Confidence or Distrust doctors?
A suspicion of Munchausen by Proxy (MbP) is a ‘vote of no-confidence’ against the parents before the fact, according to BVIKZ chairman Vera Hooglugt. Parents with children who need more care than others, simply cannot trust the Confidence doctors of ‘Safe Home’ (Veilig Thuis; VT), who are working in such biased and prejudiced way. They should stand beside these parents instead of opposing them. As the mother in the February broadcast said: “this aggression doesn’t help”.
In the files of the BVIKZ one can find examples of “overmedication by the mother”, while it was prescribed by the treating physician who is responsible for it. It is disconcerting that a VT doctor interferes with treatments for serious and debilitating diseases. They are now trying to force children to stop their medication or to get out of their wheelchair. “You are faking it; get up and walk!”
Promotion and training
Confidence doctor Worm told in the broadcast that as a VT employee she is also working on a PhD thesis on MbP. Her colleague Raat, provides a VT training for all professionals in the field.
The BVIKZ is deeply worried about these developments. VT doctors can never be impartial scientific researchers. Especially not when hospital doctors, school teachers and other professionals are told that MbP suddenly is a widespread social phenomenon via conferences and public publications. The fact that a Confidence Doctor calls upon her colleagues that assume MbP in all cases of a vague or inconclusive medical diagnosis, is telling.
The slides of this VT training could be found on Internet, but after the broadcast they were removed in great haste. Several literally translated sentences are shown below (font and punctuation marks taken from the slideshow):
After describing a case in which a girl is not growing and is vomiting after every meal, the hypothesis is given that the mother is starving her daughter. Then it is stated that “this image does not fit a disease”. On another slide it is stated that “if a diagnose is made based on symptoms’, one should consider child abuse.
Because the next sentence is: “ALWAYS think about PCF”, which is called a “serious type of child abuse” The mortality is claimed to be high, but this is not substantiated by any scientific facts.
The implications of this are rather serious, as most diagnoses are mainly based on symptoms, such as MS, ALS and CRPS (complex regional pain syndrome). This is called a ‘clinical diagnosis’. Given by doctors who are now told by VT that “as a caregiver, they are fooled and abused by parents”.
As potential target group of PCF, a whole range of illnesses and conditions is given, with the remark that “all relevant diagnoses are excluded”. Who decides what is relevant and when it is excluded?
- Babies, feeding problems, not growing
- Children met stomach pumps
- Long school absence
- Use of wheelchairs, revalidation circuit
- Lyme and CFS, when diagnosed in the alternative circuit
- “metabolic” diseases, mitochondrial diseases
- Seizures, convulsions and ALTE ['apparent life-threatening event’]
- Child psychiatry: autisme, ODD, psychoses
- Anorexia/eating problems
- Diarrhoea or obstipation
- Tired (and not going to school)
When the training then zooms in on the motives and profile of the perpetrator, nearly all parents in the Netherlands seem to be suspected of being a potential ‘fraudulent child abuser’. According to VT they “want attention or to be regarded as caring parent who puts everything else aside”, are “extremely worried”, “medicalise the behavioural problems or other ‘defects’ of the child”, “want to stay with their child (called ‘symbiosis’) and are after “financial gain!!”
According to VT this is mainly found in biological mothers (76%), who work in healthcare (14-30%) and who are active on the internet (called “Munchausen by Internet”).
What is striking is that the only two ways for parents to prove their innocence - recordings and an assessment by a qualified psychiatrist - are discarded as irrelevant or invalid: “NB: a psychiatrist can neither verify nor falsify PCF/MbP (in the parent)”.
As literature sources, Dr. Raat uses Meadow (1977) and the two last versions of the DSM, amongst some others. It is remarkable that the American Psychiatrists Association APA warned about the 2013 version of this DSM that it is "not appropriate to diagnose individuals with a mental disorder solely because a medical cause cannot be demonstrated and encourages clinicians to make a comprehensive assessment and use clinical judgment rather than a checklist that may arbitrarily disqualify many people who are suffering […] another medical diagnosis from getting the help they need".
Meadow was actually the English doctor who managed to jail hundreds of Engels mothers in the '90s, before he got caught making a grave statistical error in his testimony in court. He lost his license and was forced to retire early.
Since Raat is literally teaching doctors that there is “little role for hidden camera (= solid evidence of innocence) and that “can neither verify nor falsify PCF/MbP (in the parent)”, parents lack all means to defend themselves, as ‘falsification’ means precisely that the existence of something is excluded based on objective and solid evidence.
According to Vera Hooglugt “it is IMPOSSIBLE that - when a parent is cleared by a psychiatrist - the child still has PCF”. How the definition is now being used, makes everything untraceable. MbP is a highly controversial and rare psychiatric diagnosis, which is now been used in legal battles by medically trained paediatricians. This was specifically warned again by the APA.
