People hang themselves in prison all the time, the authorities express suitable surprise but the practice continues
People hang themselves in prison all the time, the authorities express suitable surprise but the practice continues
The death in prison by hanging in 2005 of Dr Harold Shipman (59) was however different. No other prisoner would earn themselves an obituary in the BMJ stating that he had changed the face of British medicine for ever. This was not a compliment.
A popular GP in the town of Hyde, Manchester, in January 2000 Shipman was found guilty of murdering 15 of his patients, aged 49-83, with lethal injections of heroin. After the trial, it was concluded that Shipman had murdered 260 patients (other estimates brought the figure closer to 450), making him the worst serial killer in English history.
Shipmanâs modus operandi, to use the fashionable term, was terrifyingly simple. He had many elderly patients, mostly women, in his practice. On the grounds of taking a blood specimen, he would inject a lethal dose of heroin, routinely provided for the doctorâs bag. His patients died without any awareness of what their doctor had done. Afterwards, he would return to his rooms and change the computer records to make it look as if they had an illness that killed them. Big mistake; Shipman, supremely arrogant, did not realise that all computer actions could be tracked and his redactions revealed.
While he could put on a good front for his patients, Shipman was a domestic tyrant. His wife Prudence continued to keep him on a pedestal but his children found him impossible. To others, he was a respectable middle-class figure who helped rehabilitate a local canal and went to rugby matches. Few would have thought his interest in a documentary on John Bodkin Adams, the Eastbourne GP thought to have murdered 134 of his patients, had any meaning for his own murderous work.
For British doctors, the consequences of Shipman’s clinicide was an increase in regulation and review. How much difference this will make remains to be seen. Consider this comment in Shipmanâs practice audit nine months before arrest:
Great to see a single-handed enthusiastic GP with a rolling programme of audit – keep up the good work!
The message is that a determined medical psychopath, armed with a stethoscope and syringe, will be able to go on the rampage when they chose; how quickly they get caught is another matter.
The epitaph to the Shipman clinicide came from the chief medical officer Sir Liam Donaldson.
Everything points to the fact that a doctor with the sinister and macabre motivation of Harold Shipman is a once in a lifetime occurrence.
He may have grounds to wish he had never said those words. For, while Shipman was busy despatching his old ladies, aspirant neurosurgeon Michael Swango killed 60 patients across several US states, Zimbabwe and Zambia in a spree lasting from 1983 until 1996 (with 3 years out of practice when he was in prison). Swangoâs case shows that jumping jurisdictions and concealing past misdemeanours is a regular practice for such doctors.
Clinicide is the unnatural death of multiple patients in the course of treatment by a doctor. Kinnell maintains that doctors kill more than any other group. Medical murderers will always be with us. Between them, Shipman and Swango are credited with at least 313 deaths. These figures, far in excess of what the average serial killer attains, reveal just how dangerous an unleashed medical killer can be. Veterinarians, apparently, have never produced a serial killer â it must be all those cuddly animals.
Can we explain what motivated Shipman to murder his patients, who had come to him for help, in such a fashion? What does it say about the breakdown in the traditional doctor-patient relationship that a determined psychopath was able to convincingly manipulate so many? The death of his mother from cancer when he was 17 must have laid down a template for the murders that followed. Shipman started slowly, killing patients from the time he went into practice in 1974, continuing with only a yearâs break when having treatment for Pethidine addiction, until arrested in 1998. By this time, he was killing someone every 10 days.
The paradox of Shipmanâs medical role is that, like nothing else, it reveals the loss of the human element so crucial to the engagement of doctor and patient. For those who believe that our choice of pets is a reflection of personality, let it be known that Shipman was a cat lover.
Robert M Kaplan, who enjoys the affection of the dog Boris, wrote about Shipman, Swango and other medical killers in his book Medical Murder: Disturbing Tales of Doctors Who Kill.
