TORONTO -- An Ontario nurse who murdered eight elderly patients in her care has provided great insight into the minds of health-care workers turned serial killers, an American researcher testified Wednesday at a public inquiry.
Beatrice Crofts Yorker, a researcher with California State University Los Angeles who has studied murders in the health-care profession for decades, told the inquiry examining Elizabeth Wettlaufer's conduct that the nurse's admissions to authorities have been a boon to research in the field.
"Nobody has given as much detail as she has," Yorker testified. "We have some information from family members, health-care workers about personalities and about issues, but when it comes to premeditation, she's given more insight than any other health-care serial killer."
Wettlaufer is serving a life sentence after confessing to killing eight patients with insulin overdoses and attempting to kill four others at long-term care facilities and private homes in Ontario over nearly a decade.
The 51-year-old told police she killed her patients for various reasons, sometimes being triggered at work by an unruly patient or at other times being motivated by an internal "red surge" that would only abate after a murder, but there was never a lengthy period of planning.
Yorker's research shows that since 1970, there have been 131 prosecutions and 90 convictions of health-care serial killers in the world, the inquiry heard.
The main difference between Wettlaufer and other serial killers, Yorker said, is that the Ontario nurse turned herself in and confessed her crimes before she was scheduled to work with children.
A key takeaway from Wettlaufer is that she was able to avoid detection as she preyed on her victims, Yorker said.
There weren't any "death clusters" or a rise in deaths or other incidents such as cardiac arrests that could have been detected by either supervisors or software, she said.
In hindsight, Wettlaufer fit the mould of other serial killers that Yorker researched, including using insulin -- a drug that's difficult to detect -- as her weapon of choice and dealing with mental health issues that included suicidal tendencies and substance abuse.
The judge, police and Crown attorney in Wettlaufer's case all said she wouldn't have been caught without her confession, which began with her telling a psychiatrist about the murders at a mental health hospital in Toronto.
A lawyer for a long-term care facility where one of the victims died at the hands of Wettlaufer suggested the Ontario nurse's case was an anomaly but Yorker disagreed.
"We know that it does happen," Yorker said. "We know that there are probably not enough mechanisms in place to detect if it was going on in long-term care."
To help detect someone like Wettlaufer, Yorker suggested medication tracking -- Wettlaufer easily covered her tracks because insulin was not tracked.
Yorker also suggested all health care workers, and family, learn what "good deaths" look like so that an atypical, or "abnormal death," is easier to spot.
Last, she said, health-care workers should encourage a culture of reporting anything suspicious. She cited several cases in her research where workers blew the whistle on some of the serial killers, but were fired for speaking out.