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Most reasonable people acknowledge that Karl Helge Hampus Hellekant has committed a grave moral offense: the 33-year-old Swede, also known as Karl Svensson, was convicted of killing trade unionist Björn Söderberg in 1999 at the behest of the Swedish neo-Nazi movement. What is not so clear is whether Hellekant, who is currently free on parole, should be permitted to become a physician. The former extremist was admitted to the medical school at Stockholm's Karolinska Institute in 2007, but later expelled--following considerable public debate--after school officials discovered that he was temporarily unable to verify his academic records. Sweden's most prestigious medical school, Uppsala, subsequently confirmed these records and matricatulated him in 2008. However, the Uppsala County Council, which administers the region's medical facilities, has so far refused to let Hellekant perform required clinical duties at its sites, leaving his future prospects for obtaining a medical license in doubt. The case had generated much controversy in Scandinavia, a region known for a lenient penal culture that prides itself on short prison sentences and the successful reintegration of convicts into society. However, the case raises an ethical dilemma for medical authorities across the globe: Should serious past criminal offenses be per se exclusionary criteria for admission into medicine and the related healing professions?
Current rules governing the admissions process in the United States make the likelihood of a convicted murderer gaining entrance to medical school extremely low. Since 2005, the Association of American Medical Colleges has recommended that all medical schools conduct background checks on applicants. Many states require a similar screening of prospective medical residents or to obtain a license. Although candidates are handled on a case-by-case basis, one has little realistic possibility of gaining an initial license with a prior felony conviction. An examination of media reports and court records reveals what one might expect: No unlicensed person convicted of a violent offense appears to have been admitted to the practice of medicine in any state since background checks were first implemented. This may be because medical schools function as a fine sieve, culling out past offenders. Or ex-felons may give up on pursuing a medical career before they actually start, recognizing that they have no chance of passing muster...