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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017
| Contributor Information
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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Canadian nurse Elizabeth Wettlaufer was recently convicted of killing eight elderly patients and causing harm to a further six people in her care.[1] The case was reminiscent of two from the United Kingdom in 1991 and 2004 involving the British nurses Beverley Allitt[2] and Benjamin Green,[3] respectively. We examine one of the most monstrous abuses of trust: the murder of patients by healthcare providers.
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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Herman Mudgett, aka Dr H.H. Holmes (1861-1896?)
Pharmacist; Chicago, Illinois
Considered the first American serial killer, Herman Mudgett seems to have been expelled from medical school at the University of Michigan for insurance fraud relating to stolen corpses.
He reemerged in Chicago in the 1880s as the pharmacist Dr H.H. Holmes.[4,5] The routine search of his house after arrest for insurance fraud revealed a "murder castle"—recounted in gripping newspaper reports—replete with bolted chambers, hidden chutes, butcher's table, crematory, and mutilated body remains.[6,7] Holmes is thought to have killed 200 people.[7] He admitted to 27 counts of murder and was hanged in 1896.[4-7]
In a recent twist of fate, at the request of his descendants, his body was exhumed for DNA testing to prove that the man hanged and buried in 1896 was in fact Herman Mudgett.[7]
Image courtesy of McCord Museum
Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Dr Thomas Neill Cream (1850-1892)
Physician; Canada, United States, and United Kingdom
The late-19th-century serial killer Dr Thomas Neill Cream went to medical school at McGill in Montreal[8,9] and appears to have obtained further training from the Royal College of Physicians and Surgeons in Edinburgh.[9] His murderous career was equally international, leaving a string of women and men in his poisonous wake. He was first caught in 1881 in Chicago, where he was convicted of murdering the husband of a mistress.[8,9]
Freed 10 years later, with his medical license revoked,[8] Dr Cream moved to London—where in 1892, as the "Lambeth Poisoner," he was sentenced to hang for having poisoned six women with strychnine.[10,11] Shortly before his death, sowing the seeds of intrigue, he claimed to be Jack the Ripper.[8,9] Beyond the crimes for which he was convicted, Dr Cream is also suspected of murdering other women, including his wife.[8]
Image courtesy of Wikimedia Commons
Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Jane Toppan (1857-1938)
Nurse; Massachusetts
A one-time pupil in the nurse-training program at the Massachusetts General Hospital in Boston,[12] Jane Toppan was indicted in Barnstable, Massachusetts, for the murder of three patients and, after a 6-hour trial, was found not guilty owing to insanity. She was committed to an asylum.[13-16]
Toppan confessed to using morphine to murder 31 people—among them personal acquaintances and patients referred by "reputable" physicians.[13-15]
According to an editorial in the American Journal of Nursing, Jane Toppan had been "discharged for cause" from her nursing studies in 1891 and was not a graduate.[12]
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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Dr Linda (Burfield) Hazzard (1867-1938)
Physician; Minnesota and Washington
When she relocated from Minnesota to Washington State at the end of the 1800s, "Dr" Linda Hazzard apparently benefited from a grandfather clause that granted her the title "doctor" on the basis of her limited training as an osteopathic nurse[17] and little other formal medical schooling.[18,19]
In the town of Olalla near Seattle, Hazzard opened a clinic to treat illness through food deprivation—a theory she wrote about in her book Fasting for the Cure of Disease, self-published in 1908 (and reprinted in 2016).[20]
Hazzard considered herself a wellness pioneer[19] and was responsible for the deaths through starvation of between 12 and 40 victims.[18,19] In 1911, she was found guilty of the murder of Claire Williamson, a British heiress, and was sentenced to hard labor.[18,19]
She died, apparently of self-inflicted starvation, in 1935.[19]
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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Josef Mengele (1911-1979)
Physician; Germany and Poland
Josef Mengele was one of approximately 30 physicians, led by SS captain Dr Eduard Wirths, at the Auschwitz concentration camp.[21] As part of his physician "rounds," Mengele helped oversee the process of sending prisoners to "work groups" or to their immediate deaths in the gas chambers.
