Police have confirmed that the deaths of five elderly women and three men from resident homes in Ontario, Canada were the result of unknown drugs administered by 49-year-old former nurse Elizabeth Tracey Mae Wettlaufer, who was arrested last month. This series of first-degree murders is one of the largest alleged serial killings in Canadian history.

Seven of the residents were from Caressant Care Woodstock and one resident from Meadow Park long-term-care home in London, Ont., according to police. Two residents are alleged to have been killed in 2007, three in 2011, one in 2013 and the final two in 2014.

Nurse murdered eight nursing home residents in Canada

On LinkedIn, Wettlaufer described herself as a registered nurse with a specialty in wellness and fitness, who had had experience working at Caressant Care Nursing Home from 2007 to 2014, and less than a year of employment at Meadow Park nursing home in London in 2014, as a “charge nurse.”

Wettlaufer was first registered as a nurse in August 1995, but gave up her nursing license on 30 September.

Nurses are expected to follow a code of ethics when signing off on drug administration to residents. However, loopholes exist that make it difficult to find wrongdoing or errors.

For example, a nurse may correctly fill out paperwork but elect to withhold a drug from one resident to double up on another.

A history of nurses charged with killing patients

Cases of healthcare professionals murdering patients are rare, but make headlines around the world when they do occur, as they usually involve weak and vulnerable victims.

During the early 1980s, allegations emerged that 36 babies at Toronto’s Hospital for Sick Children in Canada may have been victims of homicides. Investigations ended with the conclusion that eight babies were murdered and 15 others may have been, without the identification of a definite suspect.

There are a small number of single homicide charges against nurses in Canada, as well as charges against nurses and doctors in individual cases of assisted suicide or mercy killing. In 1992, Toronto nurse Scott Mataya was charged with first-degree murder in the death of terminally ill Joseph Sauder, 77. He later pleaded guilty to a lesser charge of administering a noxious substance.

In 2006, New Jersey nurse Charles Cullen, murdered 29 patients while working in various hospitals and care homes in New Jersey and Pennsylvania. The nurse estimated that he may actually have killed 40 patients over a 16-year period, voicing his hope that the crimes may eventually be seen as mercy killings. This was despite the fact that not all of his victims were terminally ill.

In April, 2015, Ontario nurse Joanna Flynn allegedly took 39-year-old patient, Deanna Leblanc off life support without authorization, after Ms. Leblanc went in for pain caused by a knee surgery. Flynn was charged with manslaughter, although the case is still before the courts.

In June this year, a Danish court sentenced Nurse Christina Hansen to lifelong imprisonment for killing three patients and the attempted murder of a fourth, by administering overdoses of sedatives and morphine. In the same month, Niels H., a nurse who had previously been sentenced to life in prison for first-degree murder of two patients with overdoses of heart medication, was suspected to have killed 33 other patients in Germany.

In July, a 49-year-old English nurse, Victorino Chua, was found to be guilty of killing two patients, attempting to seriously injure another and trying to poison 20 more with insulin.

Why do HCPs sometimes commit murder?

A 2006 research looking at serial murder by healthcare professionals called multiple homicides in a medical environment “a poorly understood but increasingly identified phenomenon.” It examined 90 criminal prosecutions of health-care professionals dating back to 1970, which fit the serial murder definition (and excluded mercy-killing or individual cases).

Interestingly, nurses were the accused killers in 86% of the cases. Motivations included the excitement of trying to revive a patient after the killing attempt, or a kind of “professional version of Munchausen Syndrome by Proxy.” Other motives included getting “sadistic satisfaction” from killing certain patients, or, in a small number of cases, financial profit.

Prior criminal records were extremely rare to find in the accused, but many had histories of “falsifying credentials or other aspects off their background,” according to the study.

Faced with such arguably perverse motives, one would do well to recall the words of Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, who said that the fragile condition of patients does not mean “it’s in the hands of the health professional to make (life and death) decisions.” MIMS

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