The stated aim of this book is ‘to provide a multi-disciplinary and international perspective on current understanding of Munchausen's syndrome by proxy’ (MBPS). It fulfils this task efficiently. Beginning with a brief ‘ 20-year overview’ of the subject, it offers an interesting international and cross-cultural view. The contributors are well-known in the field: Jureidini and Donald, Southall, Samuels, Jones and Newbold, Eminson, Bluglass and Bools. The latter writes well of new directions for research and service development for the future. The perspectives covered include MBPS in the medical system and primary care; legal, social work and guardian ad litem viewpoints; the detection and assessment of abusing families; and the treatment of perpetrators and victims.
Perhaps the most original chapter is by one of the editors, Gwen Adshead, on ethical and public policy issues in the management of MBPS. She explores the clinical dilemmas and consequent anxieties engendered by different clinical relationships and duties, which often clash in cases of MBPS. She also provides an overview of the power differentials and ethical responsibilities within the doctor—patient relationship and of the sometimes conflicting responsibilities of the doctor to third parties, family and society. The issue of MBPS and child abuse is examined as a paradigmatic locus of especial tension and frank conflict for professionals, for example in the question of whether a doctor has ‘a professional right to deceive in order to do good’ — as in the case of covert video surveillance. These discussions deserve greater exploration.
There has been something of a glut of volumes on this subject in the past few years — in contrast to a relative paucity of research (e.g. Reference Schreier and LibowSchreier & Libow, 1993; Reference Parnell and DayParnell & Day, 1997; Reference Eminson and PostlethwaiteEminson & Postlethwaite, 2000, for review see Reference CordessCordess, 2001). Adshead & Brooke may be counted unfortunate to follow so closely in the footsteps of the last of these: this subject advances slowly and, since it has only a poor empirical base, there was little new to be said.
Although this book presents solid findings — such as they are — and viewpoints in its 17 chapters, each chapter is too brief to allow contributors to get into their authorial stride. The text, therefore, reads awkwardly, as something between lecture notes and narrative. Typographical errors, such as the erroneous rendering (twice) on the first page of the introduction of ‘factitious’ as ‘fictitious’ (a common but unfortunate mistake in a book on the subject), left me feeling that the editors had not been well served by the standard of publishing production.
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