No. 2024-CA-0402-ME
Scott Family Court
Opinion by Judge Cetrulo
Date Rendered: August 30, 2024
Child was born in 2009, and no father was identified. Mother had been the subject of at least four investigations regarding Child, beginning when Child was just a few months old. In 2017, concerns arose that Mother was seeking unnecessary medical treatments for Child. This led to a dependency, neglect, and abuse (DNA) action, during which Mother was barred from making independent medical decisions for Child, and Child was placed with the maternal grandmother. By 2019, Mother regained custody, and the case was closed. However, the Cabinet for Health and Family Services (the Cabinet) continued to monitor the situation until October 2020, when Mother withdrew all releases of information. Shortly after, Child’s health severely declined.
In January 2021, following a referral from the Children’s Hospital of Philadelphia, a team of medical professionals concluded that Child was a victim of medical child abuse, accusing Mother of escalating medical care and falsifying symptoms. By that time, Child had undergone numerous unnecessary medical procedures, used a wheelchair, and was on over 30 medications. Despite extensive medical interventions, no underlying diagnosis was found to justify these treatments. It was also revealed that Mother had raised significant funds through social media, suggesting that Child would not survive to adulthood.
Child was removed from Mother’s care in 2021, after which Child’s health dramatically improved. Within months, Child was no longer using medications, medical devices, or a wheelchair and had resumed a normal life, including attending school and participating in social activities. The Cabinet then initiated proceedings to terminate Mother’s parental rights in 2023.
During the hearings, it was revealed that Mother had been diagnosed with Factitious Disorder by Proxy, a condition where a caregiver fabricates or induces illness in a child. Despite evidence of Child’s recovery, Mother denied any abuse and refused treatment for the disorder. Family Court ultimately found clear and convincing evidence of abuse and concluded that it was in Child’s best interest to terminate Mother’s parental rights due to her mental illness, prolonged abuse, and lack of accountability. Mother appealed the decision.
The Court of Appeals found no merit in Mother’s arguments. It agreed with the Family Court’s conclusions on several key points.
First, the Court of Appeals noted that Mother did not dispute the Family Court’s finding that Child had been neglected, which satisfied the first prong of the statutory analysis under KRS 625.090. This was not contested on appeal.
Second, the Court of Appeals found that the Cabinet had proven multiple grounds for termination under KRS 625.090(2) by clear and convincing evidence. Child had been in foster care for more than 12 months, and Mother had been unable to provide adequate care or protection for more than six months. The Court of Appeals agreed that there was no reasonable expectation of improvement in Mother’s conduct, particularly since she refused to acknowledge her diagnosis of Factitious Disorder by Proxy or take responsibility for Child’s abuse. Mother’s argument that the no-contact order imposed by the Family Court unfairly hindered reunification was rejected, as the order was necessary for Child’s protection and could have been lifted if Mother had sought appropriate treatment.
Third, in addressing Mother’s claim that the Cabinet failed to make reasonable efforts to facilitate reunification, the Court of Appeals found this argument unpersuasive. The Family Court’s findings, supported by testimony, showed that the Cabinet had made diligent efforts but that Mother’s refusal to participate in treatment for her disorder and denial of responsibility created insurmountable barriers to reunification. The Court of Appeals also found Mother’s reliance on the K.D.H. case to be misplaced, as her circumstances differed significantly from the parent in that case, who had made significant efforts to comply with reunification services.
Finally, the Court of Appeals affirmed the Family Court’s finding that termination of Mother’s parental rights was in the best interest of Child. The Court of Appeals emphasized Child’s remarkable physical, mental, and emotional improvements after being removed from Mother’s care and noted that Mother showed no remorse or empathy for her role in Child’s prior suffering. Mother’s refusal to accept responsibility and seek appropriate treatment for her mental illness left no reasonable expectation for improvement in her behavior.
The Court of Appeals found that the Family Court’s decision was based on substantial evidence and that the statutory requirements for termination were clearly met. The termination of Mother’s parental rights was affirmed as being in Child’s best interest.
Digested by Nathan R. Hardymon