"We Know You Hurt Your Kids"

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Meadow was a prosecution witness at both trials. He testified in Clark's case that the chance of two cot deaths in one family was 1 in 73 million, a statistical claim that was outside the scope of his expertise and, the appeals court declared, should never have been allowed into evidence. The Crown Prosecution Service said that in all ongoing cases involving the testimony of Meadow or Williams the defense will be told of the Clark case and the criticisms it prompted. As for past cases, "only those involving Dr. Williams and not those of Professor Meadow are being looked at," says a cps spokeswoman. At least one case involving Meadow's testimony will soon be up for review. A Nov. 22 appeal date has been set for Angela Cannings of Wiltshire, who is serving a life sentence for killing her two infant sons. Cannings' husband has said the couple are not allowing themselves to become "too optimistic," but the controversy surrounding Meadow's cases should bolster her appeal.

Meadow's critics say his belief in the prevalence of MSBP has undermined a fundamental precept of the justice system. "Largely because of Meadow's settled conviction that a high number of parents and mothers are murderers, the presumption of innocence that has always been traditional in English justice is completely reversed," says Sue Stapely, one of Clark's lawyers. Clark and Patel are, in a tragically perverse sense, the fortunate ones, because a murder trial brought the accusations against them into the public realm. Most cases involving allegations of child abuse through factitious illness do not result in death, and the matter is dealt with in family courts, where proceedings are closed and the real names of the families involved, including the Watsons, cannot be published. Family-court confidentiality is a long-standing dilemma in Anglo-American law. "It's a well-intentioned feature, because the overriding concern must be the protection of the child, but this secrecy is part of the problem," says Frederick Howe, the Conservative Party's health affairs spokesman in the House of Lords. Howe expresses "grave concern" about the number of cases involving MSBP allegations. "MSBP is an unproven, pernicious and almost certainly flawed theory that has gained general acceptance," says Howe.

Confidentiality rules bar Meadow from discussing cases or responding to the accusations against him, but his defenders say his ideas are sound. Factitious illness by proxy is rare, admits Harvey Marcovitch, a former president of the Royal College of Pediatricians, but "all pediatricians have come across it." Marc Feldman, a U.S. psychiatrist and MSBP expert, notes that similar controversies have arisen in the U.S., where the incidence of MSBP has also increased steadily over the past two decades. He emphasizes that MSBP takes place everywhere, even if it is reported primarily in English-speaking countries where professionals are familiar with its indicators. "It's not a hypothesis or a theory," he says. "MSBP needs to be discussed as a form of abuse, not as a mental disorder or a personality trait of a parent."

Many parents whose families have been devastated by MSBP allegations continue to insist they are blameless; they have staged recent protests and talk of taking their cases to the European Court of Human Rights, which last year ruled that the rights of a British woman accused of inducing illness in her children were violated when her baby was taken from her at birth. Watson is one of the rare lucky ones. In 1999 she regained custody of Emma, who along with her youngest son remains under a social services care order. Watson's claims of innocence were vindicated after Emma had seizures while in foster care. "It sounds awful, but I was elated because I wasn't anywhere near her and couldn't be blamed," she says. The pleasure she was accused of deriving from her daughter's illness is what led to Watson's troubles. Such unnatural joy indicates how deeply allegations of MSBP can twist the soul, and why the controversy around them will not end soon.