Serial maternal filicide as evidence of Munchausen syndrome by proxy

Munchausen Syndrome by Proxy (MSBP), or Fabricated or Induced Illness (FII), is a form of physical and emotional child abuse and maltreatment that remains frequently under-detected due to a significant lack of clinical awareness. This case report aims to highlight the challenges of diagnosing MSBP, its impact on victims, and the ethical implications for healthcare professionals. A 37-year-old woman charged with filicide of two of her offspring and deliberate intoxication of her remaining 3-year-old boy was diagnosed with MSBP. Despite the tragic outcome for two siblings, the timely intervention saved the life of the third child. This case adds to the existing literature related to MSBP. It illustrates the difficulties posed by and the perpetrator's ability to deceive healthcare providers. It emphasizes the need for a sound understanding of victims' and perpetrators' features to facilitate early evocation of the condition and thus prompt the adoption of adequate measures. To conclude, MSBP is a complex issue with significant diagnostic and ethical challenges. Early suspicion, careful evaluation, and a multidisciplinary approach are crucial for the protection of children and the appropriate management of perpetrators.