Munchausen by internet: The rise of medical crowdfunding scams

Photo via David Goehring/Flickr (CC-BY)

Meet the people feigning illness and posting campaigns for sympathy, not money.

 

When Jenifer Gaskin was diagnosed with cancer in 2014, her community sprang into action. From her initial diagnosis, to the painful chemotherapy sessions, to the emotional head shaving, and eventually, to the devastating news that her case was terminal, Gaskin was showered with emotional and financial support. Friends delivered dinners and hosted fundraising nights at local restaurants in her town of Eugene, Oregon. They launched a GoFundMe online fundraiser to ease Gaskin’s financial burden, and it surpassed its $10,000 goal.

As Gaskin’s condition seemingly deteriorated, so did the veracity of her story. Friends grew suspicious when Gaskin made inconsistent claims and was evasive with answers to their questions. When she used money from the GoFundMe to buy a car for her daughter, a friend of Gaskin’s called the police.

After investigating Gaskin’s claim and medical records, a detective came to a startling conclusion: Gaskin wasn’t sick. By that point, Gaskin had remarried and moved away, but her deception has lasted years.

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Gaskin is far from the first person to gain attention for a feigned illness or to use fundraisers to do so. The recent HBO documentary Mommy Dead and Dearest tells the story of Gypsy Rose Blanchard, whose mother, Dee Dee, kept her sick and confined to a wheelchair for years in an apparent case of Munchausen by proxy, a disorder in which a caregiver fakes or causes illness to someone in their care. Though Dee Dee and Gypsy’s story has a tragic end, over the years, the two received a lot of media attention, community support, and thousands of dollars from fundraisers like the one friends set up for Gaskin.

What sets cases like Gaskin’s and Blanchard’s apart, however, is that money is not necessarily the motive. Feigning illness solely for financial gain is called “malingering.” On crowdfunding sites like GoFundMe, where people can raise money for personal causes ranging from chemotherapy to indie band tours, malingering is pretty straightforward: Someone pretends to be sick or injured and requests donations. It’s abhorrent, yes, but it’s a basic scam.

When the feigning of illness is compulsive, however, and the person is aiming not just for money but sympathy, emotional support, and medical attention, their behavior is consistent with a group of psychological conditions called factitious disorder. The most severe and well-known form of factitious disorder is Munchausen syndrome, a mental disorder marked by repeated, deliberate attempts fake an illness or injury—like Munchausen by proxy but without bringing someone else into the mix.

For psychiatrists specializing in these conditions, like Dr. Marc Feldman, the phenomenon of fake ailments being broadcast on crowdfunding sites is not at all surprising. “Munchausen by internet, as I call it, has been a continual theme that has expanded as access to the internet has expanded,” Feldman told the Daily Dot. “There’s now this whole new medium for the expression of factitious disorder. It used to be that factitious disorder patients would have to get medical textbooks and read up on how to fake an illness to get the attention they craved. And now anyone can become a near expert in even esoteric medical problems online. They don’t have to be good actors anymore. They just have to be skillful with words.”

For someone with factitious disorder, a crowdfunding site might be central to the telling of their story or receiving attention—or it might simply be a byproduct of a long-term faux illness, such as when Gaskin’s friends set up her fundraiser. Either way, the online notoriety and streamlined donation process often prove irresistible to people looking for sympathy from a wide audience.

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Medical fundraisers now account for an estimated 41 percent of all online crowdfunding campaigns. On GoFundMe alone, $930 million of the more than $3 billion raised to date on the site went toward healthcare expenses. It’s impossible to know how much of that money was raised for fake illness fundraisers (factitious orders in general are hard to track because the disorder hinges on dishonesty and sufferers rarely seek help on their own), but several high-profile cancer scams have been uncovered in the past month alone. The same week that Gaskin’s story came to light, a woman in Rhode Island, Alicia Pierini, was arrested for raking in nearly $30,000 from GoFundMe fundraisers to help her pay for expenses related to her brain cancer. Pierini had feigned her illness so convincingly both online and off- (even shaving her head and getting a tattoo inspired by her cancer fight), that her close friends, mom, and boyfriend had believed her.

Adrienne Gonzalez, founder of site GoFraudMe, which tracks GoFundMe scams, says that while the exact number of cancer scams is unknown, the ones that have been uncovered are noteworthy for a couple of reasons. First and foremost: the sheer amount of money they’re raising. Roughly 99 percent of all GoFundMe fundraisers raise less than $1,000, while recent high-profile cancer scams have brought in tens of thousands. “The high dollar amount certainly makes them seem more egregious,” Gonzalez told the Daily Dot.

Also, in contrast to crowdfunding scams that hinge on a single lie or Google photo search, successful cancer scams tend to be much more involved. “These people didn’t just scam GoFundMe,” says Gonzalez. “Their friends, family, and loved ones were all fooled as well. They really commit to the lie. Often they also have community-based fundraisers, like T-shirt sales or bake sales to raise money for non-existent medical bills.”

When someone is this deeply involved in a medical fraud, Feldman says the chances are high that a psychological disorder is a contributing factor. “People with factitious disorder tend to covet their roles as patients (or victims) much more, and are often engaged in ‘real-life’ factitious behaviors as well as Munchausen by internet,” he says. “They also tend to go much further in their efforts to deceive others—they continually emphasize the purported illness with constant updates, details, and gratuitous lies that don’t have much to do with the alleged illness.”

