Listener discretion is advised, this episode features discussions of addiction and murder that may be upsetting. We advise extreme caution for listeners under 13. According to criminology experts, there are four kinds of serial killers, one thrill seeking to power and control, seeking, three mission oriented and four visionary. These categories help investigators determine a culprit's motive, but the task can still be quite elusive, especially in the case of visionary killers who hear voices imploring them to commit murder.

This, in a command, comes from their own psychosis, unaware of their own mental condition.

However, they interpret their violent thoughts as calls from the divine and proceed in perceived servitude to that higher power. In the summer of 2007, Canadian elderly care nurse Elizabeth Wet Lawfare did just this. She later recalled a voice set inside me. I'll use you. Don't worry about it. She thought God had spoken to her. By August, she had killed her first victim.

This is Medical Murders, a Spotify original from podcast, every year, thousands of medical students take the Hippocratic Oath. It boils down to do no harm. But a closer look reveals a phrase much more interesting. I must not play at God. However, some doctors break that oath. They choose to play God with their patients, deciding who lives and who dies each week on medical murders.

We'll investigate these doctors, nurses and medical professionals. We'll explore the specifics of how medical killers operate not just on their patients but within their own minds, examining the psychology and neurology behind heartless medical killers. I'm Alastair Madden and I'm joined by Dr. David Kipa, M.D..

I'm Dr. Kipper and very happy to be here with Allaster to provide some medical insight into our second episode of Nurse Elizabeth Lauffer. You can find episodes of medical murders and all other podcast shows for free on Spotify or wherever you listen to podcasts to stream medical murders for free on Spotify. Just open the app and type medical murders in the search bar. This is our second episode on Elizabeth West Lawfare, Canada's only known medical serial killer who lethally overdosed eight elderly patients between 2007 and 2016.

Last week we covered Elizabeth's struggles with repressed sexuality, drug addiction and a failed marriage, all of which came prior to her first murder.

This week, we'll explore the subsequent series of murders and Elizabeth's tumultuous attempts at seeking help. All this and more coming up. Stay with us. When reflecting on the feelings she had when she killed Elizabeth, Westlaw, for once replied the surging and then the laughter afterwards, which was really it was like a calling from the pit of hell. Eventually, she decided that the voice within her was the devil commanding her to sin. But at the beginnings of her killings, Elizabeth thought it was God who wanted her to administer lethal injections.

Her confusion about whether this inner voice was something good or bad reflects a struggle we all face as humans distinguishing right from wrong. But the difference between us and Elizabeth Lofa is rationality, where we all revile the idea of murdering an elderly patient, knowing it's despicable. Elizabeth relished in the sense of control it brought her. It was that self-satisfaction she savored on the morning of August 12th, twenty seven hours after she'd administered a lethal shot to her first murder victim.

It was approximately 4:00 a.m. when Elizabeth Westlaw four placed a call to the family of 84 year old James Silcox, she would have to break the news that James had passed as the phone rang.

Elizabeth did her best to suppress the feeling of splendor she felt within her.

She knew it would be best to sound solemn on the call. And like a perfect actor, Elizabeth conveyed only seriousness and sympathy to Diane Crawford, who was shocked to learn her father had died.

Though James had recently undergone hip surgery, he'd been in good spirits and Diane hadn't noticed any significant progressions with his dementia. Of course, neither of these were to blame for the death of James Silcox. But Elizabeth Wetmore first certainly wasn't about to explain that she'd murdered him. So instead she kept Diane in the dark, hanging up the phone to let the grieving woman sort through different theories about what exactly killed her father. But Diane wouldn't have to wander for long.

When the local coroner examined James Silcox body, he concluded that the elderly patient had died from complications of a fractured right hip, Elizabeth Wetmore was relieved the coroner's misjudgment meant he hadn't suspected James had been murdered with a harmful dose of insulin. In fact, he'd apparently done nothing to investigate the possibility that James's death was a homicide since James was already an elderly care. It wasn't unbelievable that he died from some seemingly benign health complication. Unfortunately, misattributed deaths like this one can be quite common in nursing home settings, and sudden deaths of elderly people with underlying health conditions aren't usually met with shock.

