Nurses who Murder: A Munchausen Syndrome by Proxy Connection?

Woman helping another walk.

C.E. Miller alerts us to the case of Elizabeth Tracey Mae Wettlaufer, a long-term care facility nurse from Woodstock, Ontario, accused of murdering 8 elder facility residents starting in 2007. She is accused of killing them by overdosing them on “a drug” that has not yet been named in the news.

Reminder of Charles Cullen

I can’t help be reminded of American nurse and serial killer Charles Cullen, the subject of the non-fiction book, “The Good Nurse”. The book documents how Cullen admitted to killing hundreds of ICU patients over many years at 9 different US health care facilities by giving them overdoses of the drug digoxin.

In both cases, investigators are left asking: What is the motive for all these murders? Especially by a caregiver – a nurse?

What is the Typical MSbP Murder Motive?

Let’s examine the “motive” for any murder of an MSbP victim by her perpetrator. I put “motive” in quotes, because the MSbP perpetrator’s typical goal is NOT to murder the victim, but to victimize them by controlling the public perception of the victim’s health or illness. The strategies used by the perpetrator to create these public perceptions include:

  1. creating new illnesses in the victim while simultaneously announcing that these illnesses as having a mysterious etiology,
  2. falsifying that the victim has illnesses that she doesn’t, and
  3. preventing the victim from getting treatment for real illnesses she has.Salt shaker

Because MSbP perpetrators need their victims to be alive in order to create such perceptions of their victim’s health or illness, typical MSbP perpetrators do not want to actually kill their victims. Death of MSbP victims is usually a
result of miscalculation on the perpetrator’s part that results in “overdoing it”. This is well-illustrated in the Lacey Spears case, where she repeatedly poisoned her baby son with salt presumably to instigate medical intervention. She apparently used too much salt at one point and killed him, and was subsequently convicted of murder.

MSbP and the Nurse Murderer Motive

Both nurse murderers targeted people in a population already at a heightened risk of death: patients in the ICU, and nursing home residents. By causing death using medicine, both murderers seemed to be creating a new illness or symptom of mysterious etiology (strategy 1). Further, when questioned, they likely appealed to the fact that the purported murder victims were already at high risk of death, which speaks to strategy 2. In fact, choosing patients from a high mortality risk pool as murder victims was a strategy that probably delayed their identification.

Nurse taking blood from patient.

I think it is possible that there is an MSbP motive, in that these nurses wanted to control the perception of health of these patients, only “death” was just an illness or symptom to them, not a final destination. After all, they worked with a population whose members died from time to time, so it may have been seen these occasional deaths as a “symptom” seen in their populations.

How Can we Know if MSbP was Part of the Motive?

One problem is that to figure out if someone is doing MSbP behavior, it is most helpful to figure out if they’ve been exposed to this behavior by being in an MSbP family. Unfortunately, this information usually is not gathered and reported because of the lack of awareness about MSbP families.

Some scientific papers look into whether the perpetrator was “abused” or not, but they do not look to see if the perpetrator was a victim of specifically MSbP behavior. I strongly believe that MSbP behavior is learned much more often than it arises spontaneously. But without this line of inquiry by reporters and scientists, readers cannot tell if these nurse murderers may have “learned” this behavior from their families.

In “The Good Nurse”, the author does report that apparently, Charles had a difficult family or childhood, but no details are given. So far, nothing is in the news about the background of Elizabeth Wettlaufer, but admittedly, the story is just breaking, so we may hear more.

Want to learn about a nurse who was a victim (not a perpetrator) of MSbP?

Read this touching, articulate, and scientific report from an adult nurse about her experiences surviving an MSbP family.

Images by Geralt, Dubravco Sorić, and US Army.


2 thoughts on “Nurses who Murder: A Munchausen Syndrome by Proxy Connection?

  1. Yes we have had nurse murderers. And in some nursing homes we have also had your more basic staff killing people.

    What is the motive? Probably it is just that they’ve decided to play God.

    Colin Wilson wrote lots about varieties of serial killers. And these usually are serial killers.

    But I don’t think we should be calling it MSbP. That is an idea, now out of date, which was used in a specific way.

    First of all, if a parent abuses their child, and there are not medical personnel being either complicit, or just being duped, then it is not MSbP. It is simply child abuse ( usually psychological, physical, or sexual ). That the parent may give a medical needs justification does not make it MSbP, not unless medical personnel are doing the abuse themselves.

    And you spoke of MSbP as being a motive. I feel that this is also a misunderstanding of the concept. MSbP is a syndrome, a kind of a mental illness, but it is not a motive.

    The usually motive is the getting of attention, and from medical personnel.

    Now, why does a parent commit Medical Child Abuse ( the new way of understanding this )?

    I think it is about public perception, or the parent’s public identity. It is the same reason that at the Pentecostal church of the guy I helped put into prison, nearly everybody has at least one scapegoat child. This scapegoating is always using a moral claim, but it can be medical, psychiatric, or just delinquency and salvation status. To be this concerned with a child, it almost always has to be a parent.

    Doctors and nurses can get on power trips, they can start to play God, and they can also just make mistakes. But I don’t consider it correct to be referring to this as MSbP, as the situation is totally different.



    • Hi Nomadic,

      Actually, you bring up a problem that we are working on at the Proxy Project, which is: what do you diagnose as MSbP? A person? A perpetrator? A victim? What we are trying to do is classify the “behavior” as MSbP, just like one might classify certain alcohol consumption behavior as “binge drinking”. People don’t get diagnosed with “binge drinking”, they just can be classified as doing it. Then this can be seen as a symptom of something else.

      So why do people do “MSbP behavior”? And are these killings “MSbP behavior”? You make a good point that maybe they are not. I’m not sure what the answer actually is. But I really, really like the point that you make that serial killers do want to “play God”. MSbP perpetrators end up being serial killers often (they just have to kill 2 victims to get there). They are definitely playing God, but in a particular way.

      Thanks for your great comments!



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