Tuesday, March 4, 2014

Justina Pelletier—Medical Child Abuse—Boston Children's Hospital

On the advice of her Tufts physician, Mark Korson , Justina Pelletier was referred to Boston Children's Hospital on February 10, 2013 and admitted with a diagnosis of mitochondrial disease complications.

In a scant four days the BCH review team determined that Justina was suffering from psychological distress [ somatoform disorder ] induced by her mother and father, Lou and Linda Pelletier. The parents disputed the altered diagnosis and requested that their fourteen-year-old daughter be released and transferred to Tufts Medical Center.

At that juncture BCH officials told the parents that they were no longer in charge of their daughter's medical future because Dr. Alice Newman, the head of the facility's child protection unit, had persuaded the state Department of Children and Families that Justina was a victim of medical child abuse. Justina as of March 7, 2014 remains a ward of the state and is confined to Wayside Youth and Family Support Network in Framingham.

The reports by The Boston Globe: "A medical collision with a child in the middle" and " Frustration on all fronts in struggle over child’s future" raise ponderous questions regarding Justina Pelletier's care over the past twelve months.

At Issue:

Dr. Korson had been treating Justina for more than a year for mitochondrial symptoms before intervention on the part of BCH. The Globe reports that Boston Children's Hospital has a history of medical child abuse claims leading to parental loss of children. The newspaper advises that these speculative child abuse allegations are not unusual in Massachusetts and elsewhere.

Other than one short session Dr. Korson was denied consultation with Justina's new custodians and Boston Children's Hospital refused the parents' requests for second opinions. For most of her ten month confinement, Justina resided in the hospital's psychiatric unit and was permitted a supervised hour a week with her parents. This is called therapeutic separation and is a ubiquitous practice in suspected medical child abuse cases.

Family Court Judge Joseph Johnston, Justina's overseer, issued a gag order in November. With no favorable custody resolution in sight, the Pelletiers began broadcasting their daughter's plight. Recently the Department of Children and Families asked Judge Johnston to charge the parents with contempt of court. Because of publicity and the possibility of First Amendment violation challenges the state's request was withdrawn.

The Massachusetts Department of Children and Families has decided to relinquish authority over Justina's care to Connecticut, her home state, and has agreed that Tufts Medical Center is a suitable medical provider.

The term "medical child abuse " was invented by pediatrician Carole Jenny and her psychiatrist husband Thomas Roesler and is similar to the Münchausen syndrome by proxy and factitious disorder diagnoses. Jenny's writings on the subject have prompted growing acceptance for this disorder.

The Münchausen syndrome by proxy was popularized by British pediatrician Roy Meadow in 1977.

Sir Roy Meadow's credibility on the subject of Münchausen syndrome by proxy has been largely repudiated because his testimony was responsible for the wrongful convictions of four mothers accused of murdering their babies. Dr. Meadow was the former president of the British Paediatric Association.

As a result of Dr. Meadow's actions the British Appeals Court ruled in 2004 that mothers could not be convicted solely on expert testimony. Dr. Meadow repeatedly told juries that the infant death cases he reviewed were characteristic of smothering.

Dr. Alice Newton, the head of BCH's child protection team and primary advocate for emergency state action told state investigators that she was troubled that Justina had received numerous medical procedures especially the Tufts cecostomy button in 2012. This is a curious criticism on the part of Dr. Newton in that Boston Children's Hospital recommends and performs cecostomy surgery.

The 1970 founder of BCH's child protection unit, Dr. Eli Newberger, says that there is too often a rush to judgement in medical child abuse allegations. His areas of concern: board-certified child protection specialists wielding enormous and unchecked power in and out of the courtroom, child welfare agencies being too deferential to medical opinions and states' efforts to punish mothers for their opposing points of view.

When charges of abuse are levied they target the child's caregivers, not the medical providers. How can it be that hospitals and doctors have been immune from medical child abuse prosecution when they are coparty to the alleged crime?

A child's guardian may deceive pediatricians regarding symptoms but clinical tests, x rays and scans should reveal deceptions. Medical child abuse convictions disclose that most victims received long term inappropriate and dangerous treatment recommended by their physicians.

Ryan Baldwin—Medical Child Abuse—North Carolina Department of Social Services

It will never be known how many parents across the country have been subjected to false medical endangerment charges but the story of North Carolina teenager Ryan Baldwin bears a striking resemblance to the Pelletier case.

As detailed by the Mountain Xpress in 2010, the NC Department of Social Services accused Lisa Baldwin, Ryan's mother, of medical neglect. On that pretext the state revoked parental rights, placed Ryan in several foster care venues and denied him family contact. It has been determined that the NC Department of Social Services acted irresponsibly in the Baldwin case because Ryan was suffering from chronic fatigue syndrome.

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