first, roy meadow had called this syndrome by proxy.he hadn't meant to suggest this was a real psychological syndrome which some particular psychopathology that made the people do this though, mentally ill for lots of people took it that way. it later turned out from investigation, has no particular psychopathology associate with this behavior. some people have depression hurts and people of the mental illness. others register completely mentally healthy. that's when issue. second and related issue is who is going to diagnose this behavior? was a mental health practitioners or pediatricians who came in contact with the child but not the parent usually? and the third issue an issue that the munchausen syndrome by proxy diagnosis eventually founded with how to separate these really twisted parents from parents children who were legitimately ill, often with rare illnesses that people didn't recognize. although rare illnesses mean they are rare, there are more than 7000 rare illnesses, a one in 20 children actually have a rare illness. ulti