Harold Shipman Failure of the Authorities

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The inquiry chaired by Dame Janet Smith has determined that Harold Shipman unlawfully killed 215 patients, and in a further 45 there were reasons for being concerned about the true cause of death.1 A statistical analysis gives a figure of 236.2 The first definite killing was in March 1975; the last was in June 1998. On average, there were around 10 killings a year, but the number was highly variable. Between 1990 and 1993 he killed only 3 people, but in 1996 he killed at least 30, and in 1997 at least 37, a rate of one killing every ten days. Yet even then, no concerns were raised officially until a courageous doctor from a neighbouring practice, together with her partners, began to think the unthinkable. In March 1998, by which time he had already killed well over 200 people, a police investigation was begun—but quickly abandoned. It was not until Shipman decided to forge the will of one of his victims in June 1998 that a thorough investigation took place, leading to his arrest three months later. Since beginning to investigate Shipman in 2000, I have been trying to understand how it was that he could kill so many patients without detection. There were, of course, some system failures, but it has been impossible to avoid the question as to why the system weaknesses were tolerated to the extent that Shipman was able to murder not merely one or two patients, but over 200. The conclusion I have come to is that all doctors, and not general practitioners alone, share responsibility for creating the circumstances that enabled Shipman to be so successful a killer. We must accept that responsibility, and embark on a process of professional renewal in which the principle of patient-centeredness is given greater force by the addition of the idea of the patient as the source of

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