Psychologists have long been aware of the tragedy of Munchausen Syndrome by Proxy (MSP), where a parent fabricates and sometimes artificially creates symptoms of illness, disease or injury in their child to gain attention and sympathy from medical personnel.
It is a mental illness which is a serious form of child abuse.
Many children have been subjected to invasive procedures and surgeries for no genuine reason.
Clinicians are now reporting a disturbing new trend of MSP where a parent feigns and complains that their child is the victim of sexual abuse.
This, more cerebral form of MSP, is being seen more and more often.
The disturbed parent in these cases, seeks the empathy and intervention not only of medical personnel but judicial and therapeutic agents as well.
Munchausen by Proxy is referred to in the DSM-IV as Factitious Disorder by Proxy and refers to a person who fabricates illness or injury in someone (usually their own child) to gain some benefit.
There is no doubt that this syndrome has mutated to incorporate the false allegations of sexual abuse.
This development appears to have proliferated in the climate of high conflict divorce and custody disputes.
Many psychologists have drawn a parallel between parents who engage in acute alienation of the child from the other parent and a personality disorder which may have been already present or 'triggered' by the emotional fall-out of a relationship break-down.
The same broken psychological motivation for MSP is present in the phenomena of parental alienation.
Both have been described as one of the most tragic and destructive forms of child abuse.
The reason that MSP often went as far as unnecessary surgery on a perfectly healthy child, was that medical practitioners operated under the assumption that a parent had the best interests of his/her child at heart and had the health and well-being of their offspring as their primary consideration.
MSP sufferers can be alarmingly convincing and have 'programmed' a child to believe in their own maladies.
There is little provision in an emergency ward for a malignant parent who fakes a child's often life-threatening symptoms, often going as far as artificially creating them.
Parents have injected poisons, dirt and other contaminants into their child to produce symptoms.
They have burned, fed poison, infected skin and a host of other unthinkable interferences to elicit compassion and medical attention for their child.
Gradually, through a program of education and by hands-on experience doctors and nurses have become more aware of the possibility of a parent fabricating illness.
In the family courts, parents are making more and more claims of sexual abuse in the course of a protracted custody battle.
It has been estimated that at least two-thirds of these claims are found, after thorough investigation, to be unfounded.
The damage to children and the 'other', accused parent are substantial and far-reaching.
This rise in false accusations of abuse is a very real statistic and as every case is taken on merit and investigated with due diligence, many innocent and unmolested children are being subjected to invasive, embarrassing and intrusive medical examinations.
When unwarranted and as a result of fabricated allegations by a parent, one could argue that it is sanctioned abuse of the child.
The parallels to MSP are undeniable.
A parent presenting an impassioned plea for help against a sexual child abuser will be taken on face value and investigated as if the allegation were true, just as a doctor must evaluate a patient who presents with self-reported symptoms.
Only a more thorough investigation will potentially uncover the truth.
However as there is often no tangible evidence outside of the parent and child's testimony, the truth becomes more difficult to ascertain.
Many people have been imprisoned on testimony, which months or years later is found to be false.
A parent dedicated to the fabrication of disease or abuse is a consummate manipulator and can easily transfer the 'theater of abuse' onto the key performer - the child.
Children can, in the process, develop false memories, which is tantamount to bequeathing them the same legacy as someone who was truly abused.
This form of child abuse is insidious and malevolent but sometimes difficult to determine.
Critics of the syndrome of parental alienation - point to it being a cloak or a smoke screen for real abusers who throw the blame of their crimes back onto the innocent parent, by accusing them of false accusations.
That may occur occasionally but to disregard MSP in the sexual abuse setting under the umbrella of parental alienation is irresponsible.
A doctor would be struck off for denying that MSP occurred in the clinical setting and to refuse to ever consider it, would be doing the victims a great disservice.
As doctors must be vigilant, so must clinicians and legal professionals to the very real possibility of false allegations.
The result of a case of non-abuse being followed through to conviction is as destructive and criminal as the cases of abuse that slip through the net.
The answer does not lie in rejecting parental alienation but in training professionals to be alert to the signs and developing diagnostic tests of a psychological nature to determine false accusations.
The social abhorrence of the crime of child sexual abuse, should not become irrational, viewing an alleged offender as guilty until proven innocent.
That is not justice but hysteria.
As abusers will abuse the concept of parental alienation, parental alienators will abuse the social reactions to claims of abuse.