Sadly, while knowledge of Munchausen traveled across the Atlantic, skepticism about it did not. Starting in the mid-1990s, two doctors — Dr. Carole Jenny, a pediatrician specializing in child abuse, and her husband, Dr. Thomas A. Roesler, a psychiatrist — proposed that Munchausen’s taint could be avoided by reconceptualizing the condition. Doctors, they said, shouldn’t focus on the parent’s mental state (as in Munchausen) but, instead, simply determine whether the child had received unnecessary and harmful, or potentially harmful, care at the behest of a parent. They defined “potentially harmful” to include any unnecessary medicine or diagnostic test that could have harmful side effects, even if the child wasn’t actually harmed. Such care, they argued, should be labeled medical child abuse, and treated like any other kind of child abuse.

But there is no solid evidence that their standard helps to sort out parents who intentionally use medical care to hurt their children from well-meaning, innocent parents. Indeed, Drs. Jenny and Roesler recognized that most kids identified by their criteria were truly sick (though they believe the kids received excessive, inappropriate care) and that their criteria identified far more parents than the standard Munchausen criteria.

Dr. Richard G. Boles, a mitochondrial disease specialist who has worked on some 100 cases involving suspected medical child abuse, said that only about five fit the classic Munchausen situation and should be considered abuse. Of the rest, he says, about two-thirds involved a demanding mother who got on a doctor’s nerves; the remainder involved a parent who was too anxious in dealing with doctors who couldn’t give adequate answers.

Compounding the problems with the overly broad definition of medical child abuse is the considerable misinformation spread by its proponents. In 2013, a governor’s task force in Michigan stated that “many cases of Medical Child Abuse go undetected because caregivers are skilled at deceiving the medical community.” No hard evidence, however, suggests that such parents are anything but rare. Medical child abuse is far more likely overcharged than undercharged.

The task force identified these warning signs of medical child abuse: a “highly attentive parent” who is “unusually reluctant to leave his/her child’s side”; a parent who “demands second and third opinions”; a parent who “is not relieved or reassured when presented with negative test results and resists having the child discharged from the hospital”; and a parent who has “unusually detailed medical knowledge.” These warning signs accurately describe many, if not most, loving parents of medically fragile children.

In its zealotry, the medical child abuse movement resembles two other panics from the recent past: the sex-abuse panic of the 1980s and 1990s and, more recently, the panic over shaken-baby syndrome. In both panics, experts saw foul play where none existed, government officials took their views at face value, and people were wrongly convicted and imprisoned, their lives ruined. Medical child abuse is causing similar harm.

Jessica and Sean Hilliard of Attleboro, Mass., went through the agony of watching their 5-year-old daughter die in 2011 from what two outside specialists concluded was a genetic disease that affected mitochondrial function. The couple asked Boston Children’s, where the daughter died, to test their 3-year-old son for the disease after he showed symptoms suggestive of it (mito can run in families). A hospital pediatrician specializing in child protection, citing a pattern of behavior that she contended suggested abuse, accused the parents of fabricating their son’s medical issues, though she had not spoken with his outside doctors and therapists.