Doctors in these facilities manage several patients, many with similar problems, and therefore must rely on nurses like Elizabeth for details of their care. For the most part, they only interact with patients to manage acute or severe onset problems. Another prevailing theory for this lack of scrutiny of sudden senior death is a generalised attitude of ageism. It's possible that because of where these people are in their lives, their deaths are often chalked up to an inevitability and unfortunately may be seen as less tragic when looking at these factors.

It makes sense that murders in nursing homes could potentially be overlooked.

The coroner who filled out the death report for James Silcox did look at the body. But James's insulin overdose wasn't visibly evident. He assessed recent medical history and made the best guess he could. But in doing so, he failed to realise James had been murdered.

Elizabeth rushed to agree that the doctor had made the right call. However, James's daughter Diane wasn't so convinced, so she inquired about an autopsy. Still, Elizabeth didn't fret it was unlikely even a skilled examiner would be able to conclude James Silcox died of an insulin overdose. So Elizabeth was giving her victims the exogenous form of insulin, which is the type of insulin we inject as opposed to the natural insulin our pancreas makes. It can be difficult to determine when an insulin overdose has occurred.

This mostly has to do with how quickly injected insulin degrades once inside the body. Exogenous insulin is either short acting, lasting only a few hours or long acting, staying in the blood for 18 to 24 hours. Elizabeth may have been so worry free when using it on James Silcox because she would have known that a toxicologist would likely miss its presence. On the other hand, she could have felt just as comforted using long acting insulin as a coroner would generally have less than a day to detect overdose levels.

So the medication, Elizabeth, may have also known that a general toxicology report wouldn't be sensitive or sophisticated enough to detect large amounts of insulin metabolites or the breakdown products of this medicine. In addition to all of this, it was firmly established that James was a diabetic. In this regard, finding traces of long acting insulin in his system wouldn't have necessarily been surprising if this autopsy was conducted within a day, and no one would question why he was administered insulin because of his diabetes.

So Elizabeth walk to her car after her long night shift. Red handed, but unsuspected, and she remains. So James Silcox never did get an autopsy, even though his family members requested one. The coroner's office talk them out of it, thinking it foolish to suspect James died of anything worth investigating.

Within weeks, Elizabeth was officially in the clear.

Four months after her first murder, she found her second victim, Maurice Grynet, according to his daughter. The 84 year old suffered from pancreatic cancer. Allegedly, he also had a habit of getting frisky with the nurses. Elizabeth resented this. And in the early hours of December 21st, 2007, she decided to do something about it. According to Maurice's friends, Morris seemed to be in a heated argument with Elizabeth when they entered his room.

Seeing the friends, Elizabeth composed herself and left. When she returned, she pushed past his guests and reportedly injected Morris with a shot he didn't seem keen on taking. It's possible Marie suspected Elizabeth was up to no good, but as far as his friends were concerned, the nurse was simply doing her job. Then, to their disbelief, Morris died later that morning or seemed to pass much more quickly than Elizabeth's first victim, who had cried out for hours before finally succumbing to the insulin overdose.

When looking at the murders of James Silcox and Morris Gernot, it's likely that James, who live longer after being overdosed because he didn't have the underlying pancreatic cancer that Morris had. Pancreatic cancer is an aggressive disease that also causes insulin resistance, a condition that inhibits the cells ability to absorb and utilize glucose properly without adequate glucose. The body's vital organs lacked the energy needed to function properly and will eventually shut down when blood glucose falls below a level of around 10.

Barring intervention, coma and death will quickly follow. The insulin resistance caused by Maurice's pancreatic cancer made it even harder for his brain cells to get to sugar. They needed to function, and along with the hypoglycemia induced by the injected insulin, these cells died off even quicker.