Dr Mengele's sadistic experiments—often conducted on children—sought "to illustrate the lack of resistance among Jews or Roma to various diseases"[22] and to explore his various theories on twins and heterochromia, among other subjects.[21,22]
Josef Mengele escaped justice for 34 years—briefly in Germany, then in Argentina, Paraguay, and Brazil—as one of the most wanted Nazi criminals. He died a free man in 1979.[21]
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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Dr Marcel Petiot (1897-1946)
Physician; France
In 1946, after one of the first mediatized trials in France's history, Dr Marcel Petiot was convicted of murdering 24-27 patients,[23-25] whose remains had been discovered in his basement furnace.[23] In Paris, during the Nazi occupation, Dr Petiot earned the trust of Jewish people in hiding with fabricated stories of a network of smugglers who could ensure their safe passage out of France. He then killed them to steal their possessions.[23,24]
At his trial—considered at the time "one of the biggest trials in criminal history"[25]—Petiot confessed to the murders, but claimed that he had been a member of the French resistance working to protect the nation from Gestapo spies.[25]
Image from Alamy
Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Dr John Bodkin Adams (1899-1983)
Physician; United Kingdom
In 1957, Dr John Bodkin Adams was acquitted of the murder of patients Edith Morrell and Gertrude Hullett, wealthy widows who had left money and valuables to the physician in their wills.[26] Bodkin Adams, who had been previously convicted of fraud, was subsequently found guilty of manipulating prescriptions for which his medical license was revoked (and reinstated 4 years later).[27]
Dr Bodkin Adams died a free man in 1983. He was never convicted of murder, despite being suspected in the deaths of up to 132 patients.[28]
After the acquittal in 1957, the presiding judge, Lord Justice Patrick Devlin, remarked, "The rigorous standards of the law sometimes allow that the guilty walk free."[29]
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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Dr Harold Shipman (1946-2004)
Physician; United Kingdom
On January 31, 2000, the seemingly congenial, much appreciated Dr Harold Shipman—a general practitioner with a year-long patient waiting list—was convicted of murdering 15 of his patients and of falsifying one patient's will.[30-33] He was sentenced to 15 consecutive life sentences and committed suicide in prison on January 13, 2004.[32]
Early in his career, the GP—who never admitted to the murders[31] or spoke of them[32]—had been found guilty of illegally obtaining pethidine.[33] He confessed to abusing the drug and was fined, and his case was referred to the Penal Cases Committee of the General Medical Council. They determined that no inquiry into Shipman's case should be held, and he was free to continue his medical career.[33]
Image from Ed Betz/AP
Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Dr Michael Swango (1954-)
Physician; United States, Zimbabwe, and Zambia
Dr Swango is suspected of murdering up to 60 patients over 20 years.[34-36] He was sentenced to three consecutive life sentences in a maximum-security penitentiary in Colorado, without the possibility of parole.[34,36] Dr Swango entered a plea bargain to avoid execution.[34,36]
Dr Swango had his medical license revoked in two states,[35] before practicing medicine in Zimbabwe and Zambia.[36] He was arrested in 1997 as he prepared to board a flight for a new medical career in Saudi Arabia.[34]
Image from Tony Kurdzuk/AP
Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Charles Cullen (1960-)
Nurse; New Jersey and Pennsylvania
The "Cullen Law" was passed in New Jersey in 2005 after the case of nurse Charles Cullen, who was convicted of killing 29 patients (and is suspected in other suspicious deaths).[37,38]
Cullen led an erratic troubled early life characterized by unpredictable, cruel, or aggressive behavior and several suicide attempts.[3,37,38] He was nevertheless able to graduate from nursing school,[37] and worked in nine hospitals and a nursing home over a span of 16 years.[38]
Throughout his medical career, Cullen was frequently dismissed or left employment under dubious circumstances. After his trial, the medical system was found at fault for its ultimate inability to stop Cullen from becoming one of the most prolific serial killers in US history.[3]
In March 2006, after a plea bargain in which Cullen avoided the death penalty by admitting to murder, he was sentenced to 11 consecutive life sentences with no chance of parole for 397 years.[38]
Image from AP
Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Genene Jones (1950-)
Pediatric nurse; Texas
