British doctor killed at least 215 patients, report says

He is serving life sentence in drugging deaths of 15


HYDE, England - Dr. Harold Shipman, the suburban family doctor convicted two years ago of murdering 15 of his patients, actually killed at least 215 of them, an official investigation reported yesterday.

The inquiry head, Judge Dame Janet Smith of the High Court, said the killing spree stretched over 23 years in which the gray-bearded, soft-spoken general practitioner built up a reputation for attentive and trustworthy medical care while systematically injecting the people in his care with lethal doses of the painkiller diamorphine.

"He betrayed their trust in a way and to an extent that I believe is unparalleled in history," Smith said.

Reading from the findings of the yearlong inquiry in the hushed council chamber of Manchester Town Hall, Smith said she also had "real cause" for suspecting Shipman of killing 45 additional patients but could not attach the same certainty to them as she could to the 215.

"Deeply shocking though it is, the bare statement that Shipman has killed over 200 patients does not fully reflect the enormity of his crimes," Smith said. "As a general practitioner, Shipman was trusted implicitly by his patients and their families."

She said, "Shipman's `nonviolent' killing seems almost more incredible than the violent deaths of which we hear. The way in which Shipman could kill, face the relatives and walk away unsuspected would have been dismissed as fanciful if it had been described in a work of fiction."

The report said that systems that should have safeguarded patients against misconduct of this scope had failed and that it was "deeply disturbing" that Shipman's killings did not arouse suspicion for so many years.

Though the 2,000-page report provided as conclusive a count of victims as will ever be known, Smith said: "The true number of victims is far greater and cannot be counted. I include as victims the thousands of relatives, friends and neighbors who have lost a loved one or a friend before his or her time, in circumstances that will leave their mark forever."

Prosecutors at Shipman's trial argued that his drive to kill was fueled by a desire for godlike power over life and death, but Smith said her inquiry had been unable to come up with an easy explanation. Recalling that Shipman had been convicted in his 20s for drug use, she said, "It is possible that he was addicted to killing."

The report turned up evidence that Shipman seemed to have a morbid interest in death; many of his victims were in a state of recent bereavement. Judith Page, a patient of the doctor who worked as a household helper, told investigators that Shipman once asked her if she had had the experience of finding a client dead, and when she said yes, he asked if it gave her a "buzz."

According to the report, a Shipman killing would follow a typical pattern. Shipman would call on an elderly patient, usually a woman living alone, on a weekday afternoon. Sometimes the call was in response to a complaint of an ailment of some kind. At other times it was presented as a routine check-up.

While there, Shipman would administer the deadly injection.

Most of his victims were found sitting in living-room chairs, looking as if they had just fallen asleep. Sometimes Shipman would stay on the scene and report the death to relatives himself. At other times he would leave and wait to receive word, and then return. In every case, he would have a ready explanation for the sudden death and would assure relatives that no autopsy was needed.

Known for having a good bedside manner, Shipman could turn abrupt and flippant in the immediate aftermath of one of his killings. "When my mum died, he put his hand on my right shoulder and said, `I think I'll stay here a while in case she wakes up, so she doesn't scare people,'" said Barry Swan, 52, a plumber whose mother Bessie, 79, was murdered by Shipman in 1997. "I didn't think anything of it at the time, but I do now."

When he had just killed Mary Coutts in April 1997, the report said, her son and daughter-in-law asked him about the circumstances, and he said, "Well, I don't believe in keeping them going."

Hyde is a Manchester suburb of two- and three-story red brick houses with a main street of small storefronts, one of which was the doctor's office where Shipman, now 56, ran his practice from 1992 until he was arrested in 1998. Townspeople are still struggling to work out their feelings about having had England's most prolific serial killer in this otherwise unremarkable community.

Peter Wagstaff, 54, whose mother Kathleen, 81, was a Shipman victim, said the doctor was "one of the most evil men in history," but, he added: "I do not think I have met anybody who said they hate him. It is just too difficult to understand and try to work out."

Despite the new findings, police say there will be no new prosecutions of Shipman because of the unlikelihood of finding jury members who have not heard of the case. Shipman was jailed for life in 2000, and Home Secretary David Blunkett declared last week that there would be no review of that sentence.

Shipman maintained his innocence through his trial, and he has refused to discuss the case with detectives who visit him in prison in Durham periodically. A copy of yesterday's report is being sent to him.

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