Tammi Stefano of The National Safe Child Show interviews world renowned expert on Munchausen syndrome by proxy, Dr. Helen Hayward-Brown. (Source.)
by Orissa Mora-Kent
Health Impact News
Doctors Redirect Blame to Protect Themselves Against Medical Negligence Claims
Dr. Helen Hayward-Brown is a medical anthropologist/sociologist who completed her doctorate on false and highly questionable accusations of Munchausen syndrome by proxy. She completed two post-doctoral fellowships with the Social Justice and Social Change Research Centre at the University of Western Sydney, in addition to her teaching and advocacy work.
Dr. Helen Hayward Brown joins Tammi Stefano on The National Safe Child Show to discuss the widely discredited “Munchausen syndrome by proxy” label. This label has proven to be not only destructive of families but also obstructive of justice.
Tammi Stefano introduces Dr. Helen Hayward-Brown,
We have an unbelievable show tonight. We have a world renowned expert who is addressing an issue that thousands upon thousands of parents are deemed to have Munchausen syndrome by proxy.
This doctor is an expert in this area and she is going to shed light on the facts of what this disorder or this syndrome would entail and how the so called professionals are getting it wrong when they label these parents with this disorder who have lost their children as a result of this mislabeling.
Dr. Helen begins,
I did my doctoral research in relation to false allegations of Munchausen syndrome by proxy. That’s an allegation which is made – it’s a label that is given to mothers who allegedly are harming their children in the medical context in order to get attention and very often this label is assigned to parents where children have an undiagnosed illness or there’s medical controversy over the particular illness the child may actually have and in some cases there are what I call “bad faith allegations” where the allegations are made to protect medical practitioners against medical negligence claims.
Tammi asks,
So to protect the practitioners that are giving this label?
Dr. Helen answers,
Yes, that’s correct.
Dr. Helen explains,
In about 70% of the cases that come to me… usually the parents who come to me are innocent because they are so outraged they want to reach out and contact somebody and generally its known that I have fairly good credibility so it’s known that if I look at a particular case I can usually get to the bottom of it by using biomedical scientists to review all of the medical files and get the experts that are needed to assist.
What actually happens in many of these cases, in about 70%, the mothers pick up that there’s been some kind of medical error. Sometimes they’ve made a complaint, sometimes they’ve actually started legal proceedings, but as soon as that happens very often the parents find that that’s what they’re labeled in and that discredits the mother.
It also means that if the child is removed from the family then the family can’t get a second opinion with what’s going on with the child’s health.
So there are good faith allegations where doctors really believe that there’s harm happening, they may still be wrong about it but it’s done in good faith, and then there are the bad faith ones that happen actually to protect the medical practitioners or the hospital.
Tammi relates,
I’ve seen many cases where CPS deems parents–even though they have no experience–they label parents with this Munchausen syndrome by proxy label.
Dr. Helen states,
The label carries with it moral danger and panic… as soon as anyone in the court system hears that label… the children are removed. Certainly a social worker or case worker should never be making that diagnosis; they’re not qualified. Often they haven’t even met the mother.
Tammi asks,
Where are they getting the information from in order to make this diagnosis?
Dr. Helen answers,
They’ll use general literature or just use file notes on the parents without actually meeting the mother and very often not even meeting the child.
Munchausen is a Misogynous Label Directed at Women
Tammi asks,
Am I to understand that fathers don’t get labeled with this disorder?
Dr. Helen explains,
Very rarely do the fathers, so in fact it is what you might call a misogynous label, it is actually directed at women. About 95% of the cases are women, so it is a way of discrediting women and it’s an excellent tool to use if you want to discredit a woman. The label [Munchausen syndrome by proxy] suggests that a mother should be passive in her interactions with the medical profession.
Very often doctors who are making this type of allegation… there is a certain arrogance involved, because their belief is, “if I don’t know what’s wrong with this child then there’s nothing wrong with the child” and of course that ignores the fact that that particular doctor may not know everything. Just because he doesn’t know what’s wrong with the child doesn’t mean there’s nothing wrong with the child.
