Law Enforcement

Medical Child Abuse cases are notoriously difficult to investigate and prosecute successfully. Many departments provide no training for investigators who come across these cases.

Detective Mike Weber—who has worked on dozens of MCA cases and is a member of the APSAC’s MBP Committee—has developed a guide for law enforcement which can be found here.

Weber also provides training for law enforcement and other frontline professionals.

We strongly advise reading the APSAC Guidelines for law enforcement and the APSAC Advisor.

Important Points for Law Enforcement

The Offender

  • Medical Child Abuse can occur for a variety of reasons, including FDIA (link to definition) and financial gain.
  • Healthcare providers rely on medical history from the caregiver, making this type of abuse easy to commit.
  • The offender often portrays herself as the victim of a skeptical medical community.
  • Offenders rarely have criminal histories and outwardly appear to be devoted, loving parents.
  • Offenders are extremely manipulative and skilled at deception.
  • There’s no effective psychological “test” for the offender; assessment of abuse should be evidence-based.
  • The belief that offenders suffer from a mental illness, thus limiting their responsibility, is a misconception. Experts believe these offenders know right from wrong and commit these acts intentionally.
  • Offenders often find gratification in getting attention from having an ill child, as well as in deceiving medical professionals, charity organizations, media outlets, and government officials.

The Investigation

  • Prosecutors, judges, and law enforcement must understand the potentially life-threatening nature of medical child abuse.
  • MCA cases often present atypical crime scenes that require an understanding of the depth of deception involved.
  • Law enforcement should get an extensive social history of the offender.
  • Witnesses outside of the medical community often report that the victim appeared healthier than the offender claimed.
  • Social media is crucial to MCA investigations; a preservation request should be sent to all relevant platforms at the beginning of an investigation before the offender is aware of the investigation. Witnesses should be asked about their social media connections with the offender.
  • Communications, such as emails and text messages between the offender and cooperative witnesses regarding the medical history of the child, should be collected and examined. These can provide probable cause for a search warrant for a forensic examination of the offender’s electronic devices (including cell phones), which may lead to crucial evidence of abuse.
  • Physical evidence, such as medications, should also be collected.
  • It’s crucial to separate the victim from the offender during the investigation, allowing only brief, professionally supervised visits.
  • This form of abuse is not only physical, but is also emotional and psychological; victims should never be placed with family members who believe the offender to be innocent.
  • It is crucial for law enforcement to take a team approach with the DA’s office, CPS, a pediatrician, hospital legal advisors, and others involved.
  • A complete medical history of the victim and the offender should be collected, as offenders frequently lie about their own health history as well as their child’s.
  • Cases typically involve a vast amount of data. It is helpful to integrate this into an electronic spreadsheet sorted by date (insert link to example in guidelines).
  • When interviewing the offender, investigators can gain an advantage by pretending to know less than they do, giving the offender the opportunity to lie to the investigator. The interviewer can then confront the offender with evidence that debunks what the offender has just told them. This strategy may lead to admissions from the offender.