Correspondence

Physician as Serial Killer

N Engl J Med 2005; 353:430July 28, 2005

Article

To the Editor:

I am extremely disturbed by the implications of Esmail's comments in his Perspective article on the case of Harold Shipman (May 5 issue)1: Esmail calls for a more questioning attitude toward doctors and better systems for monitoring their work. Dame Janet Smith, the judge who chaired the Shipman inquiry, has been even more outspoken about the need to increase regulation of the profession. But if one asks of which group of doctors Shipman was typical, the answer is none. Shipman was indeed a “one-off,” a serial killer who happened to be a doctor. There is undoubtedly a case for better regulation of death certification and of the storage of controlled drugs, but we must resist this extraordinary notion that the Shipman case somehow justifies throwing even more ropes around our much-maligned profession. Many British family doctors are already running scared of the risk of “Shipman” allegations and are unwilling to leave sick, elderly people in the community, preferring to admit them to the hospital given the slightest excuse, simply for fear of criticism. This response cannot be in anyone's best interest.

Roger A. Fisken, M.D.
Friarage Hospital, Northallerton DL6 1JG, United Kingdom
roger.fisken@stees.nhs.uk

1 References

1. 1

   Esmail A. Physician as serial killer -- the Shipman case. N Engl J Med 2005;352:1843-1844
   Full Text | Web of Science | Medline

To the Editor:

The article by Esmail is especially chilling since there was nothing about Dr. Shipman's behavior that suggested a problem. This was not the case with Michael Swango, who killed more than 35 patients. He was suspected of wrongdoing at each stage of his career. When he was a student, the Department of Obstetrics and Gynecology at Southern Illinois University, to its credit, “checked the box” indicating that it had reservations about his fitness for medical practice. Others on the faculty believed that it was unfair to fail a student at the end of four years of medical school, and their support allowed Swango to graduate. Over the next 10 years, suspicion of his misdeeds was ignored by a series of supervisors. James Stewart's gripping account of this disaster, Blind Eye, 1 is a worthy read for those who evaluate medical trainees.

George J. Taylor, M.D.
Medical University of South Carolina, Charleston, SC 29401
gjtay@yahoo.com

1 References

1. 1

   Stewart JB. Blind eye: how the medical establishment let a doctor get away with murder. New York: Simon & Schuster, 1999.
   

Citing Articles (1)

Citing Articles

1. 1

   Beatrice Crofts Yorker, Kenneth W. Kizer, Paula Lampe, A.R.W. Forrest, Jacquetta M. Lannan, Donna A. Russell. (2006) Serial Murder by Healthcare Professionals. Journal of Forensic Sciences 51:6, 1362-1371
   CrossRef