Liability for death: nine nurses' legal ordeals

Is a murder charge an occupational hazard of intensive care nursing?

When nurses are accused of harming their patients there is an understandable wave of concern. When nurses kill their patients there is disbelief and horror. After all, killing patients is so far from the traditional image of the nurse as to cause distress and disorientation. When the nurse in question is a woman and when the charge amounts to serial killing, our most cherished assumptions about gender roles and professional responsibility are called into question. Yet in this decade nurses have been accused of killing patients, attempting to kill patients and causing grievous bodily harm to others. In the UK, of the nurses accused of attempting to murder their patients two came from the same specialism. Two of the three accusations centred on Intensive Care Units (ICU); the case of Amanda Jenkinson (Kenny 1996) and the case of Kath Atkinson, an ICU sister in Newcastle (Porter 1998a). In the most notorious case of nurse homicide in the UK this decade, that of paediatric nurse Beverly Allitt, the profession and society at large were shaken by accusations so serious as to defy belief.

Munchausen syndrome by proxy in health care workers

The literature on Munchausen Syndrome by Proxy (MSP) is reviewed to assess the extent of existing knowledge and the incidence of this syndrome among health care workers. Although use of this diagnosis appears to be increasing and broadening, it was not until the Beverly Allitt case in the United Kingdom in 1993 that this syndrome was used to explain the behaviour of a health care worker who harmed people in his/her care. However, a review of available details of previous health care workers accused of murder reveals that five shared some of the distinctive features of MSP. Although care must be taken when applying diagnoses, in view of the risk of morbidity and mortality which MSP poses for the people involved, it is important that health care workers become more informed and involved in understanding and detecting MSP.