Or Granaz body, unfortunately, couldn't withstand the overdose. When he died, Elizabeth reported it to the facility and went about her day. Just like James Silcox, Morris Granaz death would not be ruled a murder. The 84 year old's cause of death was instead attributed to, quote, old age debility, which was likely exacerbated due to his cancer. Elizabeth had gotten away with her second killing, and the confidence sparked within her solidified a pattern of elderly abuse that continued for seven years.

Coming up, mounting pressures at the nursing home send Elizabeth spiraling into a drug haze, rage, hopelessness.

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Now back to the story. During 2007, 40 year old Elizabeth Webb Lawford did more than just learn the ropes at Ontario's Crescent Care nursing home. She also grew quite familiar with the insulin closet situated around the facility. It was there that she stole and pretz lethal injections. She used to kill James Silcox and Morris Grynet, despite her devout religious upbringing, which taught her the commandment Thou shalt not kill. Elizabeth initially didn't seem to be bothered by her crimes, but she was bothered by her increasing workload.

Crescent Care was understaffed. This meant Elizabeth had to take care of quite a few residents, and many of them quite literally, relied on Elizabeth to survive. So pressure mounted steadily every time another patient came to the facility, as Elizabeth later recalled. I was always feeling like I had to be the best possible person. It was a very, very stressful job, giving medications to 32 people. For reference, a California law instituted in 2004 listed minimum nurse to patient ratios for various medical settings in non-emergency environments, facilities are required to have at least one nurse for every four to six patients.

So it's understandable that Elizabeth felt extremely overworked. Unfortunately, this isn't uncommon in the medical field when facilities don't spend the necessary funds to support a sufficient staff, insufficiently staffed medical facilities endanger patients and nurses.

The most obvious reasons for this are that less staff means less facility oversight, less one on one care for patients and more communication difficulties.

Naturally, the more patients the nurse has to attend to, the more their attention is spread thin. Because of this, overworked nurses can be less thorough and observant within a single person they're caring for. Providing care for too many patients at once also puts nurses at a high risk for burnout. Nurses work long hours on their feet, constantly need to be mentally sharp and are expected to deal with a variety of difficulties, including patients that may be very stubborn or even physically resistant to their care.

Like many nurses in her situation, Elizabeth faced burnout, but rather than turn to helpful resources or attempt to request changes at the facility, she took her frustrations out on residents repeatedly injecting patients Michael Priddle and Wayne Hedges throughout 2008. Neither died as a result, and she never got the relief she was after. So she turned to her drug of choice hydromorphone.

The powerful narcotics sent her into a drug induced haze while on her work shifts and dulled her urge to lash out at residents. It did not, however, prevent her from instigating inappropriate encounters with staff members. On one occasion, she invited an underage nurse's aide to dinner in Toronto after bonding with the girl over the nearly two hour drive to the city. Elizabeth felt comfortable enough to reveal that she had been overdosing patients. In response, the concerned girl said she tell the police Elizabeth snapped, viciously, warning that no one would believe her if she did.

It's a bit perplexing why Elizabeth would share the crimes if she hadn't wanted to be caught. Perhaps it was a slip up, or perhaps she felt that simply sharing her wrongdoings would lighten her burdens. Whatever the case, the girl never spoke with authorities, but she did go home that day with an altered view of the irritable nurse.

These mood swings weren't uncommon for Elizabeth, and on multiple occasions in 2009, she faced complaints from staff members. Typically, the nursing home would simply record the incident requiring a meeting with the involved parties and occasionally propose follow up steps such as counseling sessions. Now, all facilities manage interpersonal conflicts differently. But perhaps Dr. Kippot, you can shed light on how CARECEN care could have better corrected Elizabeth for even the slightest of mishaps. It's critical for facilities to provide thorough and clear correction to nurses to ensure quality care.

In the case of Elizabeth, complaints about the mental health of a nurse should never be overlooked or taken lightly. Nowadays, complaints made against nurses are more heavily examined. These investigations usually take six months to a year to wrap up, and the resulting disciplinary action will reflect the severity of the offense. Some of these punitive measures include probation and restricting their responsibilities, mandatory rehab or educational programs, fines or civil penalties, and the permanent loss of their nursing license if their license isn't revoked altogether.

