HMN 2024: When the Doctor’s a Serial Killer

Source: Photo by K. Ramsland

Although you could fill a book with cases of doctors who’ve killed patients (or spouses), the physician/serial killer makes up a small percentage. It’s more often nurses or other medical staff who kill repeatedly. Yet, in Berlin, Germany this summer, investigators arrested a physician treating elderly patients. They now suspect he murdered up to eight, both male and female, setting several homes on fire to destroy evidence. His identity hasn’t been released. He’s 40 and he made house calls for an at-home service. He used medications as weapons, but his motive remains a mystery.

Healthcare serial killers might be any type of employees in the healthcare system who use their position to murder at least two patients in two separate incidents and have the psychological propensity for more. Those intent on murder exploit the atmosphere of trust in the healthcare community and their murders often go unnoticed for some time. They tend to use methods not easily detected. When caught, they’re usually quick to claim they were motivated by compassion, but a full investigation contradicts this. Some are mentally ill, but others might simply put their own needs or desires above others, dehumanizing patients to achieve their goals.

The available cases indicate that doctors often kill from the desire for a godlike sense of power over patients or from experimental curiosity. They view themselves as superior, and thus their decision to kill is often fueled by a sense of narcissistic entitlement. Several suspects for Jack the Ripper were doctors (but none was convicted of those murders). Among the more notorious physicians known to have killed several patients are Michael Swango and Harold Shipman. Both exploited their positions of authority to carry out these murders but for different reasons.

Shipman began killing right out of medical school. By the time he was caught 25 years later, he might have been responsible for more than 300 deaths. Patients adored him for making house calls, but he referred to them with scornful monikers and stole their jewelry or money. Finally caught after falsifying a will, he displayed indifference to the suffering he’d caused his victims’ families. He was sentenced to life but committed suicide in prison.

Swango traveled from one hospital to another in the U.S., poisoning patients (and colleagues) with a syringe or arsenic, and he was suspected of killing for two decades in seven different hospitals. To escape the investigations, he went to Zimbabwe, where he was finally stopped and brought back to the U.S. Evidence showed he’d been experimenting on patients and had found satisfaction in ending their lives. He’d written about it with glee in a journal. In 2001, he confessed to four murders and received life in prison. Further investigations commenced.

Healthcare providers in hospitals know how to use subtle means of murder, and they have access to drugs that can poison someone undetected. Unless some specific behavior inspires suspicion, they may effectively hide their crimes. A common thought is that older people are expected to die, so their deaths are not as likely to be investigated. They’re an easy target. Shipman thought so. Perhaps the Berlin doctor did too.

It takes several signals collectively to solidify suspicions. Notably, several death incidents are associated with the person, especially at different institutions, and inconsistencies show up in their statements about the incidents. They tend to be secretive. They may have the fatal substance, or notes about its use, in their home. Statistically, there’s a higher death rate when the suspected person is on shift, and the deaths or symptoms prior to death were unexpected.

While none of these items is sufficient for an accusation, several in constellation should alert the person’s colleagues and superiors to be vigilant. Knowing about past cases, even if singular, can assist in an investigation.