And then of course you have the issue where a lot of mothers are very well educated these days… they’re very motivated to understand what’s going on with their child. In some cases I know that there are very intelligent mothers who often know almost more than the medical practitioners about a particular disease or illness that a child has.
Tammi says,
Right. There’s no sleeping when your child is sick… you’re watching everything. So when you go in to the hospital… you’re telling them in detail–if you can articulate such–what has happened, when it has happened, what resulted… and they look at you like you have overstepped your boundary as a mother.
Dr. Helen says,
Yes, the thing is when you’ve looked after a child from birth, you have an instinctive knowledge also about what’s going on with that child… even if you’re not necessarily a well educated woman… a mother may instinctively know and understand that there’s something wrong.
The medical professionals actually look at statistics, they use statistics and they say “this is what all child should do.” Whereas in fact each child is different and it’s the mother who understands that particular child and their particular problem and really the doctors should be listening to the mothers very closely and learning from them because you have had the time as a mother to be with that child. The medical practitioners just don’t have enough time to spend with the mothers and children.
Doctors Feel Threatened by Symptoms they Don’t Understand
Dr. Helen states,
If you’re a medical practitioner and you’re rushed for time and this parent keeps coming back with this child and they have symptoms that they don’t understand – that’s very threatening to the doctor.
They want to categorize it. If a child comes to them that doesn’t fit into one of those categories, then they have to think of some other category. If it’s an adult then they’ll start to say –“it’s a psychiatric illness, it’s all in the persons head”–but they can’t say that about a young child, they can’t say that the young child has a psychiatric illness so the next thing is to blame the mother and say that the mother has some sort of mental disorder or psychiatric illness and very often that will be Munchausen by proxy. It’s a garbage bin diagnosis.
If the doctor doesn’t know what’s wrong with the child, he can say it’s “Munchausen syndrome by proxy” and that gives him the category, it gives him the label so he can stop looking then for what’s wrong with the child.
Tammi asks,
Is Munchausen syndrome by proxy actually a rare disorder or is it as common as it is being diagnosed to be?
Dr. Helen explains,
It’s certainly not as common as it is being diagnosed, not at all. We shouldn’t use the label at all, it’s not useful. The label just creates prejudice. What doctors should be doing, if they do think a mother is harming the child in a medical context, is to look at the evidence and to look at all of the hard facts and not to be using this emotional label that has prejudice about it because it means then that if you label the mother then everything else that the doctor sees they will see it through that particular prejudicial lens and start to misinterpret what information they’re getting. Doctors need to just look at the facts.
Nearly all of the cases that I’ve come across, they’ve made terrible, terrible errors in these allegations and many, many families are suffering as a result of that.
Tammi asks,
Can you explain to us what a case would look like that would be labeled properly for somebody that does have Munchausen?
Dr. Helen clarifies,
You’re asking me what would actually happen if a parent was guilty of doing something to the child?
Tammi says,
Right. What would be some of the symptoms so that people can be more privy to what that would look like.
Dr. Helen answers,
First, let me go back to the Munchausen by proxy label, the problem with that is – a mother is profiled. She’s regarded as being over caring, overprotective, answering questions all of the time instead of letting the child answer questions, lying, fabricating – this is all part of the profile of MBPS. The profile is not useful, you have to put that aside. Have a look at what is actually happening. If a parent really is harming a child, it may be fairly simple, it may be that the mother is giving the child laxatives to give the child diarrhea.
If the mother is saying, “my daughter has cancer” and shaves the child’s hair off to make it look like she’s having chemotherapy and it’s just not true – that’s an example of a mother really harming a child.
Tammi asks,
That would look like something similar to what Munchausen would look like?
Dr. Helen replies,
Yes. Although I don’t like the label. I think you should describe what the mother may be doing and look at it from that perspective.
