F.R.A.M.E (International) is an international group of parents and their supporters, academics and professionals that has been formed in Australia, in response to the exponential growth in the number of accusations/confirmations of medically substantiated forms of child abuse such as Munchausen syndrome by proxy (Msbp), Shaken Baby and non-organic failure to thrive. Anecdotally, this exponential growth  appears to have occurred among certain medical practitioners, hospital based specialty units, hospitals and particular child protection reviewers in certain countries. 

F.R.A.M.E is an acronym for Family Rights and Medical Equity and was derived in part from the perception that many parents accused of medically substantiated forms of child abuse have been treated in a less than equitable way by health professionals and child protection officers. In such cases, individual parents or families believe that their rights have not observed and they have been denied natural justice. 

Still others  feel that they have been ‘framed’, accused of these forms of child abuse to cover up for the medical mismanagement of their children, in order to advance the careers of certain self-professed ‘experts’ in the field of medically substantiated cases of child abuse, or to cover up for environmental causes of damage to their children. Frequently, parents are coerced into  'confessing' to such accusations in order to retain custody of their children or to ensure supervised access to their child(ren).

F.R.A.M.E does not deny that medically substantiated forms of child abuse occur, or that some parents abuse their children., However, just as F.R.A.M.E believes that some children need to be protected from their abusive parents they also need to be protected from abusive health practitioners - the ‘blind spot’ of child abuse. F.R.A.M.E is committed to protecting children and their families from abusive health practitioners and the injustices that proliferate in the child protection, legal and judicial systems by showing how some health practitioners, specialty based units, and hospitals confirm, notify and influence the investigative process of such cases by the child protection services. 

In addition, F.R.A.M.E will demonstrate the flaws in the health and child protection systems and how easy it is to accuse unsuspecting parents of these forms of child abuse. 

F.R.A.M.E concurs with the views of Professor Colin Morley that doctors should not be able to use generic labels such as MSBP, but rather doctors should state the nature of the abuse e.g. mother observed injecting child with a foreign substance. Morley's contention is that MSBP as a label is uninformative and does not fully clarify or quantify the potential risk to the child.

It is F.R.A.M.E's contention that labels such as MSBP effectively stigmatises the child and the child's siblings, and potentially jeopardises the future health care of these children during their childhood and beyond into adulthood. Such children are more likely to be labelled with such disorders as Somatisation disorder and Munchausen syndrome in the future if they been labelled as suffering from MSBP in childhood. The use of such stigmatising labels for children runs counter to the United Nation’s Convention on the rights of the child to which Australia is a signatory and F.R.A.M.E is of the opinion that they should not occur.

Through our contact with an increasing number of families, doctors and other health and non-health professionals, we are aware that a growing number of children and their families are being made subject to medically substantiated allegations child abuse. In part, this appears to be happening because there are a lack of interagency and agency guidelines and accountability of medical practitioners.

According to Hayward-Brown (1999), the medical evidence and the methodology used by some doctors to ‘establish’ or confirm cases of  MSBP in many cases is ‘highly questionable’.  Doctors can hide behind mandatory notification laws, the term ‘good faith’, and the current rules of evidence in child protection matters to absolve themselves from all accountability and responsibility for their actions in this area. 

This probably accounts for the reluctance of child protection agencies to push for criminal charges against the parent, as the rules of evidence in criminal matters is very different to that which exists in children care proceedings. In addition, criminal courts are 'open' courts, unlike children's court which occur behind closed doors and are therefore not open to public scrutiny and to public debate. 

It would appear that some of the doctors involved in such cases here in Australia are not being asked to provide any substantive evidence in such cases, are not observing even the most rudimentary requirements of the child protection laws to notify at the mere suspicion of child abuse, and are not adhering to even the most basic of the child protection policy and procedures guidelines and are currently doing so with impunity in the state of New South Wales., Australia.

