinicians and feminist scholars, for social historians, sociologists, and jurists, indeed for all who care about the plight of disadvantaged mothers and the rights of medical patients in our society.

Author Notes

David B. Allison is professor of philosophy at the State University of New York at Stony Brook. He is the editor of the groundbreaking anthology "The New Nietzsche."

(Bowker Author Biography)

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Choice Review

In mental health, as in somatic medicine, physicians may misdiagnose patients. In the case studies and voluminous research literature presented here, misdiagnosis of Munchausen by proxy syndrome--defined medically as a form of child maltreatment or abuse inflicted by a caregiver (usually the mother) with fabrications of symptoms and/or induction of signs of disease, leading to unnecessary investigations and interventions--takes on the character of systematic, professional misogyny. These tragedies demonstrate that "evidence" never stands without a theory and a practical point: it must be evidence for a specific, coherent claim. In their detailed cases, Allison and Roberts (both SUNY at Stony Brook) show that many misdiagnoses and injustices have been committed against innocent mothers who never deliberately harmed their children, and who, indeed, acted consistently and logically believing that their children were sick. When physicians failed in the application of their pediatric diagnostic and therapeutic skills, they often blamed the victims and their mothers. By analogy to documented abuses of power in mass hysterias and witch trials, medicine's injustices to persistently caring women are spelled out, using multiple sources of intersubjectively verifiable data. Should be required reading for all students and practitioners in psychology, psychiatry, social work, medicine, nursing, and allied health professions. Undergraduate to graduate/professional; also general readers. S. S. Merrill formerly, Elmhurst College

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