Shipman's motive may have been 'addiction to killing'

 

BRITAIN: Britain's most prolific serial killer, Dr Harold Shipman, murdered at least 215 patients. David Ward in London has read the official report on his crimes

Harold Shipman, the doctor whose bedside manner many patients came to love, had no "concept of the value or sanctity of human life", according to Dame Janet Smith, chairwoman of the inquiry into the career of Britain's most prolific serial killer.

He was, she says, possibly addicted to killing. But after a year of studying his life's details she has not been able to come up with a motive for his murderous career that lasted 23 years.

"I regret to say that I can shed very little light on why Shipman killed his patients," she admits in the first 336-page volume of her six-volume report. She adds elsewhere: "There is some evidence that he is an addictive personality, and it is possible that killing was a form of addiction."

Her chapter on Shipman's character and motivation runs to almost 20 pages and includes chilling details about how he killed, how he acquired the drugs he needed for murder and how he kept his killings hidden from doctors, coroners and patients' relatives.

It shows that he had few friends and could be aggressive, conceited and arrogant. He also despised anyone he considered to be his intellectual inferior. " suggest that his arrogance and overconfidence are almost certainly a mask for poor esteem," Dame Janet adds.

But she also reveals that he was acquisitive, taking a fancy to property he had seen in the home of a victim he had just killed.

"In 1985 he asked the family of Mrs Margaret Conway if he could have her budgerigar for his aunt; his request was not granted. In 1997 he asked the brother of Miss Lena Slater for her sewing machine, which he was allowed to have.

"He asked Mrs Joan Sellars, the niece of Miss Mabel Shawcross, for her antique bench, saying that it had been Miss Shawcross's intention that he should have it after her death. Mrs Sellars did not agree."

Dame Janet describes as "deeply sinister" Shipman's decision to create for himself the reputation of being a very caring doctor.

"Many patients describe Shipman as having a wonderful bedside manner, especially with the elderly. He would make much of them and sometimes tease them gently. They liked it. He made them feel that he was a real friend as well as their doctor. Yet he would kill them."

Shipman would call a spade a spade but many patients liked his bluntness. When Stephen Dickson asked Shipman on February 28th, 1998, how long his father-in-law, Harold Eddleston, who had cancer, was likely to live, Shipman replied: "I wouldn't buy him any Easter eggs." Mr Dickson did not take offence. Four days later Shipman killed Mr Eddleston.

Other relatives reported that Shipman's kindness and sympathy evaporated once a victim had died. He told the son and daughter- in-law of Mary Coutts in April 1997: "Well, I don't believe in keeping them going."

He would also "take on" and try to get the better of officials and those in authority. During a lecture, he repeatedly interrupted and disagreed with the speaker.

In trying to establish whether Shipman had a morbid interest in death or took pleasure from killing, Dame Janet said she formed the impression that he liked to play the role of master of ceremonies after a death.

"He would be the centre of attention and would take control. He would present himself as omniscient. He would give instructions about the removal of the body.

"He would give his explanation for the death, often saying that, although it might have been a surprise to the relatives, it had been no surprise to him. He might add remarks such as 'She was riddled with cancer', as he said of Miss Lena Slater."

He killed patients with terminal illnesses, those with chronic conditions and those who were a nuisance or annoyed him.

He became a "plausible and accomplished liar" as he described the deaths of his victims.

"Some of his descriptions of sudden death are breathtaking: 'I turned round to get my stethoscope out of my bag and she just collapsed and died'; 'I was telephoning for an ambulance and she gave one cough. When I turned round, I could see that she had died'; 'She just died while I was examining her'."

At times he stopped killing, usually because he was scared of being caught.

"When he resumed killing, he did so gradually, sometimes beginning with a terminally ill patient. It was as if he were entering the pool at the shallow end to see if he could swim." In 1997 he committed 37 murders - his highest annual tally - and was on course to exceed that total when police inquiries began.

"It may be, during these later years, that Shipman was virtually out of control. It is typical of addictive behaviour that the subject needs more and more opportunities to feed the addiction."

On Shipman's ability to avoid standard checks and controls on doctors, Dame Janet notes that was able to stockpile lethal supplies of diamorphine and to avoid post-mortem examination on his victims.

In 1996 he prescribed 12,000mg of diamorphine on a single occasion in the name of a dying patient.

"That alone would have been enough to kill about 360 people. Despite the fact that the supply and possession of drugs is said to be 'controlled', those controls did not stop Shipman from acquiring large amounts of diamorphine without detection."

All but three of the 215 deaths were registered using death certificates issued by Shipman. Most victims were cremated. Before cremation, a second doctor must confirm the cause of death and the papers must be checked by a third doctor at the crematorium.

"These procedures are intended to provide a safeguard for the public against concealment of the fact that a person has been unlawfully killed. Yet . . . Shipman was able to kill 215 people without detection. It is clear, therefore, that the procedures provided no safeguard at all."