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Logo of jmedethJournal of Medical EthicsVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Med Ethics. 1995 February; 21(1): 9–13.
PMCID: PMC1376524

The investigation of life-threatening child abuse and Munchausen syndrome by proxy.


The use of covert video surveillance in the investigation of suspected life-threatening child abuse and Munchausen syndrome by proxy raises important ethical questions. That the recently reported provision of this facility in North Staffordshire was not presented to a Local Research Ethics Committee (LREC) for approval as a research exercise raises important questions about the ethical review of research and practice. The case made for avoiding such review is first set out and then examined. The three main premisses which form the basis of the view that LREC approval is not required are identified and tested in turn. The conclusion is that there is an undeniable element of research involved in the procedure and that the welfare of all those subjected to the surveillance would be best protected by the submission of the protocol to an independent committee for ethical assessment.

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Selected References

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  • Southall DP, Stebbens VA, Rees SV, Lang MH, Warner JO, Shinebourne EA. Apnoeic episodes induced by smothering: two cases identified by covert video surveillance. Br Med J (Clin Res Ed) 1987 Jun 27;294(6588):1637–1641. [PMC free article] [PubMed]
  • Samuels MP, Southall DP. Munchausen syndrome by proxy. Br J Hosp Med. 47(10):759–762. [PubMed]
  • Samuels MP, Poets CF, Noyes JP, Hartmann H, Hewertson J, Southall DP. Diagnosis and management after life threatening events in infants and young children who received cardiopulmonary resuscitation. BMJ. 1993 Feb 20;306(6876):489–492. [PMC free article] [PubMed]
  • Foreman DM, Farsides C. Ethical use of covert videoing techniques in detecting Munchausen syndrome by proxy. BMJ. 1993 Sep 4;307(6904):611–613. [PMC free article] [PubMed]
  • Morley CJ. Experts differ over diagnostic criteria for Munchausen syndrome by proxy. Br J Hosp Med. 48(3-4):197–198. [PubMed]
  • Chatterjee A, Tosyali MC. Munchausen's-by-proxy. Lancet. 1994 Apr 23;343(8904):1040–1041. [PubMed]
  • Meadow R. ABC of child abuse. Munchausen syndrome by proxy. BMJ. 1989 Jul 22;299(6693):248–250. [PMC free article] [PubMed]
  • Nicol AR, Eccles M. Psychotherapy for Munchausen syndrome by proxy. Arch Dis Child. 1985 Apr;60(4):344–348. [PMC free article] [PubMed]
  • Southall DP, Samuels MP. Ethical use of covert videoing for potentially life threatening child abuse: a response to Drs Foreman and Farsides. BMJ. 1993 Sep 4;307(6904):613–614. [PMC free article] [PubMed]

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