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It is essential to mention that Patrick does not kill each woman he has / had sexual intercourse with. The key factor of his choice would be simple were it not for one exception. For the first sight it seems that Patrick picks assorted prostitutes serving for hard sex followed by torturing and killing whereas ladies from the upper-class are protected from being murdered just because of the fact that they have a certain social status. This theory is broken by Patrick's ex-girlfriend Bethany. She is also an upper-class figure (otherwise Patrick would not have gone out with her) with whom Patrick had a relationship at college. Nevertheless, she deserves to die according to him. And die she will. More about her death is included in the chapter "Violence".