Fabricated or induced illness, also known as FII, occurs when a child is, or is very likely to be, harmed due to a parent(s) behaviour and action, carried out to convince doctors or a child themselves that the child’s state of physical and/or mental health and neurodevelopment is impaired (or more impaired than is actually the case).
FII may also be referred to as: Munchausen syndrome by proxy, pediatric condition falsification, medical child abuse or parent-fabricated illness in a child or medical neglect. Some of these terms are outdated but are sometimes still used.
What are some of the indicators of FII?
The following are a number of indicators which professionals may rely on when claiming the child is suffering from FII:
- Reported illnesses are not observed by other independent professionals or family aside from the parent(s)
- The child is not responding to prescribed medication in the way a doctor would expect
- The parent(s) are reporting a child is presenting in a way that does not make medical sense
- Once one issue is resolved, the parent(s) complain the child is presenting with another symptom
- The parent(s) seeking continuous investigations/medical appointments from different medical professionals i.e. GP and hospital
- The parent(s) is not following medical advice and continuing to seek further investigations/procedures/treatment
- The parent(s) becomes abusive or argumentative if their views are challenged about their understanding of the child’s symptoms
- The parent(s) will not allow the child to be seen on their own by a professional or medical expert
What are some of the consequences of FII?
FII results in emotional and physical abuse, neglect and harm resulting from medical care given. For example;
- The child is put through repeated, unnecessary medical appointments, investigations, examinations and treatments
- Illnesses may be induced by the parent(s) for example by the child being given medication they do not need. This can cause health issues for the child.
- If the child is suffering a health issue this may be missed by doctors who are focusing on a fabricated illness
- The child’s development may be affected from missing school due to appointments, or missing out on normal everyday life due to assuming a sick role which can all result in the child becoming socially isolated.
- The child’s mental wellbeing may suffer if they believe they are poorly. The child may be confused or anxious over their health which can later lead to psychiatric and psychological disorders.
What happens if FII is suspected?
If a person, usually a health professional, has concerns that a child may be at immediate risk of serious harm due to FII then an urgent referral for a strategy discussion must be made to the police and children’s social care. This discussion will include the child’s health representatives. Consideration will be given as to whether the child is in need of immediate protection and whether measures are needed to reduce the immediate risk.
If the local authority believe the child is at risk of suffering significant harm or has already suffered significant harm, they will likely issue care proceedings with the court. The local authority may seek removal of the child if they are at immediate risk of harm. The local authority will set out in their threshold document why they believe the child is at risk of significant harm, in this case because the parent has fabricated or induced a child’s illness. If the parent does not accept this, the court is likely to hold a finding of fact hearing where the court will determine whether the parent has fabricated or induced a child’s illness.
The local authority may seek for assessments of the child and parents to be undertaken. These could include a paediatric assessment of the child, psychological or psychiatric assessments of the child and/or parent(s). The local authority will seek the full medical records of the child and likely the parent(s) medical records to assist with assessments. They may also request a full chronology from health professionals of any significant past medical events in the child’s life. Chronologies of significant health events are useful in understanding recurring patterns of behaviour and concerns.
What should you do?
If you find yourself in a situation where the local authority is accusing you of fabricating or inducing your child’s illnesses we would advise you to seek legal advice immediately. If you wish to speak to a specialist in our family law team please call us on 0161 696 6193.
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