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Judge Rules Against 'Warrior Mother'

E – Let’s call her Emma – is a remarkable woman. She has worked for many years within the NHS, has diplomas in public health and hygiene as well as in institutional housekeeping and catering, she has also served as a governor for one of the schools her son (we’ll call him Michael, and his father, who worked in the fire service, Andrew) attended and has also worked as a trained mediator. Emma is confident, perhaps sometimes overly so, and articulate. Given Michael’s diagnoses of autism and a learning disability, it is perhaps unsurprising that this impressive woman also served other roles in organisations concerned with autism. In 2010 she became Michael’s Deputy for Property and Affairs as well as personal welfare, under the Mental Capacity Act 2005. Michael, due to his disability, did not have capacity to manage his own affairs or make decisions about his wellbeing.

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Judge Declares Mother has Dangerous Behaviour

And yet this month a judge (specifically, Mr Justice Baker) declared Emma the last person who should have charge of Michael’s wellbeing. He called her behaviour dangerous and deplorable. He said she had fabricated or at least grossly exaggerated her accounts. Why?

Emma, as well as all of the above, is what Americans term a “Warrior Mother”. She is a leading British anti-vaccination campaigner. But even that is not as simple as it sounds: it is unclear whether this is caused by the fact Emma suffers from a factitious disorder imposed on another – a condition many of us might remember being called “Munchausen’s By Proxy”.

In 1998, Dr Andrew Wakefield and others published a paper in The Lancet suggesting a link between the MMR and autism. The facts which follow are well known: the study was found to be erroneous; Wakefield resigned from the Royal Free Hospital; and he was struck off the Medical Register. His study had been, at best, misconceived, and at worst, deliberately fraudulent. Given his other behaviour, (in stark contrast to the behaviour of Jonas Salk, who’s 100th birthday passed yesterday, Wakefield filed a patent in March 1995 claiming “Chrohn’s disease may be diagnosed by detecting measles virus in bowel tissue, bowel products or body fluids” from which he anticipated making over £72 million a year) it is difficult to be inclined to give Wakefield the benefit of the doubt and suppose his notions were simply misconceived.

Link Between MMR Vaccine and Autism?

Despite the fact that Wakefield’s ideas have been thoroughly, utterly, and completely debunked, Emma – like many others, including celebrity mother Jenny Mc Carthy – believes the link between the MMR and autism is very real.

Between September 1989 and March 1990, when Michael was between the ages of six weeks and eight months, he received the normal range of inoculations. No adverse reactions were recorded. Until December 1990 there is no record of any developmental delay in any of Michael’s medical records. On 12 January 1991, aged just less than 18 months, Michael received the MMR.

There is no record in his GP’s notes of any reaction. In fact, there is no record of any adverse reaction for the next nine years. Michael was seen by the GP several times each year for a variety of illnesses and was also seen by various specialists, including an audiologist, ophthalmologist and speech and language therapist. In none of the records prior to 2000 is there any account of an adverse reaction to the MMR.

Nevertheless, from 2000 onwards, Emma and to a lesser extent Andrew gave increasingly vivid accounts of their son’s alarming reaction to the vaccine. Descriptions include Michael screaming, convulsing, and projectile vomiting for six hours following the injection. There is even a note which states that Emma alleged that Michael had remained, thereafter, in a persistent vegetative state for six months.

Immunisations Refused

In 2004, Emma refused to give consent for Michael to receive immunisations for tetanus, diphtheria and polio. Michael’s diet was increasingly restricted and he was given an increasing number of supplements. In the same year, Emma stopped working to care for Michael, who was at that time aged 14 or 15. Predictably for a person who had undeniably thrived on her busy, vital lifestyle, Emma continued her anti vaccination campaign, writing letters including to Jack Straw in 2008, to which she received a lengthy reply.

Over the next few years, Michael was subjected to a regime characterised by excessive control exercised by Emma over every aspect of his life. More seriously, Emma fabricated accounts of his health problems and subjected him to unnecessary assessments and treatments, as well as imposing on him an unnecessarily restrictive diet, with a range of unnecessary supplements. Emma gave false accounts of Michael’s history to medical professionals and tried to rely on these false accounts to direct the course of his future treatment.

