The clinicidal physician.(Letters)(Letter to the editor)

SIR: Roger Sandall's article on "Dr Death" Patel (December 2005) provides an interesting review of his career. Patel, who now faces indictment on criminal charges, has been cited with causing a number of patient deaths, the final figure of which has yet to be determined.

This pattern is consistent with clinicide, the non-accidental death of a number of patients in the course of treatment by a doctor, an activity analogous to medical serial killing. The clinicide phenomenon is not new, but has escalated in recent decades. The two leading figures are Harold Shipman, credited with killing at least 250 patients during his career as a GP, and Michael Swango, thought to have poisoned at least sixty hospital patients.

Perpetrators of clinicide range from psychopathic serial killers to doctors who are associated with repeated casualties of their treatment yet, for reasons that are not immediately evident, persist with their activities until circumstances prevent them. In Australia, the most notorious perpetrator of clinicide is Dr Harry Bailey, the Chelmsford Deep Sleep practitioner, held responsible for eighty-seven deaths. The first deaths could be rationalised as unfortunate results of the treatment, but as the bodies piled up, it was impossible to continue without some deep inner drive to achieve just this aim, regardless of the consequences.

Patel shows a remarkable symmetry with some aspects of Shipman and Swango. Like Swango, early in his career he was marked down as having problems but found a prominent mentor who had sufficient status to override any bureaucratic reservations. How did this happen? The explanation is not just that psychopaths can be very convincing, but they have a remarkable ability to seek out their own kind, in this case, someone who was able to control their impulses, at ...