This could be the week that Marie Romero finally gets to look Charles Cullen straight in the eye and tell the former nurse and admitted serial killer how much pain he caused by killing her sister.

Romero's sister, Catherine Dext, was killed with an injection in June 1996 at Hunterdon Medical Center, where she had been admitted with a ruptured spleen.

"She's going to talk about how this deprived her of her sister and (how) it was a totally senseless, pointless death," said her lawyer, Anthony Macri.

A sentencing hearing is scheduled to begin Thursday for Cullen, who pleaded guilty to 29 murders and six attempted murders during his 16-year nursing career in New Jersey and Pennsylvania.

Cullen, 44, has told investigators he might have killed as many as 40 people, but authorities say that estimate appears to be inflated. Most of the victims were given an overdose of heart medication, usually digoxin.

The former critical care nurse was able to move from hospital to hospital, despite suspicions he was killing patients, because the institutions did not report their fears to authorities.

The sentencing may stretch out over two days because so many victims' relatives want to give victim impact statements.

"It has been a long and difficult process for these families," said Somerset County Prosecutor Wayne Forrest. "They see this as the end."

Cullen had filed papers to waive his right to appear at his sentencing, a move that outraged many of the families.

However, authorities had something Cullen wanted: the right to approve his request to donate a kidney to a relative of Cullen's ex-girlfriend. With that leverage, authorities persuaded Cullen to agree to appear at the sentencing.

"It is important that he be made to be there," said Macri, who represents the families of several of Cullen's victims. "That's something all the families want, to be able to confront him. They want to look him in the eye and tell them what they think of him and how much he hurt them. There's a cathartic value in that."

He faces life for each of the New Jersey murders and won't be eligible for parole for at least 127 years. In exchange for his plea and agreement to help identify his victims, he escaped New Jersey's death penalty.

State Attorney General Peter Harvey said he hopes to have all 22 New Jersey cases against Cullen resolved in this week's sentencing. However, the sentencing could be postponed by a week or two if no decision is made on whether to also bring charges in several open cases in Essex and Morris counties.

He also escaped death in Pennsylvania, where he still faces sentencing. A judge there already has ordered him to be present.

Harvey, who extensively interviewed Cullen, said the defendant attempted to rationalize his actions.

"He thought he was easing the suffering of people who in his view were going to die fairly soon anyway," Harvey said. "That's how he viewed the world. The question he found difficult to confront was who gave him the right to play God."

Johnnie Mask, Cullen's public defender, did not return calls last week seeking comment.