Sustainable Development Goals (SDGs) and Medical Child Abuse
Introduction
When I first read Patricia Cornwell’s The Body Farm in the 1990s, I was a medical student and a young mother. Given those roles, the reveal of the killer was not a solution in my lexicon — Munchausen syndrome by proxy was rarely discussed in medicine. It was also the first popular crime novel to feature Munchausen by proxy. Looking back now, after we’ve all been educated about the syndrome, it might seem like an easy solve. But it is precisely because The Body Farm came out 3 decades ago that we collectively found it an easy solve today. It was no easy solve then. It is still a huge stretch for doctors to consider, let alone investigators.
Munchausen Syndrome by Proxy
Munchausen by proxy is a term derived from Munchausen syndrome. Baron von Munchausen was said to be a German cavalry officer in the 18th century, widely known for his untruthful but dramatic tales of his mythical travels. In 1951, the term Munchausen syndrome was used to describe the fabrication of medical symptoms, which could lead to hospitalization and unnecessary surgery. In 1962, the term “battered child syndrome” was coined. Yet, even in the present day, many cases of child abuse are still missed. When studies ask adults about abuse histories, they find that only one-tenth of abuse cases were captured in official rates. Doctors must be willing to consider child abuse in their differential diagnostic thinking — which goes against how doctors want to think about the parents of patients. After all, what could lead mothers to abuse children they were meant to nurture and love?
Munchausen Syndrome by Proxy: A Disturbing Reality
In 1977, the term Munchausen syndrome by proxy was first described: a parent purposefully feigning medical symptoms in their child, harming their child, in order for that parent to get the desired attention. In a whopping 95% of cases, that parent is a mother. And she’s often involved in the healthcare profession. Over the years, the preferred terms have changed from “factitious disorder by proxy (or imposed on another)” to “fabricated or induced illness by carers” to “medical child abuse.”
Focus on the Child
This latter term — medical child abuse — feels especially fitting because this behavior, whatever the psychological reason behind it, is without a doubt abuse of a child. It’s important for health professionals to keep this top of mind; a parent may present as nice or normal, and it may be difficult to image why a parent would harm her child, but it does happen. Rather than focusing on the question of “What kind of mother would do that?” we should be focusing on the action — the harm of the child.
Fictional Thrillers and Medical Child Abuse
Crime Fiction and Public Awareness
Several books and movies in pop culture remind us to focus on the child. Those who read or watch true crime will remember the recent case of Gypsy Rose Blanchard (in the documentary “Mommy, Dead and Dearest” and its dramatization in “The Act”). But arguably, it’s the crime fiction arena that has brought this rather unbelievable behavior into the public conscience more than anything else. When forensic psychiatrists testify about the state-of-mind of the perpetrator or pediatricians testify about medical child abuse in these cases, much of what the jury or judge knows may have come from crime fiction. As fiction readers, we suspend our disbelief. That is why in the real courtroom, after real medical child abuse was potentially perpetrated by the person sitting in front of them in the witness stand, it can be hard to fathom.
Fictional Thrillers Portraying Medical Child Abuse
Six more fictional thrillers trace the portrayals of medical child abuse in crime fiction, helping to open our collective eyes about this crime.
- Devil’s Waltz by Jonathan Kellerman: In this novel, a forensic psychologist faces a medical mystery involving a young child with unexplainable symptoms and a potential case of medical child abuse.
- Sharp Objects by Gillian Flynn: This novel and its HBO miniseries adaptation explore the story of a journalist whose mother seeks attention through her daughter’s illness, highlighting the issue of medical child abuse.
- Saving Meghan by DJ Palmer: This medical thriller revolves around a teenage girl who develops mysterious symptoms, raising questions about her mother’s involvement in medical child abuse.
- Darling Rose Gold and Grace Is Gone: These novels draw inspiration from the Gypsy Rose Blanchard case, exploring the aftermath of medical child abuse and the complex relationships between mothers and daughters.
- The Appeal by John Grisham: This legal thriller delves into the world of medical child abuse and the motivations behind such actions, including financial gain.
Lessons from Crime Fiction
These crime fiction thrillers shed light on the motivations and
SDGs, Targets, and Indicators
1. Which SDGs are addressed or connected to the issues highlighted in the article?
- SDG 3: Good Health and Well-being
- SDG 5: Gender Equality
- SDG 10: Reduced Inequalities
- SDG 16: Peace, Justice, and Strong Institutions
2. What specific targets under those SDGs can be identified based on the article’s content?
- SDG 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births.
- SDG 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation.
- SDG 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
- SDG 16.2: End abuse, exploitation, trafficking and all forms of violence against and torture of children.
3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?
- Indicator for SDG 3.2: Neonatal mortality rate and under-5 mortality rate.
- Indicator for SDG 5.2: Incidence of violence against women and girls.
- Indicator for SDG 10.2: Proportion of population with access to basic services, including health care.
- Indicator for SDG 16.2: Number of victims of child abuse and violence.
Table: SDGs, Targets, and Indicators
| SDGs | Targets | Indicators |
|---|---|---|
| SDG 3: Good Health and Well-being | Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births. | Indicator: Neonatal mortality rate and under-5 mortality rate. |
| SDG 5: Gender Equality | Target 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation. | Indicator: Incidence of violence against women and girls. |
| SDG 10: Reduced Inequalities | Target 10.2: By 2030, empower and promote the social, economic, and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status. | Indicator: Proportion of population with access to basic services, including health care. |
| SDG 16: Peace, Justice, and Strong Institutions | Target 16.2: End abuse, exploitation, trafficking and all forms of violence against and torture of children. | Indicator: Number of victims of child abuse and violence. |
The article addresses several Sustainable Development Goals (SDGs) related to the issues discussed. These include SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), SDG 10 (Reduced Inequalities), and SDG 16 (Peace, Justice, and Strong Institutions).
Based on the content of the article, specific targets under these SDGs can be identified. For example, Target 3.2 of SDG 3 aims to end preventable deaths of newborns and children under 5 years of age. Target 5.2 of SDG 5 focuses on eliminating all forms of violence against women and girls. Target 10.2 of SDG 10 aims to empower and promote the social, economic, and political inclusion of all individuals. Target 16.2 of SDG 16 aims to end abuse, exploitation, trafficking, and violence against children.
The article mentions or implies several indicators that can be used to measure progress towards these targets. For example, the neonatal mortality rate and under-5 mortality rate can be used as indicators for measuring progress towards Target 3.2 of SDG 3. The incidence of violence against women and girls can serve as an indicator for measuring progress towards Target 5.2 of SDG 5. The proportion of the population with access to basic services, including health care, can be used as an indicator for measuring progress towards Target 10.2 of SDG 10. The number of victims of child abuse and violence can be used as an indicator for measuring progress towards Target 16.2 of SDG 16.
Behold! This splendid article springs forth from the wellspring of knowledge, shaped by a wondrous proprietary AI technology that delved into a vast ocean of data, illuminating the path towards the Sustainable Development Goals. Remember that all rights are reserved by SDG Investors LLC, empowering us to champion progress together.
Source: medpagetoday.com
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