Justice Has a Price Tag Many Families Just Can’t Afford
Dr. Helen stresses,
You have to look at the evidence of what’s happening to that child. Make sure that you cover all of the ground and don’t accuse the mother of harming the child when in fact the child may have a rare or unusual illness or even simply severe allergies and sensitivities which are not necessarily easily recognized… which a lot of mainstream medical practitioners simply don’t know how to deal with.
Tammi relates,
Like you said, they don’t have the time to really address these issues in such a capacity that’s necessary.
Dr. Helen advises,
That’s right. We encourage parents to go to a medical integrative doctor who is able to spend more hours and more time with the family to try and get to the bottom of what is wrong with the child, but very often that can be expensive.
Tammi states,
So many families just don’t have the finances. Many of them are on some type of a state insurance, and that is problematic in itself because now the state can look at that, can actually monitor the amount of times that the child is seeing the doctor and communicate with the doctor directly even though they shouldn’t.
Dr. Helen says,
I think that’s very common practice on an international basis.
Seeking a Second Opinion? Beware You Just Might Lose Your Child
Tammi says,
Part of what we have noticed [National Safe Child] is that if a parent wants a second opinion, because the opinion of the first physician–I’m not saying that they’re right or wrong, we don’t know–but that parent caring about their child–they just want to be sure–because the diagnosis is possibly surgery, possibly medication that could potentially be harmful or have long term effects… well as soon as they go for that second opinion… they are “doctor shopping.” Years ago we were encouraged to get second opinions but now for a parent to get a second opinion has the potential of losing your child.
Dr. Helen agrees,
Yes. I know it sounds quite scary but yes I think that is actually the case. It may be that the first doctor really is not able to get to the bottom of what’s wrong with the child… that first doctor will be afraid of being accused of medical negligence.
Tammi relates a question from an audience member,
I want to get into a project that you’re working on and I have one question for you that one of our audience members has asked:
‘What can women diagnosed with this wrongfully, do to prove that they don’t have this disorder, that they’re acting very normally?’
Dr. Helen says that the first thing to do is find a good lawyer or attorney who will get the label removed and try and get expert evidence to show what is happening with the child or at least show an alternative to what is happening with the child.
Dr. Helen advises,
Parents need to recognize that this label has been discredited. This notion that it’s an accepted diagnosis needs to be knocked out of the park. The lawyers should argue that it really should not be used at all.
Someone needs to come in like a biomedical scientist or a medical practitioner or a nurse and go right through all of the medical files and find out what’s really happening. For example, you may find that in fact a doctor may have overdosed a child in error.
Dr. Helen and Tammi go on to discuss how often it is argued that the child became better after being removed from their parents’ custody–that’s not always the case–frequently medications are changed and in those cases the child’s improvement cannot be attributed to their new environment–away from their mother–when in fact their health changed because of a change in prescription.
Dr. Helen advises,
It’s really, really vital that parents get access to all of the medical files, the child protection files, through a good attorney and then these particular issues can be discovered if necessary. It’s very, very important to do all of those things. It’s not easy as you would know but it is possible.
Tammi agrees,
Absolutely.
When “Justice” Operates Behind Closed Doors
Dr. Helen makes a point,
Justice needs to be seen to be done. If justice is done behind closed doors then you have problems with being able to see the process and seeing that the process of justice is actually being done.
There is a lot of fear involved in opening these courts up because there is no familiarity with operating these cases in the full glare of public knowledge. It’s about the fact that the people involved in these court cases, they’re not familiar with it, they’re not familiar with having to operate under full scrutiny so of course they’re afraid and they’re afraid of going back and looking at all of the errors that have been made. So very often you have courts maybe protecting what’s happened previously in court, or you find that a more senior court may protect what a lower court has done.
