In the Munchausen Syndrome by Proxy, there is illness in a child which is simulated (faked) and/or produced by a parent or a parental figure. There is presentation of the child for medical assessment and care, usually persistently, often resulting in multiple medical procedures. The parent denies knowledge of the etiology of the child's illness, and the acute symptoms and signs of illness abate when the child is separated from the perpetrator. This paper presents a sample case of the syndrome and lists features commonly associated with it. Thirteen recommendations are offered for the medical approach when the Munchausen Syndrome by Proxy is suspected. Suggestions are also offered for working with the social services department and the court in cases involving the syndrome. Disregard for fetal development involves the mother's substance abuse, mental illness, or medical neglect of the fetus. This paper presents a checklist for assessing the significance of danger to the fetus and presents an algorithmic approach to medical decisionmaking in cases of possible disregard for fetal development. 9 references.