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Michael Cook
Michael Cook is the editor of MercatorNet. He lives in Sydney, Australia.
Last week English neonatal nurse Lucy Letby was found guilty of murdering seven babies and attempting to kill six others. The attacks took place between June 2015 and June 2016 in a ward for premature babies in Countess of Chester Hospital, in the city of Chester.
On Monday the 33-year-old nurse was given a whole-life sentence, the severest possible penalty under English law.
Her crimes ought to influence how we perceive “voluntary assisted dying”. But first the facts of the Letby case.
Letby refused to attend her sentencing hearing at Manchester Crown Court and so the judge had to speak to the empty dock. Mr Justice Goss declared that “there was premeditation, calculation and cunning” and “a malevolence bordering on sadism” in her actions. “During the course of this trial, you have coldly denied any responsibility for your wrongdoing,” he said. “You have no remorse. There are no mitigating factors.”
Letby’s trial took 10 months and the jurors deliberated for 22 days. She steadfastly maintained her innocence, so the evidence was largely circumstantial. There had been a spike in deaths while she was working in the neonatal unit. When doctors began to investigate, they concluded that the only common factor was her presence.
Some of the babies were killed with overdoses of insulin, some by injecting air into veins, one by force-feeding him too much milk. Two babies who survived suffered severe brain damage.
After long delays, Letby was assigned to a desk job late in June 2016 and was finally arrested in July 2018.
When police eventually searched her home, they discovered bizarre words scrawled on post-it notes. These included phrases like, “I AM EVIL I DID THIS, I killed them on purpose because I’m not good enough, I don’t deserve to live, I am an awful person.”
As soon as she was removed from the ward, the deaths stopped, according to The Guardian. Since then, more than 2,500 babies have been cared for in the neonatal unit and there has only been one death.
Questions about Lucy Letby
There are two unanswered questions which hover over these ghastly crimes.
The first question is the killer’s motivation. What baffled everyone about Lucy Letby, who is the worst baby killer in modern British history, is how normal she was. She appeared to be cheerful, competent, confident, and caring. She enjoyed holidays and partying with her friends. None of her colleagues had the slightest suspicion that she might be responsible for the mounting death toll. “It can’t be Lucy. Not nice Lucy,” a doctor recalled saying when the evidence began to point to her.
The prosecution suggested that she might have enjoyed “playing God” by resuscitating babies in a crisis. She had been flirting with a doctor and she may have wanted to impress him. Whatever her motives were, she certainly didn’t fit into the stereotypes of a psychopath.
The second question is why the hospital administrators reacted so sluggishly.
In June 2015, after three deaths, the chief doctor on the neonatal unit, Stephen Brearey, and the hospital’s nursing director saw that Letby had been involved in all of them. After more incidents, Brearey requested an urgent meeting with hospital executives in February 2016. Nothing happened until May 2016 when the administration wrote a letter in which they said: “There is no evidence whatsoever against LL [Letby] other than coincidence”. It was not until the end of June and two more deaths that Letby was removed from nursing.
One doctor recommended raising the matter with the police. He alleges that he was told that this would risk damaging the hospital’s reputation and would turn the neonatal unit into a crime scene.
Two external reviews were ordered which the hospital executives regarded as exonerating Letby, although they were not actually reviews of her responsibility for the deaths. In January 2017 the hospital administration even demanded that seven doctors sign a letter of apology to Letby for bringing her name into disrepute. “We are very sorry for the stress and upset that you have experienced in the last year,” the letter said. The doctors were also told that Letby’s parents had threatened to report them to the General Medical Council. Two of the doctors were ordered to attend mediation sessions with Letby. One of them complied.
It was only in May 2017, following continuing pressure from the doctors, that the police were called in.
Dr Brearey told the BBC that it seemed that hospital executives were trying to “engineer some sort of narrative” to keep the police from investigating. “If you want to call that a cover-up then, that’s a cover-up.”
Questions about ‘voluntary assisted dying’
These crimes also raise serious questions about whether safeguards, however strict, will deter serial killers like Letby when assisted suicide and euthanasia become legal. Healthcare workers who kill are rare, but they do exist. English nurse Beverley Allitt was convicted in 1991 of four baby murders. English doctor Harold Shipman was convicted in 2000; he is believed to be responsible for 250 deaths. American nurse Charles Cullen was convicted in 2004 of 29 murders, but he may have killed as many as 400. German nurse Niels Högel was convicted in 2015; he may have killed 300 people.
First, a warm and confident façade can mask a murderer. Letby’s dominant characteristic was “niceness”. Many doctors who regularly perform euthanasia are perceived as caring, compassionate individuals. Most of them, however misguided, probably are well-meaning. But there is no guarantee that some of them will not overstep the mark.
Second, who will ever know? In a normal hospital setting, doctors and nurses are dedicated to saving lives. With euthanasia, their intent is to end lives. The measure of the success of a “voluntary assisted dying” regime is more deaths — always, to be sure, more voluntary deaths. Rising numbers of deaths indicates to euthanasia supporters that there are fewer barriers to choosing VAD. VAD would provide a good cover for someone like Lucy Letby.
Third, the murderer’s bosses are bound to sweep crimes under the carpet. Time and time ago, in settings ranging from sexual abuse to politics, managers stonewall and cover-up. Medical murderers are devilishly hard to detect, as Letby’s case demonstrates. The reputational risk for bureaucrats is immense and they will battle to protect their organisation’s image until the evidence is overwhelming.
Canada ought to bear in mind the crimes of Lucy Letby when it considers enlarging the scope of its euthanasia laws.
The latest development is proposed guidelines which practically require doctors and nurse practitioners to recommend medical aid in dying to people who might qualify.
The Model Practice Standard for Medical Assistance in Dying (MAID) was released in March, but the most sinister of its proposals was only noticed recently. Section 6 says that patients must be informed of MAiD if “MAID is consistent with the person’s values and goals of care”.
Unless you are clutching a copy of the Qu’ran or a Rosary, activist doctors will probably assume that MAiD is consistent with your values. And if a sweet young thing like nice Lucy Letby whispers that MAiD would be soooo good for you, wouldn’t you be inclined to agree?
