Forgoing life-sustaining medical treatment in abused children

A decision to forgo life-sustaining medical treatment (LSMT) for a critical ly ill child injured as the result of abuse should be made using the same c riteria as those used for any critically ill child. The parent or guardian of an abused child may have a conflict of interest when a decision to forgo LSMT risks changing the legal charge faced by a parent, guardian, relative , or acquaintance from assault to manslaughter or homicide. If a physician suspects that a parent or guardian is not acting in a child's best interest , further review and consultation should be sought in hopes of resolving th e conflict. A guardian ad litem who will represent the child's interests re garding LSMT should be appointed in all cases in which a parent or guardian may have a conflict of interest.