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September 1988

Munchausen's Syndrome by Proxy and Video Surveillance

Am J Dis Child. 1988;142(9):917-918. doi:10.1001/archpedi.1988.02150090015007

Sir.—In their informative article in the October 1987 issue of AJDC describing various aspects of Munchausen's syndrome by proxy, Zitelli et al1 made the statement, "Practices such as secretly going through mother's possessions, unannounced home visits,2 and concealed videotaping3 may be unacceptable to many professionals, difficult to carry out, and in some instances illegal [reference numbers changed]." We strongly disagree with the authors' inclusion of concealed videotaping (with reference to our 1983 article3) among unacceptable or illegal practices. We also find such an inclusion surprising, since the authors emphasized the difficulty of achieving a favorable outcome in legal proceedings initiated to protect the child. Our decision to use hidden camera surveillance in this instance,3 and in subsequent cases,4 was based on the knowledge that a definitive diagnosis, supported by incontrovertible evidence, is crucial in such court proceedings. We believe that our primary obligation,