He exhibits many of the traits of serial killers. I suspect that his psychological profile would probably indicate that he aroused by his decisions that are directly responsible for the deaths of people.

He believes he is more intelligent than everyone and exhibits a godlike complex. There are many examples of doctors with this same personality type that were serial murderers.

He hides his murderous lust behind the bureaucratic protection of his role in government where he can carry out his form of killing while believing he is immune from prosecution by the cattle he believes he can so easily kill.

His modus operandi is quite literally using and abusing his bureaucratic authority to make decisions that determine if people live or die. He's able to kill and gratify himself without being caught.