Child Abuse: Forensic Pediatrician Faces Misconduct Charges
June 28, 2005 5:33 PM   Subscribe

In the emotive world of child abuse, Professor Sir Roy Meadow became a celebrity in the last 25 years. He described Munchausen's Syndrome by proxy in which parents were said to have confabulated symptoms in their children in order to obtain medical treatment. Among child and health workers, Police and Social Workers, his eponymous law held that multiple childhood deaths in individual families were indicative of abuse and infanticide.
He was of course a popular forensic expert and his testimony resulted in murder convictions and removal of at-risk children from their families. But the Court of Appeal in UK has found that Prof. Meadow's statistical assertions and scientific reasonings were themselves confabulated and there have been a number of convictions overturned. He is now fighting for his professional reputation before the General Medical Council in London. [More Inside]
posted by peacay (17 comments total)
Spike magazine presents a review of Prof. Meadow's scientific aberrations with a rebuttal (of sorts)that holds that it was society's unhealthy obsession with abuse that allowed for therapeutic entrepeneurs to proliferate and for courts to be willing to convict with flimsy or circumstantial evidence. It is further noted that such an obsession impedes many adults from engaging in social activities with children for fear of generating suspicions and that some parents may be reluctant to seek medical treatment for their children for fear of similar untoward reactions from health professionals.


wiki-Meadow's law

wiki-Munchausens by proxy
posted by peacay at 5:41 PM on June 28, 2005

The report concluded that families who had suffered one cot death were more likely to experience a second, but Sir Roy told the court the chances of such a occurrence were one in 73 million.

Wow, that sounds like a seriously flawed understanding of conditional probability. Spiked Online, though, appears to have quite an agenda concerning family violence (check out their commentary on how it's just not polite for health care workers to ask pregnant women about the possibility of domestic abuse.) Le Fanu's piece was interesting and somewhat balanced, but Fitzgerald's continually hammers the theme that our society has blown the problems of child abuse by family members out of proportion even though almost all of the examples of trumped-up abuse charges he could come up with involved daycare workers.
posted by transona5 at 7:22 PM on June 28, 2005

But how about the families where multiple children were continually being hurt or worse? Does it never happen at all?
posted by amberglow at 7:35 PM on June 28, 2005

Munchausen syndrome by proxy and sudden infant death (British Medical Journal) ...As there is no single psychological profile in Munchausen syndrome by proxy,10 w31-34 and the label makes unwarranted assumptions about the parent's mental state and motivation, many UK paediatricians feel that the term should be abandoned. The preferred term is now fabricated and induced illness.15 Fabricated and induced illness is seen as part of a spectrum of child abuse, and death caused by suffocation is at the severe end of that spectrum. The term keeps the focus on the presenting features of the child who needs to be protected, rather than on the supposed psychopathology of the parent. ...
posted by amberglow at 7:47 PM on June 28, 2005

But how about the families where multiple children were continually being hurt or worse? Does it never happen at all?

From what I've personally seen I say yes, but in ways that make "MSbP" seem mild.
In my world they were a bit more...uh... direct.

And I'd say understanding the mentality of the parent might well help protect the kid, though it can be overdone -- like it isn't really necessary to know the exact reasons a parent drop-kicked an infant down the stairs.

Perhaps it makes sense to keep a division of labor between "protecting/treating the kid(s)" and "focusing on the parent(s)". Kinda like you don't usually have the Deputy Prosecutor doing surgery.

Throwing out "MSbP" just because this one "expert" in it shows a self-serving type of it seems a disservice to everyone involved. Imagine deciding baby-rape is a big myth just because a few women make baseless accusations in divorce cases. If need be, be more picky in deciding who's guilty of what, not less.
posted by davy at 8:07 PM on June 28, 2005

Yeah..I thought both Spiked-Online pieces had persuasive elements. I like these kinds of issues in terms of discussion because there's no simplistic position that can be adopted as with political FPP's for instance.
The blatantly asinine statistical anomaly was in reference to cot deaths and it seems likely that there's a small(?) number of people who have been convicted of murder who are likely innocent and the convictions came about at least in part because, as we all know, there's been this tendency in the last 20-odd years to be very protective of kids and suspicious of those who spend time with kids. I think it's quite relevant to the discussion of Prof. Meadow's testimony in cases where convictions were returned because it shows that the courts and the juries had a willingness to believe the headlinesque atmosphere of rampant abuse.

But the specifics of Pro. Meadow's role here points to there being a much smaller incidence of things like suffocation and child shaking syndrome (brain damage) than he has otherwise suggested.

Obviously with the Catholic church developments and the reality that there's a small number of bona fide child abuse cases by persons outside of the child's family, there is credence in the argument to say of course, yes, there's a certain amount of abuse that goes on.

But I do agree with the proposition that we as a society have blown it out of all proportion to the actual incidence, which is miniscule comparatively. And I hate it. We are all suspicious or watchful or expectant of negative behaviour whereas the great majority of people, like me, love kids and love interacting or playing with them. But these days, one really has to think twice about having any contact in public with a child that is not your own (and even if it is). That is really sad. And it's people like Prof. Meadow and his illconceived righteousness with aberrant data and attitude that are predominantly responsible.
posted by peacay at 8:20 PM on June 28, 2005

Well, a lot of people think they know statstics when they don't. This can lead to problems...

It's really amazing, but people go to jail on bad science all the time.

I saw a "Dateline" once where a pathologiest was sent to jail because a new test detected a type of poison. He was convicted, yet later it turned out that the test always came up positive. The origional researchers had never tested with non-poisoned people!
posted by delmoi at 9:15 PM on June 28, 2005 [1 favorite]

Wow, what an interesting post, and thanks Peacay and everyone for the additional links in the thread. After reading all the links I am still uncertain--though it seems pretty clear that "Meadow's Law" is an example of a moral panic.

