The Evolution of a Serial Killing Doctor (Harold Shipman)

The following is the original version of an article, written by Professor David Canter, appearing in an edited form in The Independant (UK), Wednesday 2nd January 2000.

As the media storm bursts around the life and times of the most prolific serial killer in British history everyone wants to know why Dr Harold Shipman killed so many of his trusting patients. If he had been born into a self-destructive dysfunctional family, been physically or psychologically abused himself, indulged in bizarre sexual activities or lived on the edge in a deviant or criminal underworld, replete with vulnerable victims, then the explanations for his crimes would have been in easy reach.

Forensic psychologists are beginning to unpack the confused self-images and distorted thought processes that are created by early disturbances in psychological growth. But the men who emerge out of the morass of destructive familial life are not able to maintain the commitment and intellectual dedication that is needed to get a medical qualification. They do not survive relationships for very long and certainly do not manage an apparently stable married family life with successful children as Shipman seems to have done.

Doctors do go off the rails, of course. They suffer from greed, lust, jealousy and the other deadly sins, like the rest of us. They can harness the killing power of modern medicines to satisfy these sins. So the annals of murder have many examples doctors who killed to get rid of inconvenient spouses, embarrassing lovers, or for financial gain. But none of these explanations are really convincing for Shipman. Even the bodged attempt to forge Kathleen Grundy’s will seems to have been an afterthought once he was well on his destructive path. There is little indication that greed of this sort was a dominant aspect of his murderous rein.

How can we begin to explain why a well respected GP would scythe down so many of his healthy patients? Why should a man devoted to the healing arts become the very opposite of all that his life focused on? If we put aside unconvincing theories about sexual peccadilloes, or the more mundane possibilities of financial gain, or the seething anger that characterises many violent criminals we are left with the central fact that he was a Doctor. Any explanation must take account of that central fact.

The Doctor has always been the epitome of respectability in out society. The GP’s signature on the back of your passport photograph is the hallmark of unchallenged trustworthiness. Only a judge comes close in the ranks of social esteem, but where judges only have power over our freedoms we grant our Doctors power over our life. The might of the medical profession is shown by the fact that it is Doctors who are preventing Pinochet being extradited not the judges would. Doctors wield this power with firm conviction. It is an open secret that euthanasia is practised when Doctors see fit. There are huge changes in progress as medical training emphasises the person not just the body, but Shipman was not part of that training.

What, then, happens to an arrogant man that believes he has the right to decide whether people should be allowed to suffer or ‘helped in their passing’ as doctors of an earlier age have put it? An independent minded man who delights in taking responsibility for his own circumscribed medical domain? A family doctor who has himself had a pact with mood altering drugs? How might such a man evolve from over-prescribing analgesics to deliberately injecting lethal doses? Until Shipman himself is prepared to share something of the thoughts that went through his head when he was killing his patients we cannot be at all sure about the route his actions unfolded along. But his building an evolving personal narrative for himself seems to me to be the most feasible account of how he came to be a serial killer.

I do not believe that Dr Shipman decided at some point that he would set about killing a selection of his patients. I do not think, as some have been suggesting, that he harboured some psychological conflict about the death of his mother when he was a teenager, and that somehow he converted that conflict into the killing of his patients. For a start some of his probable victims were men and many of his female victims where a quarter of a century older than his mother’s 43 years at the time of her death. A developing view of himself as a decider of human fates, starting at levels he was not even aware of and emerging in to a full-blow campaign seems to be most likely process.

For such a process to evolve it had to have fertile ground. In this regard serial killings are not unlike industrial disasters. There are invariably early warning that are ignored. Communication processes between crucial agencies break down. Individuals doing what they know is wrong get away with it and believe that they are charmed or fated to carry on with their chosen habits. In these environments were the opportunities for fatal actions are readily available but safeguards ignored it is only when the dangers reach a level that no one can ignore, usually with considerable loss of life, that the tragedy waiting to happen becomes clear with the benefit of hindsight.

Shipman was a danger zone that no-one was protected from. He became aware of that and it probably added excitement to the story he was creating for himself. He shows us that human frailty has many sides. In the Century of the individual, where power and personal celebrity are so all-embracing it may be that the quest to exert the authority you have in life-threatening circumstances is all that is need pull an aeroplane out of the sky or turn a doctor into a serial killer.

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