The problem with this, as with all the better “Evanite” arguments, is that they are fundamentally formalistic.
It is not about the substance of what happened, but the form. Rules have been followed, conventions complied with, and (ergo) justice done.
However vociferously they argue that Ms. Letby will stay behind bars, these arguments — and, look: they may well be transpire to be right, at least in the short term — do not engage with any of the substantive objections or concerns about the conviction.
1. The police and CPS were, from day 1, presented with a theory of harm which was never sufficiently tested against alternative, non-malice explanations. They have a legal obligation to consider these—a custom more honour’d in the breach—but rarely do so and plainly did not in this case.
2. No doubt influenced by the recent goings on at nearby Steppings Hill (Victorino Chua was convicted of healthcare serial murder just 20 days before COCH involved the police, and only 40 miles away) the Consultants were at grave risk of, and judging from their contemporaneous correspondence, clearly suffering from, confirmation and recency bias.
3. Alternative, non-malicious explanations for the collapses were orders of magnitude more likely, as a matter of prior probabilities (that is, leaving aside actual evidence gathered in the investigation).
4. The posterior evidence (that is, the actual evidence gathered in the investigation) did not significantly change the prior probability that the cluster of collapses had an “innocent” explanation:
(a) There was no direct evidence of Ms. Letby harming, trying to harm, or even speaking about harming, any infants.
We should not gloss over this: There were twenty-two allegations over a 14-month period. All took place in an intensely monitored environment (the clue is in the name: “intensive care”) and notwithstanding explicit (if misguided) suspicions held by senior consultants on the ward who were both in a position to monitor Ms. Letby’s behaviour and under a professional obligation to do so. These suspicions date from June 2015. So we are expected to believe that Ms. Letby got, literally, away with murder, whilst being suspected of it, for twelve entire months without anyone seeing anything. This, as a matter of basic probability, is pretty unlikely in itself.
(b) The evidence specifically implicating Ms. Letby over any other person is *remarkably* weak: some handover notes (at the time, nurses taking handover sheets was in the media as a common concern across the NHS, so hardly indicative of murderousness), her contractual duty to be on the ward, and some ambiguous notes made years later in therapy for depression occasioned by her arrest.
(c) The medical evidence (none of which, bear in mind, specifically implicates Ms. Letby at all—not even circumstantially) is also weak, much of it tendentious and speculative and in any case all of it is comfortably capable of alternative explanation.
5. The main medical expert was, and remains, highly problematic. He was plainly wrong about his critical diagnosis, he completely misunderstood a paper about a rare and non-specific condition (air embolus), and plainly was not dispassionate (something for which he had been criticised in other cases) nor comprehending of his limited role as an expert witness. Rather than a careful scientific analyst, Dr. Evans acted as witchfinder general.
6. The case was conducted in a media atmosphere which strongly presumed Ms. Letby’s guilt.
7. For reasons we do not know but perhaps are related to the above, the trial judge repeatedly ruled against the defence on key procedural matters about disclosure, order of evidence, and credibility of witnesses in ways that plainly damaged the defence case.
7. Ms. Letby had no motive, no history of criminal, behavioural or psychiatric disorders, no drug or alcohol dependency, no disciplinary record, was popular with her colleagues, well-liked and widely regarded as an excellent nurse. There is simply no reason she would start murdering defenceless premature infants in an intensive care unit.
8. The victims were seriously ill premature infants requiring intensive care in a hospital that was underperforming even at its stated operating level, and was handling children it was not equipped to treat even if functioning properly. It had recently received a severely critical review by the Royal College of Physicians, and was undergoing a pseudomonas infection on the ward. While there is no extant evidence of these as direct causes of collapse, that does not mean they were not: absence of evidence is not evidence of absence. And in any case, nor was there any direct evidence of murder!
9. While the COCH cluster was an unusual spike and well over the unit’s annual average, it was not statistically extreme, and was not even the most significant cluster in a maternity hospital that year.
10. Given the lack of direct evidence and the tacit reliance on probabilities (Ms. Letby was essentially convicted “because it cannot have been a coincidence she was always there”), there was no statistical done,. much less any statistical evidence led at trial. Indeed the crown prosecution service directed that a statistical inquiry be discontinued, apparently in breach of obligations to consider alternative explanations.
In summary, these are significant substantive concerns. It may be they do not amount to new evidence, but that is hardly the point: the whole problem is there wasn’t *any* good evidence!
Yes: these are substantive and not formal points and yes, Ms. Letby was nonetheless formally convicted upon what some would pass for due process.
What I don’t understand is how anyone can be comfortable that a system that is ostensibly functioning correctly—we will have to agree to disagree about whether it is actually functioning correctly, but still—can produce a result that is so obviously, manifestly, perverse, because:
There, but for the grace of God, go you.
Need your help Twitter. A neighbour’s autistic daughter needs a new fire engine. It has to be this and only this one. Mum is desperate. Manufacturer Galey but no longer made. We can do this. Pls retweet.
@DrNeenaJha I didn't, I'm a nurse and I'm on a run of nights so I was sleeping. Probably lots of others in my situation too, and others working in the day.
Meet Forest❤️born at GDS & unbelievably still here. Sweet natured Podenco loves to play & go walks. Born in a refuge & still here 16mths later... lets change that by sharing far & wide. Forest needs a home🙏🏻❤️ https://t.co/SR6fFvwX8Q