Beatrice Yorker’s research on serial murder by health care professionals and Munchausen by Proxy has led to more safeguards to protect patients and children.
By Charles McNair
Early in her career, roughly once a week, Bea Yorker (J.D. ’88) saw a child with suspicious burns, fractures or bruises. Blood in the underpants. Anxiety.
The shocking frequency of classic signs of child abuse shook the young clinical specialist. This was 1982 in downtown Atlanta, when Yorker worked part-time in Child and Adolescent Psychiatric Mental Health Consultation Services at Grady Memorial Hospital and Children’s Healthcare of Atlanta. She also attended Georgia State Law part-time.
“I had no inkling that in pediatrics one of the components of treating mental health issues was to deal with the fact of child abuse,” Yorker said. “It surprised me as well as my colleagues.”
That experience set the course for Yorker’s life work.
After earning her J.D., she involved herself more and more deeply in probing the shadowy corners of the psychology of human care. Her investigations led to a law review article on covert video surveillance of a rare form of child abuse — Munchausen Syndrome by Proxy, in which a parent makes their child ill for medical attention. Her interest in this type of abuse led to a landmark study on nurses accused of murder that established her as an authority in her field … and as a health care rights champion.
In 2006, in the Journal of Forensic Sciences, Yorker headed an international team of researchers in publishing “Serial Murder by Healthcare Professionals.” Spurred by the prosecution of Charles Cullen, a New Jersey nurse who killed at least 40 patients over a 16-year period, the authors examined 90 criminal prosecutions of health care providers.
The 90 cases had resulted in murder convictions for 317 patient deaths, with more than 2,000 other suspicious deaths attributed to convicted caregivers.
Yorker’s publication offered the most comprehensive overview ever seen of serial murder in clinical and hospital settings — a problem mostly unrecognized and little-discussed before the revelations of Yorker and colleagues.
Her profession took notice.
“A nice side effect of our look at the number of patient deaths and injuries,” Yorker said, “has been the safeguards such as barcodes for medication administration and strict pharmacy controls put in place to deter potential rogue nurses. Now it’s much harder to get away with injecting a patient with a lethal dose of medicine.”
Since 2010, just 14 percent of serial murder in health care has occurred in the United States. (International cases predominate.) Virtually every subsequent publication on serial murder in health care cites Yorker’s original work.
Yorker’s work led her to California State University, Los Angeles, where she serves as professor emerita in the College of Health and Human Services, School of Nursing. From 2005 to 2015, she oversaw that college as dean, also acting as a professor of Nursing and Criminal Justice & Criminalistics
“It’s my dream job, combining my love of forensics and nursing,” she said.
While dean, Yorker headed schools of Nursing, Criminal Justice, Social Work, Child Development, Public Health, and Criminal Justice and Criminalistics. Her university also built the new Hertzberg Davis Forensic Science Center, housing the Los Angeles Police Department and Los Angeles County Sheriff ’s Department crime lab and Forensic Science Institute, which provides state-of-the-art DNA, ballistics, trace evidence processing and other forensic analysis.
“I am very fortunate to have been able to close out my career in such an interdisciplinary and rewarding setting,” Yorker said.
Yorker recalls her Georgia State Law experience with great affection.
“I always felt welcomed and appreciated as a woman at GSU,” she said. “Coming from a female-dominated profession of nursing, I learned balance from entering a more traditionally male profession … although when I entered, there were many women in law, and now, since its inception, four out of six deans at Georgia State Law have been women.”
Yorker says law school increased her skills in court, handling cross-examination and confidently presenting to judges and juries about child abuse. (She teaches nurses today how to testify in sexual assault cases, family courts and even congressional hearings.)
Yorker credits founding dean Ben F. Johnson Jr. with helping her write to publish in professional journals. Steven Kaminshine, professor of law and former dean, helped her understand employment law, valuable when she became an academic. Marjorie Knowles, former dean and professor of law emerita, taught her about women’s issues in academia in an intimate seminar on women and the law.
“It is still difficult for women to find mentors in academia,” Yorker said. “Fortunately, I had Dr. Susan Kelley, [former] dean of the College of Health and Human Sciences at Georgia State University, who nurtured my academic career. We worked together on Project Healthy Grandparents, which assists grandparents raising grandchildren in parent-absent homes. She showed me how to successfully obtain funding for research that helps vulnerable children.”
Yorker’s work isn’t finished. Abuse in the health care arena persists, and professionals must be on watch. She has in the works a new, expanded follow-up study on serial murder in health care. And a task force she serves, the American Professional Society on the Abuse of Children (APSAC), published national interdisciplinary guidelines this year on Munchausen by Proxy, providing up-to-date guidance for practitioners, prosecutors, defense attorneys, judges and the lay public on how to recognize and appropriately handle this baffling type of child abuse.
“We as a society are very familiar with traditionally masculine forms of violence — shooting, bludgeoning, stabbing. We go after perpetrators of these obvious types of violence and try to put them away,” she said.
But?
“We are much less aware of traditionally feminine forms of violence — suffocation, poisoning, injection … so-called ‘killing with kindness.’
“Anycaregiver, in or out of facilities, can appear very caring but may insidiously poison or incapacitate. It’s easy for a judge or jury to convict a father who has beaten his kid, but not as easy to convict a mother who has injected fecal material into her child.”
Thanks to Yorker’s path-breaking work, health care today has a better chance of punishing these crimes and even preventing them from happening.