A nurse's infraction will remain in the public record for around three to 10 years or even forever, depending on the situation.

This kind of oversight and penalty system is very important in health care facilities. It helps keep medical professionals accountable and dissuades inappropriate and reckless behavior.

Because CARECEN Care didn't recognize these complaints made against her as notable red flags, Elizabeth's behavior went largely unchecked and she failed to make necessary changes, putting herself and everyone around her in danger.

This was reflected by her personnel file, where several complaints from colleagues and patients were listed with little to no notes about follow up or confrontation, Elizabeth continued to deliver sharp remarks when angered, take drugs on work time and make inappropriate comments about her personal life. But over the span of at least one year in 2010, Elizabeth didn't attempt to murder anyone. Then in 2011, Elizabeth felt something she thought she'd forgotten, the red serge, the voice from within, telling her to kill again.

So her personal life around this time remains a mystery for the most part, she did begin writing dark poetry in one poem she wrote. She watches some life drain from the notch of his neck vein as it's soothingly pools, it smothers her pain. The violent intent behind her words did not hold back, and once again, neither did Elizabeth. In 2011, Elizabeth lethally injected and killed three female nursing home patients Gladys, Mylord, Helen Mattsson and Mary Zabinski.

Elizabeth seem to feel that these deaths were acts of mercy, and perhaps that calmed her guilty conscience. In 2013, 90 year old Helen Young, for instance, frequently said she wanted to die. In the months leading up to her murder, Elizabeth had grown tired of hearing it. One afternoon she couldn't take it anymore and thought, OK, you will die.

When other nurses found Helen having an apparent seizure that evening, Elizabeth never mentioned that it might be the result of insulin injections. She had no intention of letting Helen live.

That sense of control sated her, but only briefly, and then she moved on to the next high with each passing year. Her substance abuse worsened. She began upping her abuse of hydromorphone pills and alcohol.

And though Elizabeth had been unstable for quite some time, her growing disconnection from reality was noticeable.

Elizabeth's neighbors recalled her odd behavior when sharing that someone at Crescent Care had passed. She was dismissive, all too eager to claim she had no idea what had caused it. This urgency suggests Elizabeth knew her actions were wrong. She may have even felt guilt because in 2013 she sought counsel from a pastor and his wife. She told them that she'd killed people at work, just like she told the young nurse's aide. But unlike the girl, the pastor and his wife didn't believe Elizabeth.

They promised they pray for her. But at this point, Elizabeth would need more than prayer to stop her, since those she confided in never snitched on her and no one at the nursing home suspected she was a murderer. The only thing standing between Elizabeth and her murderous desires was her own guilt. To quiet it, Elizabeth turned to substances once more and lashed out at patients with greater frequency. She didn't know it at the time, but she was speeding headfirst toward disaster.

In March 2014, 46 year old Elizabeth administered lethal insulin injections to Maureen Pickering, who was battling Alzheimer's. When Maureen asked Elizabeth what it was, Elizabeth lied and said that she was administering supplements. About two and a half hours after the first injection, Elizabeth injected morphine again, supposedly laughing all the while, several days later.

Maureen Pickering died. Once again, Elizabeth laught. But her amusement was rooted in the assumption that she'd get away with the crime without raising any suspicions as she had done till now, this joy was short lived.

By the end of March. Elizabeth received a severe letter from an administrator at Crescent Care.

Apparently, the nursing home had a long record of Elizabeth administering the wrong medications. And while it's unknown whether Elizabeth supervisors knew about her actions with Maureen, specifically a medication error recorded in late March seemed to be the last straw. Crescent Care decided Elizabeth was a danger to her patients, but CARECEN Care didn't pursue legal action. It's possible that this is because they didn't have the funds to enter a legal battle or because it would have been too hard to prove nursing neglect.

