Munchausen syndrome by proxy: social work's role

Munchausen syndrome by proxy is the diagnosis used to describe a variation of child abuse whereby the parent or adult caregiver fabricates a medical history or induces symptoms in the child, or both, resulting in unnecessary examinations, treatments, hospitalizations, and even death. This article reviews the assessment procedures, provides case studies, and describes family dynamics of the syndrome. The authors make recommendations for team management of the child-family system and recommendations for social workers. They propose broadening the assessment of the family on the basis of knowledge of the widespread physical and economic oppression of women and children in our society.