Medicolegal and Ethical Challenges in Diagnosing and Managing Factitious Disorder Imposed on Another (FDIA): A Case Report

Factitious disorder (FD) is a condition in which patients fabricate evidence and produce false stories that often subject them to needless medical interventions with no clear benefits. In some instances, it can be imposed on a secondary victim often as a form of abuse. Most often, victims of a factitious disorder imposed on another (FDIA) are children or the elderly. Despite a mortality rate between 6 and 10% among victims, FDIA still remains underdiagnosed. Research on it often fails to address healthcare management initiatives, as well as the legal and ethical challenges physicians must navigate when managing it. In this report, we present a rare case of FDIA in an adult patient with a history of diabetes, substance use disorder, and schizoaffective disorder. This case highlights the importance of appropriate communication and detailed documentation when signs of FDIA are suspected. It also identifies the benefits of implementing a multidisciplinary approach when appropriate to minimize harm and improve outcomes.