Intended for healthcare professionals

Rapid response to:


The evidence base in child protection litigation

BMJ 2006; 333 doi: (Published 20 July 2006) Cite this as: BMJ 2006;333:160

Rapid Response:

Re: Response to reponses

Dr Chadwick. in reference to my Rapid Response, states " The note
by LC Blakemore-Brown (a psychologist) illustrates a serious but common
error about the Munchausen Syndrome by Proxy (MSBP). This is the idea that
the condition can be defined or excluded by psychological observations or

I am afraid it is Dr Chadwick who has made a serious but common
error, and one regularly found at the very outset in false allegations of
MSBP/SBS - he has made an early false assumption about my concerns and
then built his case on that.

Where in my response do I say what he has attributed to me?


However, I do state that I am a Psychologist and it would seem that
Dr Chadwick has therefore leapt to the conclusion he reached because of

In actual fact, I am in total agreement with Dr Chadwick about
psychological observations and criteria! I too do not consider that they
help us to establish whether a parent has abused their child. Thinking
that there is a psychological or psychiatric profile is simply not

I differ from Dr Chadwick in that he thinks that covert video
surveillance can lead to conclusive diagnoses. To my certain knowledge
great errors have been made in the interpretation of such videos and to my
certain knowledge women have had children removed despite no evidence at
all following covert surveillance, only to have them returned by a Court.

Furthermore, by knowing, as I said in my response, that some women
have harmed their children, this should not lead us to assume (assumption
again) that many have. This means that because some people have genuinely
been seen to cause harm to children under covert surveillance, for
instance, cannot possibly allow us to make assumptions about the vast
majority who have been accused when they have been nowhere near a camera.

The fact that Professor Southall may have been able to capture some
cases of disturbed women harming their children and that this may have
also happened in some cases around the world, does not permit us to make
assumptions about the vast majority who fall foul of this allegation
without ever being filmed doing anything. The theorising and methodology
is palpably not robust.

To make it clear, my fundamental concern as a Psychologist is, in
agreement with Dr Chadwick, that we are assuming psychological profiles
can be used to accuse parents and this is simply wrong. Furthermore and
clearly not in agreement with Dr Chadwick who has made the same sort of
errors and shown the same sort of thinking in his response, we are using
assumption and rumour and processes of suggestibility to guide and train
thousands of medically unqualified staff to go on to accuse parents of
causing real illnesses and disorders.

It is my opinion that many of those illnesses and disorders could
very well have been caused by iatrogenic processes.

I want to see iatrogenic abuse becoming a routine part of the
differential diagnosis in child abuse cases.

I want to know why it NEVER is.

Competing interests:
Expert in Autim and related conditions often misdiagnosed as child abuse

Competing interests: No competing interests

15 August 2006
Lisa C Blakemore-Brown