Taking Elizabeth Lauffer to court presented a couple problems for the elderly care facility. One hurdle would have been the difficulty in proving the allegations of abuse, and this was primarily because the victims weren't alive to testify. Also, as we've seen, oversight and recordkeeping weren't top notch at this facility, as Elizabeth was able to operate with little to no monitoring, bringing this incompetence to light would severely damage their reputation and ultimately give the nursing home some indirect culpability in Elizabeth's crimes.

It's very possible that CARECEN Care knew Elizabeth had done something sinister but kept quiet to save their own reputation and money rather than being forced to own up to what she did in court. Elizabeth was fired a sudden end shook her, but it didn't take long for her to find work at another nursing home called Meadow Park. She told them she'd had trouble administering medication at Crescent Care, but they dismissed her concern. Rather than rejecting Elizabeth because of her tainted past, Meadow Park offered her a new hunting ground in August of 2014, just five months after her disaster at Crescent Care.

Elizabeth murdered again. This time it was a 75 year old dementia and diabetes patient, Arpad Horvath. This only reaffirmed, regardless of where she worked, the impulse would return. Elizabeth could no longer blame Crescent care for her evils. Confronting this new knowledge had her yearning to dull her senses again. So the following month, she was delighted to see a pharmacist delivering four bags of prescription drugs to the Meadow Park facility. When no one was looking, she stole her share from the mother lode of narcotics and antipsychotics.

Perusing ample supplies of drugs like hydrocodone, hydromorphone and Seroquel, Elizabeth likely went for the hydromorphone, her long time sedative of choice after she stole what she wanted. She filed her resignation from the nursing home, citing addiction struggles as her reason for leaving that weekend. She overdosed and nearly died, landing herself in the hospital. Days later, the facility realized drugs had been stolen and suspected that it was Elizabeth, but she was gone and they never successfully reprimanded her.

According to Meadow Park, it was enough that Elizabeth claimed to be in a program to better herself. And she was. Elizabeth dedicated the next year of her life to overcoming her addictions. She regularly attended Alcoholics and Narcotics Anonymous meetings, working with sponsors to fight for her sobriety. And according to her own testimony, she spent the next year of her life drug and alcohol free. She even posted a caption to Facebook in celebration of her achievement. She wrote, One year ago today, I woke up not dead, 365 days clean and sober.

It seemed that Elizabeth had pulled herself from the dark place she had suffered in for so long. But even while she boasted to her online friends that she was actively recovering on the inside, Elizabeth still struggled. No matter what she did to try to heal herself, she couldn't get rid of that violent urge, the awful voice in her head that she could no longer believe was God. Whatever it was, Elizabeth didn't know where to turn to silence it. And at its behest, she would soon circle in on her next victim.

Coming up, Elizabeth attempts her final kill. Now back to the story. Elizabeth Webb spent the majority of 2015 getting clean and sober after murdering eight elderly residents during her employment at two nursing homes in Canada, and for a brief time, she thought she might be on the right track when she sought work again.

She no longer looked at long term care facilities. She knew that one of her triggers was a hefty patient load, so she figured her best option would be to pursue temporary care in private residences. There'd be fewer drugs tempting her to use and fewer patients tempting her to murder. She reached out to multiple temp agencies and began going on long term contracts with specific patients who needed nursing assistance from their home.

But August 2016 brought back an unpleasant sensation in Elizabeth. Her rage was rising again from someplace she'd never quite understood. And as it did, she wanted only one thing to kill again. She administered 180 units of insulin to her patient, 68 year old Beverly Bertram, a dose that Elizabeth herself described as huge.

Miraculously, Beverly lived after the incident. Elizabeth Salta new gig within her health care providers network and requested they transfer her. They countered with an assignment to a school with diabetic children.

This panicked Elizabeth, she'd managed to justify the many elderly patients she'd killed over the years, but she didn't dare put kids in danger. She couldn't accept the position. And the realization served as a wake up call. While before Elizabeth had been eager to move on from her past, the prospect of endangering children forced her to confront how she wanted the rest of her life to unfold. On the one hand, she could continue in the medical field where she'd likely kill more patients or she could seek help.

