Dr Gosnell’s House of Horrors
Article submission by Robert M. Kaplan in The Medical Republic.
Publishing date: 17/12/2015.
The following article is a reader contribution by Dr Robert M Kaplan, a forensic psychiatrist at the Graduate School of Medicine, University of Wollongong.
Police who searched the West Philadelphia clinic premises found filthy blood-stained rooms with foetal body parts in glass jars and refrigerators, describing it as a house of horrors. Gosnell was charged with killing a pregnant refugee and seven newborn infants. Gosnell, who made millions from abortions and dispensing addictive painkillers, also faced a separate trial on prescription drug charges.
All but one of the nine clinic workers arrested with Gosnell pleaded guilty, three of them to third-degree murder. Unlicensed doctor Steven Massof testified that he snipped the spines of more than 100 live babies. He pleaded guilty to third-degree murder of two babies allegedly stabbed by Gosnell while Massof assisted with the abortions. Gosnell’s wife Pearl pleaded guilty to performing an illegal, late-term abortion and other charges.
Gosnell maintained that his Women’s Medical Centre treated the poor, immigrants, teens and women with late-stage pregnancies who could not get abortions elsewhere. This is typical of the defence used by doctors in these situations, an alternate defence is “euthanasia” to relieve suffering. It was little help to Gosnell who was sentenced to life imprisonment without parole.
The Gosnell case raises an important point about such appalling medical scandals. While doctors who slide into inept and abusive treatment are not unknown, what does it mean when someone is engaging in practices in which death of the patient is a recurring feature and cannot be justified as just a consequence of treatment?
This falls into the category of clinicide – multiple deaths of patients which cannot be attributed to the usual process of treatment – in this case, treatment clinicide. The doctor does not set out to deliberately kill the patient (serial clinicide) but through ineptitude, greed or sheer obdurate refusal to accept the consequences of their actions, multiple deaths result.
In Australia, the most notorious example is Dr Harry Bailey who was responsible for the deaths of dozens of patients at his Chelmsford Clinic through the use of discredited Deep Sleep Therapy.
Why do doctors kill their patients, or use their medical skills to commit horrendous abuse? The answer is that murderous doctors are different from their colleagues and from other lethal healthcare workers. Such doctors have a grandiose view of their own capability, developing a God-complex, getting a vicarious thrill when a person dies.
The inability to admit they could be wrong exemplifies the ancient Greek sin of hubris. Such individuals, while not necessarily psychopathic, go to extraordinary lengths to get what they want. A fatal hubris permits these doctors to perceive themselves as dedicated, if not heroic, and any criticism of their work is responded to in paranoid terms. This explains the most puzzling aspect of clinicide, the doctor who cannot step back at an early stage from the casualties of treatment and seek assistance or stop what they are doing.
Gosnell’s case shows all the features of treatment clinicide. There is the leading figure, who is often charismatic, dominating and, at the very least, obsessively driven. Their helpers are willing accomplices, may have problems of their own or are outright criminal in intent. There is often a pattern of recurrent abuse of medical regulations, for example in drug prescribing and flagrant overcharging.
Gosnell’s case raises another issue. It is that if there is no access to safe, legal and properly supervised abortions, such travesties will occur at regular intervals. Those who go to great lengths to fight for the lives of unborn children may have pause to consider the appalling fate of their mothers in these cases.
Robert M Kaplan is a forensic psychiatrist at the Graduate School of Medicine, University of Wollongong. His book Prophet of Psychiatry: In Search of Reg Ellery was released in January 2015.