Genene Jones is currently serving two concurrent jail terms: 99 years for the fatal injection with a muscle relaxant[41] of 15-month-old Chelsea McClellan in 1982[39-41] and 60 years for the injection with an anticoagulant of a 4-year-old boy who survived.[45] Jones, who claimed innocence,[41] is suspected of having fatally injected lethal substances into a further 40-60 babies and young children.[40]
Under a mandatory release law, Jones is scheduled to be freed in March 2018. However, in May 2017, with the availability of new evidence, she was charged with the murder in 1981 of 11-month-old Joshua Sawyer,[39-41] who died of an overdose of dilantin.[41]
Image from Ed Reinke/AP
Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Donald Harvey (1952-2017)
Nurse's aide; Ohio and Kentucky
In 1987, Harvey confessed to killing 37 people, mostly by poisoning them with cyanide, rat poison, arsenic, or petroleum, which he mixed into drinks and food.[42,43] The murders, chiefly of critically ill elderly patients, took place over a two-decade career—at a hospital in London, Kentucky, in the 1970s, and in the 1980s at a hospital in the Cincinnati area.[42-44]
Harvey was convicted of three other murders, including that of a neighbor, and was sentenced to multiple life sentences. He avoided the death sentence through a plea bargain.[42]
In spring 2017, after 30 years in jail, Harvey died of injuries after being assaulted in his prison cell by a fellow inmate at the Toledo Correctional Institution.[42-45]
Images courtesy of Amazon
Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Perspective
The medical profession has been accused of producing more serial killers than all other professions combined.[46] Dr Herbert Kinnell, writing in the BMJ, suggested that those with a "pathological interest in the power of life and death" may gravitate towards patient care.[46]
In the New England Journal of Medicine, Dr Aneez Esmail argued that "it was the very fact that Shipman was a doctor that enabled him to kill and remain undiscovered" and called for more oversight and questioning of physicians.[32]
Factors that facilitate healthcare serial killers include[3,47]:
Opportunity—access to vulnerable people;
Trusted status;
Means of killing—access to drugs; and
Being capable of cover-up.
Another profession with a "disproportionate' amount of killers is dentistry.[32]
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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Recognizing Patterns of Behavior
Yardley and Wilson,[3] writing specifically about nurses, build on Ramsland's 22-point checklist[48] to present the following characteristics and circumstances that, when grouped together, should raise grave concern about a healthcare professional and prompt appropriate investigation:
A comparatively high incidence of death on their shifts
A history of depression and/or mental instability
Behavior that makes their colleagues anxious
Possession of drugs (eg, in the workplace or at home)
Seems to have a personality disorder
The authors caution that no checklist is perfect.
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Murderers in Medicine: Perpetrators and Policies
Steven Rourke | August 14, 2017 | Contributor Information
Ways to Protect Society
Lubaszka and colleagues[47] suggest that healthcare serial killers should be the easiest to apprehend. They propose the following four policies:
A system of national-level communication among hospitals to report and share matters of discipline and misconduct of healthcare professionals.
Better systems for accounting for medicines (such as fingerprinting and weighing).
Better means for hospital administrations to encourage patients and staff to report inappropriate behavior, which should be investigated. Along the same lines, families of patients should be encouraged to listen and act on the concerns of their loved ones.
Revamped in-service ethics training to reinforce the moral and legal obligations of all healthcare employees.
The Federal Bureau of Investigation estimates that < 1% of all murders committed in any given year are the act of serial killers; medical murderers are a subset of these.[49]
The medical profession has produced a disproportionate share of serial killers. How are they alike and distinct from nonmedical killers, and what policies can help protect patients?Perspectives, August 2017
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Author
Steven Rourke
Freelance writer
Disclosure: Steven Rourke has disclosed no relevant financial relationships.
Yardley E, Wilson D. In search of the 'angels of death': conceptualising the contemporary nurse healthcare serial killer. Journal of Investigative Psychology and Offender Profiling. 2016.13:39-55. http://onlinelibrary.wiley.com/doi/10.1002/jip.1434/abstract Accessed June 19, 2017.
Hazzard LB. Fasting for the cure of disease. Republished January 23, 2016. Digital Ninjas Media, Inc. [Originally published in 1908 by Physical Culture Publishing Co., New York, New York]
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