No evidence base, and harm caused

Fabricated or Induced Illness: The controversial history, missing evidence-base and iatrogenic harm.

Andy bilson and Alessandro Talia

This chapter is co-produced with parents who were wrongly identified as having Fabricated or Induced Illness in their child.

It provides a brief history of the development of FII from the discredited work of Meadow and the miscarriages of justice at the turn of the century through to its

current form in the 2021 guidance of the Royal College of Paediatrics and Child Health. It shows how the definition has widened increasing the risk of misidentification and how earlier recognition of the limitations of diagnosis and the harm caused by misidentification have been abandoned.

It provides a literature search on FII exposing the lack of evidence for the concept and the harm caused by misidentification.

Finally, it shows the flaws in the current approach of identification using alerting signs showing the significant risk of this leading to serious harm to children who have rare, undiagnosed or hard to diagnose illnesses and their families.