One of the most pressing issues of concern to F.R.A.M.E is the number of children who have been falsely reported as suffering from MSBP or Shaken Baby cases long after this has been found not to be the case and when the mother/parent has been completely exonerated of causing the child’s illness, or when the child’s death or illness can later be attributed to other causes. These false allegations are not privately or publicly retracted, the child’s file notes and the computer generated files are not amended, and this potential compromises the care of the child in the future, misrepresents the true incidence and prevalence of the disorder and potentially skews the mortality and morbidity figures associated with such disorders.

Of additional concern is the compromising of the right of the child to be taken for a second opinion or to obtain alternative health care or health care elsewhere, as this right is invariably blocked when the allegation of MSBP is made. This access to a second opinion is even blocked when there is no evidence that either of the parents has induced the child’s illness. In addition, not only do other child health specialists not want to be involved in such cases, but they also form preconceived ideas and opinions about the mother/parent, so compromising their objectivity in such cases. This has the potential to effect their clinical assessment of the child. 

The children's care court often stipulates that the child remain in the care of the current treatment team as a proviso for granting a care order or allowing the parent (s) to retain custody of their child. This then acts as a powerful incentive to unscrupulous medical practitioners who have medical mismanaged the child’s care to notify the child to DOCS as suffering from MSBP. This then becomes an unwarranted form of institutionalised child abuse. The child is abused because it is made subject to an unnecessary notification and must remain in the care of practitioners who have, and will possibly continue to, medically mismanage it’s care long into the future.

To conclude, F.R.A.M.E is dedicated to:

• Forming supportive and informative state based, national and international networks between mothers/parents who have been accused of medically substantiated forms of child abuse and other interested third parties.

• Exposing vexatious and malicious notifications.

• Providing information to, and facilitating the education of all, key stakeholders which includes: child protection authorities, individual hospitals, Area and County Area Health services, government ministers, opposition government ministers, public interest groups, government watchdog organisations, and the media 

• Exposing trends in accusations/confirmations and/or notifications of medically substantiated cases of child abuse.

• Facilitating group and individual counselling for children / mothers / fathers / parents / families.

• Recruiting members, fundraising and ensuring the spread of information to all members of F.R.A.M.E and other interested third parties.

• Exposing the common links between these children/women/parents via a national and international de-identified database.

• Conducting research

• Formulating  educational documents/papers

• Maintenance of  membership and notification databases.

• Gathering information about these forms of child abuse, and disseminating information by formal and informal experts in these fields.

• Reviewing, identifying, and lobbying for the change to deficient child protection policies and procedures, interagency and agency guidelines, and child protection laws.

• Advocating with, and on behalf of, individual parents/families and assisting them to obtain information and make their views known.

• Facilitate second opinions for children said to be suffering from medically substantiated forms of child abuse (Such as Msbp and Shaken Baby syndrome) .

This organisation has been formed in response to the inaction and perceived inaction of individual bureaucrats and senior bureaucrats, Ministers, certain 'watchdog' organisations, health facilities, and child protection agencies to protect and promote the rights and health of children subjected to a medically substantiated allegations of child abuse, and to protect the integrity of their families and the wider child protection system. 

As one mother so eloquently stated, in her letter to the chief executive officer of an Area Health Authority:

"You are no longer dealing with people of the past. We are the baby boomers (even though I personally hate that expression) the generation that has been politicised and globally educated. And, as you would know, we have a sense of entitlement, commitment to positive and lasting change, a high expectation of our leaders and the where-for-all to demand and ensure that these are met. We will no longer accept the same old garbage that our parents endured, and be under no illusion Ms *****, we have the personal resources and political links to be heard and to be listened to. We expect responsive and wise leaders that put personal and political ambition aside and strive for personal and professional excellence (they go together)".

This is the sentiment shared by all members of F.R.A.M.E. 

We expect nothing less than a total professional and personal commitment from all people involved in these cases to ensure that: 1) children and their families are protected from medical malpractice and vexatious and malicious accusations/confirmations/notifications of child abuse., 2) people engaged in these practices are held to account for their actions., 3) that those entrusted with the protection of our children orientate themselves toward and act to promote and protect the integrity of the child protection system in a transparent and accountable way.