The prosecution of Charles Cullen, a nurse who killed at least 40 patients over a 16-year period, highlights the need to better understand the phenomenon of serial murder by healthcare professionals. The authors conducted a LexisNexis search which yielded 90 criminal prosecutions of healthcare providers that met inclusion criteria for serial murder of patients. In addition we reviewed epidemiologic studies, toxicology evidence, and court transcripts, to provide data on healthcare professionals who have been prosecuted between 1970 and 2006. Fifty-four of the 90 have been convicted; 45 for serial murder, four for attempted murder, and five pled guilty to lesser charges. Twenty-four more have been indicted and are either awaiting trial or the outcome has not been published. The other 12 prosecutions had a variety of legal outcomes. Injection was the main method used by healthcare killers followed by suffocation, poisoning, and tampering with equipment. Prosecutions were reported from 20 countries with 40% taking place in the United States. Nursing personnel comprised 86% of the healthcare providers prosecuted; physicians 12%, and 2% were allied health professionals. The number of patient deaths that resulted in a murder conviction is 317 and the number of suspicious patient deaths attributed to the 54 convicted caregivers is 2113. These numbers are disturbing and demand that systemic changes in tracking adverse patient incidents associated with presence of a specific healthcare provider be implemented. Hiring practices must shift away from preventing wrongful discharge or denial of employment lawsuits to protecting patients from employees who kill.

Factor analysis shows a three factor solution with ten items. The discriminatory power was good. High reliability was found for two factors and lower reliability for one factor. The patient-questionnaire for stance toward psychosomatic rehabilitation contains three scales: "knowledge", "confidence", and "motivation", and can be characterized as a reliable and economic instrument. After pre-treatment a general improvement was observed regarding patients' stance toward psychosomatic rehabilitation. The analyses result in significantly higher mean for patients with pre-treatment. Patients without previous information showed less "confidence" and "motivation". Pre-treatment can have a positive impact on the stance toward psychosomatic rehabilitation.

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The essay investigates if and how Greco-Roman theorists attempted to motivate altruistic behaviour and devise a social-welfare ethics. In comparison, it studies actual social-welfare practices on both the private and the state level. Various social-welfare tasks are touched upon -health care; care for the elderly, widows, orphans and invalids; the patron-client system as countermeasure to unemployment; distribution of land, grain, meals and money; alms, donations, foundations as well as education -with hardly any one of them being especially tailored to the poor. The enormous role of civil society -private persons, their households and associations -in holding up social-welfare functions is shown. By contrast, the state was comparatively less involved, the commonwealth of the Romans, especially in Republican times, even less than the Greek city-states. The Greek poleis often invested income such as wealthy citizens' donations in social welfare, thus brokering between wealthy private donors and less well-to-do persons. The church, living in private household structures during the first centuries, took over the social-welfare tasks of the Greco-Roman household and reviewed them in the light of Hebrew and Hellenistic-Jewish moral traditions.

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