Attack of the Killer Nurses: A look at a curious phenomenon - nurses who kill their patients

National Review, May 28, 2001 by Theordore Dalrymple

The young woman in my hospital about whom the senior nurse was very worried also suffered from bulimia and (if suffering is quite the term for it) from Munchausen's syndrome. And the hospital had received telephone calls making threats against her that, when traced, turned out to have been made from her own cell phone. Could she be another Beverly Allitt?

I suggested that any deaths on her ward, in the past, present, and to come, be carefully investigated (in the event, there were none that aroused suspicion). I left the senior nurse to decide whether the illness of faking illness in her spare time, and the making of nuisance telephone calls, were by themselves sufficient cause for dismissal. I am not sure I would have wanted the young woman in question to nurse me, however.

Psychiatrists suggested that Beverly Allitt, like several of the other nurse-murderers, was "suffering" also from Munchausen's syndrome by proxy. This extraordinary pattern of behavior was first described by a British pediatrician, Professor Roy Meadow, who discovered that parents, particularly mothers, sometimes induced symptoms in their children in order to gain the attention of doctors. They would put blood in their urine, provoke rashes, and in some cases (proved by covert video surveillance) asphyxiate their children to produce respiratory arrest. The most common explanation for this behavior is that the women who do this want drama in their otherwise rather humdrum lives. Perhaps not altogether surprisingly, the children of parents who "have" Munchausen's syndrome by proxy have a much reduced life expectancy.

Some of the nurses who kill are thought to want to be present at real life-and-death dramas, as if they were inhabiting a television soap opera. Moreover, by reviving the people whose hearts and breathing they have stopped, they cast themselves in a heroic light. Their fantasy is made flesh: but in the process, of course, a certain number of participants, that is to say patients, pay the ultimate price.

The motive remains a mere hypothesis, since people like Beverly Allitt rarely confess or confide their thoughts to anyone. But in any case, it is clear that other nurse-murderers have other motives: One motive does not fit all.

In another case, for example, the nurses in a ward ran bets as to which of their patients would be first to shuffle off this mortal coil. So eager was one of the nurses to win her bets (perhaps she had money problems) that she cheated a little, no doubt calming her conscience with the reflection that she was only giving a helping hand to the inevitable. As Engels remarked, what is freedom if not the recognition of necessity?

In more than one episode of serial murder, in both Canada and the United States, nurses have been moved to kill by sheer public spirit. They wished to demonstrate the need for a local pediatric intensive- care unit, and what more convincing method could there be than to bring about the very kind of emergencies that such a unit would treat? Alas, in the absence of such a unit, the babies died, but whose fault (really) was that? From a strictly utilitarian point of view, it is clear that the cause of humanity would be served by the babies' deaths: for in the long run, more lives would be saved by the intensive-care unit than were lost in proving the necessity for it.