Tammi asks,
Do you think Helen–from your experience–that there is some type of collusion going on between the judges, the attorneys, the evaluators, the doctors, the hospitals… where they all kind of have gotten together, they’re now comfortable, they’re familiar with each other, they’re affiliated with each other, they’re perhaps friends and they just pick up the phone and make a call and say,
‘hey, I’ve got another case here, send xyz social worker down – I don’t want to deal with this, this is a crazy Mom’?
Dr. Helen replies,
Yes, well I think that what you’re looking at here is the situation where parents very often find themselves in court a bit by surprise. They’re not prepared, they’re not familiar with the processes. They believe that if they tell the truth then it will all be alright in the end.
So you’ve got the belief of the parent and their unfamiliarity with the situation as against the judicial process and the lawyers and case workers and doctors involved who are very familiar with the process and they all as you said, they know each other, so they have a familiarty with each other and they all believe and support each other.
…and of course a doctor has enormous status so how does a parent stand up against that?
Tammi states,
It’s darn near impossible for these parents and that’s why we see so many parents losing their children just because they ask some questions.
Sworn to Protect “Best Interests of the Child” or a Doctors’ Career?
Dr. Helen explains,
Well you see the thing is that once you start asking questions then you may uncover some form of medical negligence or by asking the questions some doctors may see that as ‘oh, well you’re questioning my competency,’ and that is not liked. Very often these cases become not so much about what’s in the best interest of the child but it becomes about protecting the medical career and reputation of the doctor involved. …the children are not heard properly themselves in these cases.
Tammi states,
Often they’re not heard at all… they’re really silenced.
Dr. Helen agrees,
That’s right. Very often an independent children’s lawyer is appointed. I think you might call them guardians ad litem.
Tammi and Dr. Helen go on to discuss that these guardians ad litem and minor’s counsels who are supposed to be representing the best interest of the children often rely soley on what the doctors and the social workers are saying in these cases, without question. Dr. Helen says that often these independent children’s lawyers fail to interview their clients [the children]. Tammi points out that this is illegal [for them to fail to interview their client] but they are protected. Often these failures of the minor’s counsels and guardians ad litem to properly represent their clients are not exposed until much later.
Tammi asks,
What resources can we point attorneys to showing that this Munchausen label has been widely discredited?
Dr. Helen answers,
It’s very important for attorneys to have access to somebody like me who can pick up the clues in the paperwork, the earlier the better in the actual process. The other thing is to get a biomedical scientist as I said to also go through all of the medical documentation to find out exactly what is going on from that perspective and the other perspective is to have a look at prior cases. Case law and precedents.
Dr. Helen explains that she prefers to work as a consultant rather than an expert witness because when working as a consultant she can look at all of the information and data but if she works as an expert witness, her first duty is to the court, not the family. In the role of an expert witness, she would have to isolate herself and stop contact with the family.
She also explains that the label of Munchausen by proxy gets renamed regularly to make it sound more scientific. For example, Munchausen is also known by Factitious Disorder or Medical Child Abuse. It’s actually not a scientific diagnosis and renaming it does not afford it legitimacy.
Dr. Helen advises,
You need to seek out particular practitioners who have actually questioned the diagnosis. People like Dr. Eric [unclear audio]–
Tammi asks,
[interposing] I’m sorry, spell his last name if you would.
Dr. Helen clarifies,
Dr. Eric M-A-R-T is a psychologist who has questioned and queried the manner in which the Munchausen by proxy label is being used in court.
Hearsay Often Admissible in Family Courts, Lawyers Must Argue for Evidence to be Used
Dr. Helen advises,
There are people out there who can be accessed to show that this is not a valid diagnosis, that it’s more likely to be prejudicial than to help a court find out whether or not a mother is harming a child or not.
So it’s really a matter of incredibly hard work and intensive study and research. Parents have to be willing to do a lot of the research themselves because often their attorneys can’t do that for them. So they need to get a team of people if they can with their lawyers permission to go through everything and work through everything and do a lot of the work themselves in terms of finding out exactly what’s happening – getting the documentation, getting witnesses.
