Friday, July 24, 2009

A Chasidic Mother – Guilty or Innocent?

There has been much ado about a psychiatric report by a psychologist named Yaakov Weill. This report was the result of a court order that required a psychiatric examination of a Toldos Aharon (a Chasidic sect) mother accused of nearly starving her 3 year old son to death!

The hospital medical staff studied the case and observed her behavior via a security surveillance camera when she thought she wasn’t being watched. The surveillance camera recorded it for review. They determined that this woman suffers the rare disease of Munchausen by proxy whereby an individual as a caregiver makes the person receiving care sick for purposes of getting attention and praise. The police were contacted she was arrested and removed from her children.

That led to some of the most destructive mob violence Jerusalem has seen in recent days. And that’s saying a lot. The violence was perpetrated by the broader community that included not only Toldos Aharon Chasidm but the entire gamut of Chasidim – of the type mostly associated with the Edah HaCharedis - that reside in her Meah Shearim neighborhood.

Protestations of her innocence and accusations of conspiracies against Charedim by Haddasah Hospital and the police have been flying high. Much of the protest included denying she was an unfit mother and testimony by those who knew her that she was a fit - kind and caring mother. They accused the doctors themselves as guilty of starving the child - including giving him unneeded and dangerous chemo-therapy in order to cover up a cancer misdiagnosis - and then blame the mother.

The court ordered a psychiatric evaluation. This is where Dr. Weill comes in. His report was apparently released and it claims that she is not suffering from Munchausen by proxy.

Her lawyer, the protestors, some of their rabbinic leaders and the many sympathizers - are all slapping themselves on the belly and saying, ‘See! I told you so!’ ‘She is innocent and this whole thing is a conspiracy.’

Is it? Is she innocent? Were the protestors right? Case over? The surveillance video – thrown out?

Not so fast.

I have received the following e-mail from Dr. Josh Backon. I have never met him personally. But we have had a relationship via an e-mail list for probably well over a decade. Over the course of this period I have come to know him as a serious and highly principled individual - who speaks his mind freely.

He is an American trained Frum Doctor – very knowledgeable in Halacha and in medicine. He has many years of experience practicing medicine in Israel. He is also on the faculty of medicine at the Hebrew University among many other accomplishments. He has been on top of this case and is very upset - even angry - at this whole thing. Here – in part and with his permission – is what he said.

Guest Post by Dr. Josh Backon

Before (anyone) quotes the psychiatric report of Dr. Yaakov Weill which exonerates the charedi woman accused of severely treating her child here are some facts:

* Dr. Weil who ran the sexology unit at the psychiatry clinic at Hadassah Hospital was fired last year. Hadassah now claims that Weill is getting even at them.

* Weill never spoke to hospital staff, the child himself, schools where the other children went, other members of the family.

* The district psychiatrist, Dr. Kalian, of the government's Ministry of Health, vehemently rejects Weill's diagnosis.

* Professor Zev Klein, who chairs the Israeli board of psychiatry and Israel Association of Psychiatry vehemently rejects Weill's diagnosis. He states that Munchausen by proxy can NOT be diagnosed by 2-3 short interviews.

* The medical literature shows that Munchausen by proxy is diagnosed by pediatricians, not psychiatrists.

* In the past few years, courts have thrown out Weill's psychiatric depositions.

* The district attorney's office is investigating whether Weill had an ulterior motive in his diagnosis.

I will reiterate what I wrote a few days ago:

Since 6 months of age the child had a diagnosis of severe "failure to thrive" (FTT). He had been starved for 2.5 years !! He had been hospitalized since November 2008 and was NOT getting better.

The child was on TPN (total parenteral nutrition). And just as I wrote in email: a huge slew of possible diagnoses had to eliminated and a many diagnostic tests were carried out (I noticed: CT, angiogram, MRI, antinuclear antibodies and other interesting possibilities such as myositis and rheumatoid disorders and very rare inherited metabolic disorders like TRAPS (TNP R mutation associated periodic fever) .

You might want to check it on . But the clincher was no bowel movements since February with no stenosis or blockage or bowel obstruction. And bleeding from the oral cavity. That means the kid was STARVED by his mother. Indeed, she was caught in flagrante delicto on camera yanking out the feeding tube.

If you were on prolonged hyperalimentation and had a naso-gastric tube yanked from you forcibly, you'd also be in agonizing pain and couldn't take food per os (by mouth).

The deputy head of social services at Hadassah is a frum American woman whose husband is the gabbay at our shul. I know the chief of pediatrics, head of pediatric hemato-oncology, and head of pediatric intensive care.

The child NEVER had cancer and never ever received any chemotherapy. It's an utter blatant SHEKER.

If you'd see the patient's medical chart you'd see how it is 101% positive that the mother had Munchausen by proxy and had very severely endangered the life of the child.

After the child had 2.5 years of failure to thrive, now when the mother has not been permitted to be with the hospitalized child for the past 2 weeks, the child is "miraculously" [tm] getting so well that he can be released from the hospital.

There's a 50 minute videotape of what the mother did to the child. The security guard was called in, social services as required by law notified the police.

Look in Shulchan Aruch CHOSHEN MISHPAT 424:7 in the nosei keylim. With regard to the slightest CHASHASH of an abused child, doctors are halachically mandated to contact the authorities (see Rav Rabinovitz's article in Sefer Halacha U'Refuah Chelek Alef page 336). The person who is abusing the child has the Din of RODEF !!

Dr. Josh Backon
Hebrew University
Faculty of Medicine