More Ethics Emanations From The World Of Medicine: The Charles Cullen Story

Having spent a fair amount of time yesterday and today in a hospital, I was reminded of this post that had been stalled on the runway…

In November of last year, Netflix began running “The Good Nurse,” a disturbing movie based on the real story of Charles Cullen, a serial killer-nurse (played by Eddie Redmayne in the film), who murdered between 45 and over 400 patients at a series of hospitals and medical facilities in New jersey and Pennsylvania over a 16-year period. The film concentrates on the colleague who finally brought him down, Amy Loughren, a fellow nurse and freind (played by Jessica Chastain) who alerted the police after she became suspicious of Cullen’s links to patient deaths as well as his irregular computer accessing of medications.

The real horror of the film and the facts is that so many of the administrators of  the hospitals where Cullen committed his murders either strongly suspected that he was killing patients, were certain he was, or resorted to contrived ignorance to avoid discovering what was right in front of their staff’s eyes. At least 16 hospitals fired Cullen on various other grounds and gave him sufficiently ambiguous recommendations to allow him to find new employment where he could kill again. Law enforcement authorities were also alerted by hospital staff more than once, and let Cullen slip through their fingers.

A typical example was St. Luke’s Hospital in Bethlehem, Pennsylvania. Over a three year period, Cullen murdered at least five patients and attempted to kill at least two more. A co-worker found medication vials in a disposal bin, triggering an investigation that implicated Cullen. Neverthe less, fully knowing he was untrustworthy and possibly dangerous, St. Luke’s allowed him to resign with a promise of a neutral recommendation, Seven nurses at St. Luke’s later alerted the Lehigh County district attorney of their suspicions that he had used drugs to kill patients, but the matter was not pursued.

The behavior of the hospital administrators was essentially identical to the conduct of the Catholic Church regarding predator priests, and  is frighteningly typical of bureaucracies, businesses, and especially non-profit institutions that see themselves as being “on the side of the angels.” Revealing horrible misconduct within the organization risks lawsuits, criminal charges, and the loss of trust, esteem, reputation, support and contributions. Protecting the organization is seen as the paramount consideration, even when it means inflicting a sociopath on innocent people.

Following the Cullen case, New Jersey and many other states tightened the laws requiring hospitals to support suspicious patient deaths, but law is not a substitute for ethics. I see no reason to believe that hospitals do not have the exact same impulses and priorities today that let Charles Corbin pursue his homicidal hobby for so long,

 

2 thoughts on “More Ethics Emanations From The World Of Medicine: The Charles Cullen Story

  1. A more prevalent crime that gets the same reaction from hospital administrators as Cullen did for murder: narcotic diversion.

    Nurses who find workarounds to steal opioids for themselves or others have suspicion land on them frequently. However, even with electronic med tracking and security cameras, 1) hard evidence takes time and effort to gather, 2) it isn’t always provable, and 3) nurses can tell when their activity is being monitored so they scale back on stealing.

    Nurses committing this crime often leave when they realize they are suspected, quitting before they are fired. After all, once they are gone management doesn’t care about spending resources investigating a former employee. Nursing unions can also increase the minimum activation energy required, so to speak, to punish or report an bad actor. Most often managers start putting pressure on a suspected nurse in other ways, or finding other reasons to penalize them, such as making their work schedule unpleasant or reduce it, and hope that the nurse in question just chooses to leave on their own.

    And it follows the same pattern as Cullen. The nurse moves on to steal from another hospital.

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