Clinicians' autonomy till the bitter end--can we learn from the extraordinary case of Harold Shipman?

Harold Shipman has attained the dubious reputation of being the greatest mass murderer of modern times. A specific feature of his murders was that these were committed during regular general practice care, over a period of 20 years. There are no grounds to assume that Shipman's case is unique in itself, or unique to British general practice and this paper analyses ways in which the medical profession can safeguard itself against future medical murderers.