And amen, Peacay, about our unreasonable fears. Last night I took my son to a local river where we played in the shallows and caught nymphs and crayfish and had a fabulous time. Talking to my neighbor this morning she was shocked--didn't I know that cattle wade upstream, and the reports of high bacteria levels two years ago? Her kids stay inside.
posted by LarryC at 9:33 PM on June 28, 2005

Child maltreatment in the United Kingdom: a study of the prevalence of child abuse and neglect (by the NSPCC)

"On these pages we present a summary of the first report of a major national study undertaken to explore the childhood experiences of young people in the UK, including their experience of abuse (physical, sexual and emotional) and neglect, collectively described as maltreatment. The research described here is the only UK study, and one of the few world wide, to have addressed the issue of maltreatment comprehensively in a large random probability sample of the general population. It is also the first UK general population study to cover all kinds of abuse both inside and outside the family."
posted by TimothyMason at 12:19 AM on June 29, 2005

An article discussing the probabilities in the Meadow's case involving three child deaths in one family. (From the previously discussed Bad Science column in the Guardian.)
posted by biffa at 2:04 AM on June 29, 2005

This book is an interesting view of MSbP. Although a bit melodramatic in parts, it's still rather good.

This is a very interesting post, and I agree with LarryC about the excessiveness of some parental fears lately. Just this weekend I overheard a mother accuse another mother of child abuse because she had neglected to put sunscreen on her child. And the kid wasn't burned, he'd spent most of his time in the shade, but the first mother was appalled at the sheer neglect of the second mother.
posted by teleri025 at 7:12 AM on June 29, 2005

But how about the families where multiple children were continually being hurt or worse? Does it never happen at all?

Murder misdiagnosed as SIDS: a perpetrator's perspective : an interview with a mother who killed her infants.

Covert Video Recordings of Life-threatening Child Abuse: Lessons for Child Protection: video recordings in-hospital of parents hurting their children.
posted by v-tach at 8:07 AM on June 29, 2005

I like these kinds of issues in terms of discussion because there's no simplistic position that can be adopted as with political FPP's for instance. Tend to agree.

The above was an interesting read. I don't have children but am interested in childrens welfare issues, thanks everybody.
posted by Chimp at 9:57 AM on June 29, 2005

Great FPP!
posted by agregoli at 11:31 AM on June 29, 2005

I don't have kids, but if I ever do, I plan on keeping them in a perpetual state of lock-down, and I won't let them out until Nancy Grace tells me the coast is clear.
posted by gigawhat? at 11:35 AM on June 29, 2005

TimothyMason's link:
"It presents the findings of a survey of the childhood experiences of 2,869 18-24 year olds, including their experience of abuse and neglect...... A number of common stereotypes are challenged by the findings of this survey, in relation to all forms of maltreatment. Very few respondents were physically, sexually or emotionally abused by step-parents; very few were sexually abused by strangers or in public places, and there were no examples of sexual abuse by care workers or youth workers." [In the year: 2000]
biffa's link:
"...let's take where the 73m [Prof Meadow's 1:73,000,000 chance of a cot death occurring twice in the same family] came from. Meadows appears to have taken a figure for sudden infant death syndrome (Sids), about one in 8,500, and squared it to find the likelihood of Sids happening twice in the same family. This would only be valid if we could be sure Sids always happened by chance and independently of family factors such as genetics and environment. In fact, there are strong reasons to believe that there are, unknown, genetic and environmental factors which will make Sids more likely in any child, and since genetic factors and environment tend to be shared in families, you may be more likely to find Sids twice in the same family than the initial calculation suggests. The error in the figure 73m is therefore likely to be extremely large, and in one direction only, that is, overestimating. The true figure may be much less incriminating.....Press reports at the time said 73m to one was the chance the two deaths of Clark's children were "accidental". The court appeared to concur. But this was an error. A very rare event has already occurred: the unexplained death of two siblings. What the jury ought to have considered is: which is the more likely rare event, double murder or double Sids? If anything we want the relative probabilities. The original case did not consider this; if it had, you would have thought a conviction to be less likely. The appeal court ruling accepted flaws with the figure, but said it established "a very broad point, namely the rarity of double Sids".
teleri025's amazon link:
"When her mother feeds her handfuls of pills, withholds food or instructs her to "act sick," Gregory does as she is told because she wants to please her. Then, undernourished and doped up on drugs for problems that don't exist, Gregory is dragged from hospital to hospital in search of "answers." Interspersed throughout Gregory's narrative are real medical records that show the efforts of dozens of doctors, procedures and surgeries to "heal" her, efforts which instead become the source of new illnesses. Not until adulthood, when she hears a professor describe MPB during a lecture, does Gregory realize what the real problem is. Gregory's impressive and disturbing memoir uncovers the truths of this elusive and disturbing form of child abuse that is often overlooked and misdiagnosed." [published in 2003]

[all emphasis mine] That final sentence is editorial hyperbole and it's a little worrying that it's being pushed to sell the book. It kind of reflects the bad statistics of Prof Meadow in that just because one person did suffer induced illnesses as a result of their mother's own psychological problems, it must therefore follow that others are not diagnosed -- yes, yes it is of course likely that there's cases unreported but the incidence is extraordinarily low versus many other forms of behaviour. But they are trying to sell a book.
posted by peacay at 12:42 PM on June 29, 2005

My doctor thinks I might have Munchausens' Syndrome, but he'll have to do more biopsies to be sure.
posted by Floydd at 1:44 PM on June 29, 2005

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