Canberra Times (Australia)
July 18, 2009 Saturday
Final Edition
Killers who flout the Hippocratic oath
‘He was a marvellous GP," said the son of one of Dr Harold Shipman’s
patients, "apart from the fact that he killed my father." Robert
M. Kaplan’s Medical Murder explores the recently named phenomenon of
"clinicide". (But I can’t help questioning the American-style middle
initial: how many Robert Kaplans can there be?)
This is a fascinating book, describing extraordinary and terrible
crimes committed by aberrant medicos. Kaplan, a forensic psychiatrist
at the University of Wollongong, exposes the terrible disparity
between the ethos and practice of medicine as we usually think of it
and these shocking stories. He focuses on several emblematic
individuals, as he acknowledges, a tiny fraction of a profession
routinely enjoying unparalleled means and opportunities to kill if
moved.
These notorious medical murderers include Dr John Bodkin Adams, who
murdered elderly (and wealthy) ladies of Eastbourne, Sussex, acquitted
of killing up to 132 patients. Despite having coincidentally accepted
bequests from several victims, he escaped conviction by law but not by
posterity.
Not so Dr Harold Shipman, Britain’s most notorious multiple murderer,
convicted in 2000 of having killed 15 elderly women over several
years, though later investigations suggested he had murdered between
250 and 450 over 20-odd years.
Kaplan’s account of Shipman’s compulsion to kill is among the most
effective (and indeed, affecting) in the book. While never conceding
the legitimacy of Shipman’s crimes he invokes pity for a person moved
by so deep an evil.
Shipman’s actions were unforgivable, but Kaplan’s skill as a
psychiatrist at least makes his behaviour explicable.
Patients regarded these homicidally driven doctors as caring and
attentive.
Other cases involved practitioners who treated patients with
indifference or even (in the case of feral Sydney neurosurgeon Harry
Bailey) brutality. Kaplan describes Bailey’s notorious "Deep Sleep"
therapy, in which he killed more than 80 patients in Chelmsford
private hospital before colleagues and authorities stopped him in the
late 1970s. Bailey caused deaths from arrogance and indifference
rather than intentional homicide, but one of the virtues of Kaplan’s
somewhat uneven survey is to at least illuminate the varieties of
medical murder, its motivations and manifestations.
Bailey’s bogus and lethal treatment saw bodies arrive at the morgue of
Hornsby Hospital for years before someone apparently a patient blew
the whistle.
Kaplan touches upon but does not make enough of how insufficient
professional and official scrutiny enabled several killers to
continue.
Months before his arrest, Harold Shipman’s auditors commended him for
his diligence in inviting them to examine his (falsified)
records. "Keep up the good work!" their report ended.
Kaplan shows how doctors, like auditors, are but human, subject to
emotions and drives like the rest of us. In discussing Turkish doctors
who participated in or even directed the Armenian genocide in the
Great War, Kaplan quotes Dr Mehmed Resid, who, shortly before he
killed himself, admitted that "My Turkishness prevailed over my
medical calling." Not that that’s any excuse.
Kaplan has a fondness for jargon and obscure philosophic reflection,
not always happily for the reader. He introduces us to the concept of
CASK "carer-assisted serial killing". Here his focus strays from the
pathological killer into more murky ethical waters. One person’s
merciful release is of course another’s mortal sin: Kaplan’s
discussion of Philip Nitschke and Jack Kevorkian’s "assisted suicide"
sit uneasily in his framework of medical murder.
But clinicide could be more common than Kaplan’s concentration on
celebrity- killers suggests. He also writes that American
investigators claimed that perhaps two-thirds of all elderly deaths in
Virginia were deliberate. Such deaths might be regarded as medical
murders, though Kaplan proves to be an unreliable pilot through the
ethical shoals of euthanasia. Some may find it morally repugnant to
assist a terminally ill sufferer to die, but such a death is surely
not murder. Kaplan is more assured dealing with aberrant psychology.
Medical Murder is an absorbing, disturbing, stimulating book. It shows
that as well as healing and helping, individual doctors have been as
ready as any to hurt and harm. Kaplan reminds us of the doctors who
willingly participated in the Nazi Holocaust, Soviet "mental
hospitals", Argentina or Greece’s dirty domestic wars, or indeed,
"our" atrocious torture camp of Guantanamo Bay.
Though idiosyncratically organised, often inexpertly written and
insufficiently edited, Medical Murder remains a fascinating book. It
is full of digressions, chronological jumps and oddities of
citation. Kaplan confuses "uninterested" with "disinterested" and
"mendicant" with "mendacious", and his editor hasn’t corrected
him. Still, the interest of this rather scrappy study is undeniable.
Regardless of its literary shortcomings, Medical Murder is an
absorbing read, even if we become wary that our doctor might want us
to say "arrghh".
Peter Stanley is a Canberra historian.