Taking rather drastic measures, Elizabeth resigned from the nursing agency and went on a road trip to Quebec in search of answers.

When she returned, she knew only one thing. She wanted to come clean about the victims she'd murdered. But first, she sought guidance from the Internet.

According to Lloyd Billingsley, author of Lethal Injections, on September 8th, 2016, 49 year old Elizabeth Westlaw Faran online searches of all the suspects she had killed. Then she read articles on killer nurses and insulin deaths. It was the first time she faced the repercussions of what she'd done, and it armed her with the guilt she needed to actually own up to her past. About one week later, on September 16th, Elizabeth checked herself into the Center for Addiction and Mental Health, or camp, in Toronto when she arrived at the facility.

She told them she was struggling with depression, drug use, thoughts of suicide and guilt.

She also told her psychiatrist, Dr. Alan Khan, that she killed nursing home patients with lethal overdoses. The revelation was shocking at that point, Dr. Kahn suggested she writes about what had happened in her own words, he may have had her do this knowing he'd have to file a report with the police. The concept of physician patient confidentiality is protected by the Health Insurance Portability and Accountability Act, or HOP. And doctors take an oath to uphold the principles of this act.

However, if a doctor becomes worried over a patient's safety or a patient threatening the safety of others, they're legally obligated to come forward and divulge their concerns to authorities in Elizabeth's case. Dr. Kanou, her personal safety was at risk due to her suicidal thoughts, and he also knew her nursing home patients were in danger because of her admitted killings. He would have been criminally liable here if he didn't break the physician patient privilege. This was likely something Dr. Conte did to further bolster or validate the report.

He knew he'd have to hand over to the police.

But Elizabeth wasn't focused on what came next throughout her time at the mental health facility, she complied with the doctors and even wrote out her crimes, as Dr. Khan suggested, in a rather organized fashion. She wound up with two lists, one labeled people who died, the other labeled people who didn't die. Her blunt admission astounded the facility's medical professionals, but it was even more shocking that she tried to justify each murder, blaming her victims for being untenable and stubborn.

Those explanations made it seem as though Elizabeth felt in part that she was right to kill. Yet she also insisted her attending physicians that she knew what she did was wrong. She said the same to the police interrogator on October 5th, 2016. Even with tip offs from Elizabeth's psychiatrist at Cambridge, law enforcement didn't have grounds to arrest her yet, so they brought her to a stark interrogation room at the Woodstock police station in Ontario, Canada, and invited her to get comfortable.

Across from Elizabeth, Detective Constable Nathan, her got of the Woodstock, Ontario, police zipped through introductions, observing Elizabeth's movements with a careful eye. He was surprised to see that Elizabeth wasn't agitated or out of touch. In fact, aside from occasionally pacing, she remained rather motionless as she admitted to killing eight elderly patients between 2007 and 2016. She was all too ready to explain herself as detective. Her got gently pressed her about her motives. Elizabeth said she hadn't been in the right mind and believe that if she'd been on the right medications, she wouldn't have killed.

She also brought up the voices within her that she once thought had been God forcing her hand. Interestingly, Elizabeth never seemed to mention this to her psychiatrist. So its accuracy remains in question, especially because this claim contradicts the rest of her story. Elizabeth emphasized time and time again that she knew exactly what she was doing when she administered the shots, she claimed to have been of sound mind, though she had been extremely angry despite her obvious mental health issues.

Elizabeth made it nearly impossible for herself to claim insanity in court, and maybe she didn't want to. Elizabeth didn't seem disillusioned about her fate, referencing the possibility of prison time more than once during questioning.

A day later, the judge released Elizabeth on a peace bond.

Under this, she had a curfew, was required to attend AA meetings, could not possess drugs and could not go to any care facilities. These stipulations were rather relaxed given the fact that Elizabeth had admitted to eight murders. But criminal law rules that a confession alone isn't enough to convict someone.

