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The families of eight people killed by an Ontario nurse, as well as one of her surviving victims, lamented a fundamental lack of respect for human life in the province’s long-term care system Monday as they addressed a public inquiry probing the circumstances around the woman’s crimes.

In closing submissions at the inquiry into Elizabeth Wettlaufer, those most impacted by her actions called for an array of changes, from nursing-home staffing levels to coroner protocols, but railed most emphatically against what they saw as a lack of compassion that harmed everyone involved.

“The people with needs have a voice. Now that we’re sick, nobody listens,” said Beverly Bertram, who survived one of Wettlaufer’s attacks in August 2016. “If there was a change I would like to see happen, that would be respect given. Respect for individuals regardless of the roles they’ve played or will play in the future.”

Wettlaufer, 51, confessed to murdering eight patients and attempting to kill several more over the course of nearly a decade by injecting them with overdoses of insulin at care homes and private residences across the province.

Bertram pulled no punches when outlining the effect Wettlaufer’s attack had on her.

The 70-year-old said she no longer knows who she is after the attack, adding she is “consumed” by Wettlaufer and her actions.

But Bertram also told the inquiry that the same lack of compassion that allowed her fellow victims to die in relative obscurity also harmed their confessed killer, who told investigators about her long-standing struggles with addiction and mental health issues.

“She cried for help many times and none was given,” Bertram told the inquiry. “She was not paid attention to, and this is the aftermath of her journey.”

The son of one of Wettlaufer’s other victims also emphasized what he described as the system’s lack of compassion, but his emotional remarks were directed at what he perceived as the people and systems that allowed the nurse to prey on patients with impunity for years.

“I saw finger-pointing, I saw people throwing each other under the bus, I saw a lack of compassion,” said Arpad Horvath Jr. “For them to just come and put money and reputation in front of human life is pathetic.”

Horvath Jr’s father, 75-year-old Arpad Horvath Sr., became the last of Wettlaufer’s victims when he died at a London, Ont. nursing home in 2014.

His death came after Wettlaufer had already killed seven residents of Caressant Care in Woodstock, Ont. The inquiry heard that her crimes went undetected, and that she likely never would have been caught without her confession to police.

The nurse was disciplined several times by her employers at the facility, who ultimately fired her in 2014 due to multiple medication errors.

Caressant Care’s closing statements reiterated that the facility never suspected Wettlaufer’s crimes despite her mediocre work performance. The submission also states that the facility believes there were no systemic issues that “facilitated or concealed” the murders.

“Given what we know from (Wettlaufer’s) confession about her motives ... it is submitted that the crimes that she committed at (Caressant Care in Woodstock) could have been committed in any Ontario’s long-term care homes over the same period,” it said.

The public inquiry has heard that complaints about Wettlaufer began at the start of her career in 1995 and continued until her confession in 2016, weeks after the attack on Bertram. Wettlaufer ultimately pleaded guilty to eight counts of first-degree murder, four counts of attempted murder and two counts of aggravated assault.

Submissions from the families of Wettlaufer’s victims included a number of recommendations for improvements to the province’s long-term care system.

Those included calls for more substantive reference checks at long-term care facilities, overhauls to inspection protocols at the provincial health ministry, and standardization of death investigation practices among Ontario’s coroners.

A joint submission made by children of Wettlaufer’s first victim James Silcox, however, expressed open skepticism that those calls would be heeded.

“Without radical changes to the collective attitude towards the long-term care system as represented by the government of Ontario, we are not hopeful that the glaring problems unearthed by the inquiry will be solved,” four siblings said in a joint submission.

“The inquiry into long-term care has offered an enormous amount of insight into the failure of the province of Ontario to protect our most vulnerable.”

The inquiry will continue to hear closing submissions in the coming days, including from the other long-term care facilities where Wettlaufer worked, the coroner’s office, the Ontario Nurses’ Association, the College of Nurses of Ontario and the Registered Nurses Association of Ontario.

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