Counting the Cost of Misdiagnosis

A recent report from the Lehigh County Controller highlights how current specific policies within the child welfare system are leaving children and families vulnerable to medically-based wrongful allegations of child abuse. This newly released report, The Cost of Misdiagnosis, specifically outlines the high number of Munchausen by proxy or medical child abuse diagnoses in the area.

While this report focuses on Lehigh County's unusually high number of medical child abuse cases, more and more families across the nation are finding themselves wrongly accused of abuse due to flawed medical and investigative policies.

The Family Justice Resource Center works with the child welfare system to protect children from the grievous harm that comes when innocent parents are wrongly accused of abuse and neglect. We often work with families who have children who are ultimately found to have difficult-to-diagnose conditions, such as osteogenesis imperfecta, mitochondrial disorders, connective tissue disease, metabolic disorders, benign external hydrocephalus, vascular malformations, bleeding disorders, and neurogenetic conditions. These conditions take months, and sometimes even years, to diagnose. While they wait for a diagnosis, children can experience symptoms that can be mistaken for signs of abuse, such as unexplained fractures, bruises, subdural hematomas, and failure to thrive.

These very symptoms can cause a child to be diagnosed as the victim of abuse by child abuse pediatricians, most of whom work for clinics directly contracted with state child welfare agencies. When such a contract exists, a child abuse pediatrician’s diagnosis of abuse is not considered just one opinion of many—it is almost always treated as a settled fact, by child welfare agencies, law enforcement, prosecutors, and judges. If the case goes to court, the child abuse pediatrician is then the prosecutor’s key witness, who argues for the validity of their own allegation.

The risk of confirmation bias cannot be understated.

The child welfare system is designed to protect children. Everyone involved within that system is obligated to make it an utmost priority to ensure that the system is doing just that; and when anyone involved observes a policy or practice that could place children at an unreasonable risk of harm, they are ethically required to take steps to mitigate that risk of harm.

The full report can be accessed here.