Hooglugt: “This is a kind of accusation before the fact. Which makes it impossible for parents to develop a trusting relationship with the VT Confidence doctors. Privacy, human rights and medical ethics are at stake. Only when its beneficial for them, VT will use ‘privacy’ for any silly detail. But in the meantime, they violate the privacy of both parents and children”.
One of the ways in which this happens is VT reporting to itself, in lack of an external report. Privacy rules are then broken without further consideration.
“This how they navigate around the basic principle of our legal system”, one of the BVIKZ board members explains during the interview. “Who accuses has to have proof. Now parents have no rights and they need to prove that they did NOT do something. Which is impossible.”
The BVIKZ wonders where VT’s mandate comes from. Within the Dutch legal framework it seems to fall under the responsibility of two Ministeries as well as a separate law of public governance. According to this law, the parents should have rights and government official should abide the rules.
If so much goes wrong in the first link of the chain, the whole chain is powerless. The other organizations simply need to assume that VT works with integrity and care. If not, who is doing the truth finding? This should be done in the Triage model, which is not the case.
Human rights at stake
All the above has a large impact on the social security of these parents and their children, who approached the BVIKZ for help. Several fundamental human rights are now violated: freedom of education, freedom of opinion, free choice of education and access to care. Access to care is described in the AAAQ framework of the World Health Organisation WHO.
The current situation leads to avoidance of care, to emotional constraints and traumas of children by the use of force and indoctrination by VT, and to parents who are disempowered and are silenced into submission.
The only reason for the rise in MbP suspicions could well be the PhD studies and the campaign of the VT doctors. The BVIKZ has serious doubts about the objectivity of the researchers. Any doctor working in an Emergency Room can now simply tick a box with MbP on their forms. Once the suspicion of ‘child abuse’ is present, it is almost impossible to get rid of it. If this PhD is concluded, it foretells a social disaster.
According to the aforementioned psychiatrist Bransfield "disagreements regarding diagnosis and/or treatment in medicine are common. However when organizations who hold a particular opinion on a medical issue accuse those with different opinions of creating fictitious disease (Munchausen’s or Munchausen’s by proxy), they are misusing diagnostic criteria, the power of the state and loopholes in the law.
The proper diagnosis of fictitious disease requires proof of actual contrived illness, such as injecting a toxic substance to create illness. An improper accusation that parents are creating a fictitious disease, when it is instead a medical disagreement, constitutes an actual contrived and fictitious diagnosis of fictitious disease and is an organized and institutionalized form of child abuse."
What can parents do?
This situation is not exclusively happening in the Netherlands, but seems to be a worldwide tendency. This is partly supported by a rise of newly created and highly questionable ‘somatic disorders’. In the Netherlands, the BVIKZ calls upon parents to join them, so that they can collect more documentation and help individual families as early in the process as possible. They find that the fact that an external party is present at the conversations and is analyzing the files, often helps diffuse the allegations.
People outside the Netherlands, who are facing similar problems, may find it valuable to learn from their experience. If you want to organise yourselves effectively, consider the following points.
- select people who understand the emotional stress of the parents and are able to empathize with them, but who also can take enough distance to look at the cases objectively. They should also have a thick enough hide.
- select people from different and relevant professional backgrounds and build a wider network of scientists, doctors, journalists and so on
- work with lawyers who really know their business and are willing to speak up, like Mr. Korver (see the SOS Lyme trailer with him featured in it)
- make sure your own legal framework is in order as well as the authorisations of the parents to act as their legal representative
- try to intervene as early in the process as possible and always have a third party present
- check your rights and use them. For example, the Dutch have the right to record all conversations in which they are present. Many Dutchmen don’t know this or are reluctant to use this right. But VT will make you sign a weaver to not use the recordings in court, when you are polite enough to ask for permission
- do not count on politicians to willingly help you, but don't underestimate the power of public opinion. After the initial rejection, the Dutch Secretary of Health did call the BVIKZ and promised to have the Health Inspection research the matter
It can also be valuable to understand how international cooperation can move things forward on a national level. In June 2017, the fifty recorded cases of Lyme parents were reported to the Special Rapporteur of the UN as part of a wider report on the current worldwide violation of the human rights of Lyme patients. This will open doors in all 80 UN member states.
In order to build such a case, good documentation is essential. So in the meantime it is also important for parents to be reporting doctors to the Disciplinary Boards, just like the parents of Tibbe and Micha did. This will show them that they cannot keep on acting the way they do and build legal documentation at the same time.
The better the documentation, the easier it will be for high-quality journalistic programs such as EenVandaag to expose these gross violations of human rights by government institutions.
Interviewer/author: Huib Kraaijeveld
- first interview BVIKZ about Lyme & CPS
- On Lyme interview with lawyer Korver
- 'The mysterious statistical bias of Dutch Child Protection Services' & Follow the Worms by Huib Kraaijeveld
- 'Munchausen's syndrome by proxy and Lyme disease: medical misogyny or diagnostic mystery?' by Virginia Sherr
- 'Munchausen unusual suspects' by Pamela Weintraub
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