Gonzalez agrees. “I refuse to believe an otherwise sane and healthy individual just wakes up one day and says, ‘Looks like a good day to fake cancer!’”

Because of the nature of crowdfunding sites, this level of involvement also corresponds to a higher payoff. The GoFundMe help center includes a page of tips for promoting crowdfunding campaigns, including “tell a compelling story” and “go public” by “reach[ing] out to your local newspaper, radio, and TV stations to promote your campaign.”

For someone with a terrifying and expensive diagnosis and no insurance, tips like these can mean the difference between going broke or affording life-saving care. For someone with Munchausen syndrome, self-promotion of one’s suffering is the crux of their disorder. It’s second nature.

While crowdfunding can be a beautiful, generous thing, the emphasis on “going viral” with a heartstring-tugging story has turned it into a morbid game: a clickbait competition with human lives at stake. No wonder so many people with factitious disorders are playing—and winning big.

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The most dire potential consequence of these scams is the undermining of people’s trust in online crowdfunding, which has become an integral piece of our healthcare system. With the GOP working tirelessly to further chip away health insurance coverage and Medicaid, sites like GoFundMe and YouCaring are saving patients from bankruptcy and even death. Crowdfunding campaigns have become the default reaction to personal tragedies and even acts of terror, raising money for everything from medical bills to life-saving clinical trials. Scams only detract from those who really need help, people like Beth Stebner, who was diagnosed with ovarian cancer in May and used an online fundraising site to help offset the cost of her medical bills and recovery.

“I wouldn’t say [these fraudulent fundraisers] undermine my trust in crowdfunding sites as much as it makes me distraught over the state of humanity,” Stebner told the Daily Dot. “In the absence of any socialized healthcare system, the funds that friends and family generously gave me helped immensely, and took away so much stress and dread. I couldn’t imagine deceiving the people I love most in the world.”

GoFundMe, for its part, does offer a guarantee for its donors: If a fundraiser is found to be fraudulent, the company will reimburse donations up to $1,000 per person. The company will investigate campaigns when notified of red flags, but there is no verification process when setting up a campaign to raise money for medical care.

Stebner says she sees both sides of the verification debate. “When you’re you’re fresh out of surgery and in worlds of pain, the last thing you want to do is jump through a bunch of bureaucratic hoops to make sure you can afford to pay your mounting medical bills,” she says. “On the other hand, I needed to collect tons of verification for my work in the form of doctors’ authorizations, detailing how long I would be out, and it wouldn’t necessarily be difficult to forward that onto a crowdfunding site.”

Cindy Augustine, who was diagnosed with breast cancer in April and set up a GoFundMe page soon after, told the Daily Dot she could get behind more stringent verification in theory, but she worries about the ramifications. “It would make sense to ensure charity cases are exactly that,” she said, “but that leads to a lot of questions including: ‘What constitutes hardship?’”

Augustine also pointed out that verifying every medical fundraiser would require a lot more time and labor from crowdfunding sites, which would likely mean an increase in fees. Right now, GoFundMe takes nearly 8 percent of each donation. “While it would be fair to the public to ensure the money they choose to give goes to a person who is actually in need,” says Augustine, “people are in charge of their own wallets at the end of the day.”

Augustine’s point is as old as time: Buyer beware. If we know crowdfunding sites aren’t foolproof in detecting and preventing fraud, then the best thing donors can do to protect themselves is exercise caution.

“A basic guidelines,” says Feldman, “is that if it seems too bad to be true, it may be exaggerated. On a lot of these sites, the person goes way overboard describing miraculous recoveries alternating with severe health crises, often invoking religion and God to explain what, from an objective standpoint, makes no sense.”

Another red flag: People with factitious disorder use all kinds of misdirection and evasion techniques to avoid questions about their (lack of) illness. The excuses and lies are endless. Both Stebner and Augustine said that if they had ever needed to prove they were really sick, they easily could have with the amount of paperwork that piles up over the course of a serious illness.

But even if someone was caught hosting a fake fundraising campaign, justice is far from a sure thing. Prosecuting people for fraudulent online fundraisers is tricky, and results vary case to case and state to state. Prosecutors in Oregon told a local news station they couldn’t afford to charge Gaskin, because the $10,000 raised on her behalf came in small amounts from people all over the country, and “we do not have the ability to bring in people from across the country who made $20-50 donations so Gaskin can face her accusers in a trial.” Meanwhile, an Alabama woman was jailed and charged with two counts of first-degree theft of property for faking a terminal cancer diagnosis and pulling in $38,000 in GoFundMe donations.

In other words, this is all fairly new criminal-fraud territory. As long as factitious disorder and crowdfunding exist, says Feldman, fake illness fundraisers will be part of our cultural landscape. “I think the majority of these cases are slipping through our fingers.”

To Stebner, the real outrage isn’t that people are exploiting the crowdfunding system, but the lack of choices for people with valid health crises.

“If there’s a system in place, you’re always going to have people who think they can con that system,” she said. “It’s infuriating that the only real options we have in this country to cover life-saving medical procedures are the same options filmmakers use to fund their indie projects.”

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