Münchausen's syndrome by proxy. A little-known type of abuse.

Clinical decisions are guided by a patient's medical history and symptoms, but when the history is factitious or the symptoms are produced, such decisions may have catastrophic results. In Münchausen's syndrome by proxy, patients are at the mercy of "illness manufacturers." Drs Leonard and Farrell discuss characteristic features and offer a profile of perpetrators that may help physicians distinguish medical fact from medical fiction.