One example of this is on 21 June 2012, when Michael complained of tooth pain, Emma took him to the emergency dentist. The family dentist not being present, Michael was examined by another dentist, Ms Malik. Ms Malik is, according to other practitioners, an excellent clinician. Ms Malik diagnosed the possible presence of an abscess behind an upper tooth. She did so from an X-Ray examination. She recommended Emma make an appointment with Michael’s usual dentist to deal with this.

Emma denies she was told anything of the sort. The following day she emailed Ms Haywood, a nutritional therapist, telling her nothing showed up on the X-Ray, and therefore she was told it was likely to be sinusitis. On 25 June 2012, an out of hours GP prescribed a course of antibiotics for sinusitis. In another email to Ms Haywood, on 27 June 2012, Emma told Ms Haywood Michael had been put on antibiotics for a list of reasons including inflammation of his brain.

On 27 July 2012, Emma took Michael to another dentist at a different surgery, who detected nothing abnormal – no doubt due to a combination of the antibiotics prescribed by the GP helping with Michael’s pain and the fact that Emma requested no X-Rays be taken.

Michael was seen by an oral hygienist on 4 September 2012 at his usual surgery and nothing was detected, but, a hygienist would be unable to make such a finding. On 23 May 2013 Emma took Michael to yet another dental surgery where X-Rays revealed a cyst consistent with that which Ms Malik had found some 11 months earlier. An oral surgeon confirmed, on 6 June 2013, that surgery under general anaesthetic would be required on one or possibly two of Michael’s teeth, which were pulpetic and abscessed. On 7 June Emma emailed Ms Haywood, telling her the abscess was now twice the size it was last summer, when Michael previously had X-Rays, which had, she said, not picked it up.

On 5 August 2013, Michael underwent surgery under general anaesthetic in which the two teeth were removed. The hospital notes for this admission reveal that, in summarising Michael's medical history, Emma said that he had "tested positive for Lyme disease." The two teeth were subsequently given to Emma, who stored them in her home freezer with a view, it is said, to send them for testing in America by Mr (formerly Dr) Wakefield.

In ignoring Ms Malik's advice, failing to make an urgent appointment with Michael’s usual dentist on his return, taking Michael to another dentist, failing to give a full or accurate account to that other dentist and expressly declining further X-~Rays which would have been likely to reveal the abscesses, Emma was solely responsible for allowing Michael's infected mouth to go untreated for over a year, thereby condemning him to continued and escalating pain and suffering as the area of infection gradually got worse. Instead Emma pursued other increasingly extreme theories for the causes of Michael's pain, none of which had any basis in fact, at a time when she knew or ought to have known that the cause of the trouble was the abscess which she was concealing.

It is not suggested that Emma had any deliberately sinister motive – Emma and Andrew were both deeply devoted to Michael. Rather, it is due to her condition that she was not capable of acting in her son’s best interests. During the course of evidence, one Dr Beck said she was unable to rule out the possibility that Emma may pose a risk of harm to Michael in order to prevent her loss of control over him as a source for attention for herself.

Judge's Conclusion

Mr Justice Baker, during his conclusion, commented as follows:

“Emma’s “behaviour amounts to factitious disorder imposed on another. In addition, E has a combination of personality disorders - a narcissistic personality disorder, histrionic personality disorder and elements of an emotional unstable personality disorder.

“Despite her serious conclusions about E's personality, it is Dr Beck's view that these parents have a lot to contribute to their son if they are capable of offering the care and support he needs under the guidance of an overarching programme of care coordinated by the local authority. I agree that they would have an enormous amount to offer their son if they could work in collaboration with the local authority social workers and other professionals in M's best interests. I have not given up hope that this may be achieved.”

Michael’s life, therefore, was blighted not by his own condition, but that of his mother. Disabilities and mental capacity issues can be more or less obvious – whilst autism like Michael’s may be evident to anyone meeting him, his mother’s condition was not. To the entire world, she was a concerned, loving mother. This is not to say all Warrior Mothers suffer from factitious disorders, but rather to say that issues of mental capacity and mental health are not all clear cut. There exists a realm in-between those clearly having full capacity or health and those clearly not, in which many people sit, either not presenting as clearly lacking capacity, or having capacity in some areas and not others. This is where Emma sat. She demonstrates – quite perfectly – how mental capacity and health is not as clear cut as we would like to think. She was more than capable in her employment. She was more than capable of managing her finances and her own wellbeing. But for her son, whom she loved dearly, she was the last person who should make decisions about his wellbeing.