Part of the problem, is in a lot of the courts, is to do with the rules of evidence and as you know very often in children and family courts, hearsay evidence can be used rather than rules of evidence – that’s where parents fall into traps.
If possible lawyers need to try and argue that evidence should be used and that hearsay should be knocked out.
Tammi states,
Unfortunately hearsay becomes what is considered factual.
Dr. Helen advises,
The other thing I would strongly, strongly recommend to parents if there’s a lot of medical data involved in their cases, is to go right back to the original source of the material. Don’t accept that a doctor who has written a letter or a summary of some report or some test, don’t accept that on face value. If you go back to the files and go beyond that and ask for the original test results, very often you will find that they’re different than what the doctors are actually saying. I just cannot underline enough how important it is that you go back to the original source of the document, the original scan, the original blood test, all of that.
Tammi says,
Absolutely. We had a parent that was on the show, maybe three or four months ago–Mrs. Amy–and she was accused of some things that were just so ludicrous. They made this poor mom go for these drug test and then they said that she had positive results from the drug test and when she was adamant about getting these tests, lo and behold, the test results were not even hers. They accidentally–“accidentally”–and I put quotes on that if I could, they had her name and another social security number. (emphasis added)
See Amy Duran’s interview here:
Los Angeles County DCFS Horror Story: Baby Kidnapped for Two Years and Innocent Mother Incarcerated
Women Who Dare to Ask Questions
Tammi and Dr. Helen go on to discuss a documentary film that Dr. Helen is working on called Witch Hunt. The film will contrast the profile of a medieval “witch” with the modern day profile of a mother accused of Munchausen syndrome by proxy. Dr. Helen explains that the profiles are exactly the same, which should be an embarrassment to the supposedly “scientific” medical community.Has science not progressed much since the dark ages? Are we still “witch hunting” women because they have the audacity to question, to learn, to know and to disagree?
“Witch Hunt” (Source)
Dr. Helen summarizes,
We’re really basically giving a voice to women whose voices have been silenced.
Dr. Helen and Tammi point out that this can happen to anyone, at any time. Highly educated women and less educated women alike are targets.
Dr. Helen says,
Very often I have found that it’s often the best mothers who actually get accused. For example, I had one case where a mother’s child had trisomy and the child really shouldn’t have lived at all and they didn’t even look to see that the child had trisomy, they didn’t even look at the blood tests because they believed the mother had Munchausen by proxy. In fact the mother was a brilliant mother, and had been feeding the child with an eye dropper and kept this child alive with a particular variant of trisomy. The child could have lived so long.
Are Children Dying because of this Label?
Tammi asks,
Do you think that children are dying?
Dr. Helen,
Oh, I know that they are and that they do.
Tammi asks,
Once a parent gets deemed to have Munchausen, then the child’s illnesses or psychosomatic illnesses are all based on the parent having this disorder, this syndrome; do you find that the physicians in many instances stop looking and they miss really important and necessary–
Dr. Helen answers,
[interposing] Yes, yes most definitely. It’s much easier to say that the mother has Munchausen by proxy or that the mother has Munchausen’s herself than it is to keep on looking and searching, which may be more difficult. Very often we find that these children and parents all suffer from genetic illnesses.
Tammi exclaims,
I would like to deem this a state of emergency worldwide because that’s what I feel. I feel that parents are in a state of emergency with this diagnosis that is bogus. It’s ridiculous!
Dr. Helen shares,
People often say to me, ‘well how can you believe the mothers? how do you know whether to believe them or not?’ but it isn’t a matter of belief as I said to you previously. It’s a matter of looking at the facts and the evidence and the process.
It’s a matter of looking at that and being forensic in your investigation.
Tammi echoes,
The facts are the facts are the facts.
Dr. Helen emphasizes,
Parents need to have an attorney who is willing to listen, who is willing to do the research and who is forensic in their approach.
How to Contact Dr. Helen Hayward-Brown
(Source.)
Watch the entire interview here:
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