So for the next three weeks, while investigators compiled accounts from the facilities where Elizabeth had killed, Elizabeth bided her time at home. Neighbors later recalled that Elizabeth seemed unfazed.

Then, on October 24th, 2016, police arrested Elizabeth and charged her with eight counts of murder. She was almost immediately transferred to the Virginia Center for Women, which houses criminals awaiting trial.

During the months that followed, Elizabeth showed up in court proceedings via video chat, but each time she remained rather quiet as she told her police interrogator she didn't feel that sorry was enough. This sentiment may indicate that Elizabeth did feel remorse for what she'd done, but it didn't matter much to the families of Elizabeth's victims who were traumatized to discover how their loved ones truly died. They had to grieve all over again, this time facing the ugly truth. With this new knowledge, the families of victims, Arpad Horvath and Helen Mathison, agreed to have their loved ones exhumed and autopsied to help the prosecution build its case, but biochemists predicted that there was no possibility of finding insulin's since so much time had passed, it remains unclear whether any damning evidence was found in the bodies.

But one thing that did help the prosecution was Elizabeth's employee record at Crescent Care.

The prosecution leaned into her more than 40 reported incidents of medication errors, poor attendance, inappropriate sexual comments, unprofessional behavior and treatment mistakes, claiming it revealed a general disregard for others. Coupled with Elizabeth's own confession. The judge had heard enough. In June 2017, Elizabeth pleaded guilty to eight murders, four counts of attempted murder and two counts of aggravated assault. She was sentenced to eight concurrent life terms with no chance of parole for 25 years. The victims families exhales, sighs of relief, though they would continue to grieve.

The case did hold positive implications for the medical world.

In 2018, the province of Ontario investigated the systemic failures that allowed Elizabeth to continue killing for nearly 10 years. One year later, a four volume report totalling more than a thousand pages was made, providing 91 recommendations that aimed to clean up the Canadian health care industry. As of this recording, we hope to see them implemented soon. Still, the nursing homes weren't the only ones at fault for Elizabeth's murders.

Systemic barriers to proper nursing home care may have enabled Elizabeth, but they didn't excuse her 10 year killing spree. In a strange irony.

Elizabeth will ultimately be responsible for saving lives in the future, as her case brought about much needed reform to nursing home care, largely because of her oversight and assisted living facilities, has become more vigilant and strict. Her case also speaks to the importance of mental health maintenance for medical care providers themselves. We so often forget that people caring for us also need care, and it's clear that mentally or emotionally compromised health care professionals can sometimes do more harm than good.

And while Elizabeth's motive remains rather elusive, one thing is clear whether it was a voice commanding her as she claimed it was, or simply the raw desire to decide human fate, her lethal injections took lives. No rationale or act of repentance can justify the fact that she stood by repeatedly laughing in the glory of the red surge as life drained from her trembling victims.

Thanks for listening to medical murders and thanks again to Dr. Kipa for joining me today. Thanks very much.

For more information on Elizabeth Wet Loafer, among the many sources we used, we found the book Lethal Injections by Lloyd Billingsley. Extremely helpful to our research. You can find all episodes of medical murders and all other PARCA shows for free on Spotify, not only to Spotify. Already have all of your favorite music, but now Spotify is making it easy for you to enjoy all of your favorite podcast shows like Medical Murders for Free from your phone desktop or Smart Speaker to stream medical murders on Spotify.

Just open the app and type medical murders in the search bar. We'll see you next time.

Medical Murders is a Spotify original from podcast. It is executive produced by Max Cutler, Sound Design by Trent Williamson with production assistance by Ron Shapiro, Carly Madden, Kristen Acevedo, Jonathan Cohen, Alexandra Trick, the daughter, and Erin Larson. This episode of Medical Murders was written by Lauren Dalil with Writing Assistants by Megan Meier and stars Dr. David Kipa and Alistair Murden.

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