What, psychologically, causes a doctor to kill his patients?

I read an interesting book called Blind Eye about the doctor Michael Swango, who just could not stop himself from administering lethal doses of drugs to patients under his “care”, over and over again, at several different hospitals. (He managed to get re-hired as a doctor multiple times by forging documents and adopting new identities.) He also repeatedly fed ant poison, arsenic, botulism and other homemade poisons to his co-workers during his time as a paramedic and at several other jobs as well. It’s believed that he even poisoned his wife over a long period of time, resulting in her developing headaches so powerful that she committed suicide to end the pain.

The book was exhaustively detailed about Swango’s life story and “career”. But it was remarkably short on any attempt at a psychological profile.

What, exactly, is “broken” in someone’s brain that causes them to be like this? Swango was as compelled to poison people as you or I are compelled to drink water and eat food. He simple could not live without doing it. And he never even once expressed any remorse whatsoever.

What causes a person to behave this way?

Linked from the serial killer link in the article you provided.

Otara

I don’t know the answer to the question but I’ll ghoulishly suggest reading up on Harold Shipman.

What do you “do” with a person like this? Is he a complete sociopath, a pure killing machine with absolutely no conscience and no feelings for anyone but himself? Aside from isolating him from society via imprisonment, or execution, is there any reason for anyone to feel sympathy for him and try to engage him on a human level? Is there some way of curing him of his impulses, or was he simply born with no conscience?

It would depend on if there is an underlying condition. Does he have OCD, and yet for some reason actually acts on his obsessions, rather than trying to prevent them? Is he schizophrenic and feels like voices are telling him to do this and it’s the only way to get the voices to stop?

From what you describe, he doesn’t sound like he has no conscience, just that his impulses override it. So if you can treat his impulses, of course he’d be better.

But he still should not be a doctor, since his compulsions are towards poisoning people. He should never be in a position where he can act on these impulses, even after he’s supposedly cured.

From the link you gave “At his sentencing hearing, prosecutors read lurid passages from Swango’s notebook, describing the joy he felt during his crimes”

I dont think theres much evidence for a conscience myself. I would hope a cure would one day be possible, but dont think theres much we can do for these kinds of cases yet.

Otara

We don’t know. Psycology and Neurology are complex fields where ignorance still outweighs knowlege. We simply aren’t advanced enough to tell yet. if we were we would be working on how to fix it or at least screen for it so we could keep these people away from where they could do the most harm.