Lucy Letby was never seen to harm any babies, and almost all the babies who died had autopsies that identified natural causes or raised the possibility of accidents. The medical evidence against her started to be constructed only after her supposed killing spree had ended, by which time evidence was limited to what could be found in the medical notes or could be recalled by the four doctors who took their suspicions to the police.
The murder methods attributed to Letby were many, but the explanations followed three patterns.
The first pattern started by identifying a commonplace symptom and then arguing that this symptom was explained by deliberate harm. This explanation pattern was initially developed to allege that Letby was attacking babies by injecting air into the vein to cause an air embolism. This then became the template for explanations using other commonplace symptoms, such as bleeding, as their starting point.
The second pattern was much more specific. Test results, it was said, showed the presence of artificial insulin. Here, it was argued, there was direct evidence of poisoning.
The third pattern took a baby’s sudden, unexpected and (supposedly) unexplained collapse as evidence enough of foul play: the very fact that a baby had collapsed, even in the absence of evidence of commonplace symptoms, including air, was sufficient to diagnose that air had been deliberately administered to the baby. This diagnosis used a process of elimination. As Dr. Dewi Evans, the main expert witness for the prosecution, put the matter when looking back on the trial:
These are cases where your diagnosis is made by ruling out other factors, and you end up with the diagnosis where this is the only explanation. You’ve ruled everything out; what’s left is the diagnosis.
This medical evidence has now been so thoroughly discredited that it appears, almost literally in some cases, to have been conjured up out of the air. On May 13th 2024, a long article by Rachel Aviv in the New Yorker set out many of the problems in all of the evidence against Letby, including the medical evidence. (The article was censored in the U.K. due to ongoing trial but was easy enough to find online.) Then, on July 9th, two substantial articles in the Guardian and the Telegraph focused on flaws in the medical evidence. Both articles cited numerous medical experts, including neonatologists, who explained that there are any number of natural and accidental explanations that might account for the symptoms said to be evidence of murder or attempted murder. None of the supposed murder methods were viewed as more than possibilities, and unlikely ones at that.
The idea that babies were being murdered by forcing air into the stomach came in for particular criticism. The insulin evidence, superficially more convincing, was immediately invalidated by the testing facility explicitly warning that the test could not be used as evidence of poisoning. But even leaving this aside, several experts explained how the test results had been misinterpreted. As for Dr. Evans’s methods of diagnosis, no one amongst the experts had a kind word to say about them, and some were more or less openly contemptuous. More generally, the articles highlighted shortcomings in the state of the neonatal unit at the Countess of Chester Hospital where Letby worked, ones which suggested that insofar as the collapses and deaths of the babies were not the inevitable result of natural causes, they were the result of substandard care.
Given that the medical evidence against Letby is so poor, why was it that, on May 24th 2024, Dame Victoria Sharpe, Lord Justice Holroyde and Mrs Justice Lambert announced they would not allow Letby to appeal against her convictions?
To find the answer we need to look at the reasoning that underlies their judgment, published on July 2nd 2024. However, before entering in to this reasoning, I first rule out three explanations for why the judges denied the appeal.
- Were the judges so constrained by the laws on appeal that they could not do otherwise? No. I rule this out with the general observation that judges have considerable flexibility. The Appeal Court judges could have easily come up with reasons to grant leave to appeal if they had wanted to.
- Did the judges realise that Letby should never have been found guilty, but decide to deny her leave to appeal anyway for reasons of their own? No. I rule this out on the grounds that the judges were mistaken rather than evil.
- Did the judges arrive at their decision by knowingly drawing on the reasoning in comparable cases in the past? No. I rule this out because there are no references in the judgment to such cases. There have occasionally been cases that seem closely comparable to Lucy Letby’s, including the Lucia de Berk case in Holland, when a paediatric nurse was convicted of multiple murders and attempted murders, and was only some years later found not to be guilty after all. Obviously the judges did not consider this case. However, there are also a large number of U.K. cases, including civil cases, that are broadly similar to the Letby case insofar as: (a) babies or children have died or have signs of injuries; (b) the evidence that the death or injury has been caused by the suspect (typically a parent or step parent) is circumstantial; (c) the question of whether natural or accidental explanations for the deaths or injuries are plausible is critical to the outcome of the case; and (d) there is contested expert medical evidence.
There is surely much wisdom contained in the judgments of these other cases. And had they considered them this might have helped the Appeal Court judges in their reasoning over what is needed, in these types of circumstances, to get at least some way towards certainty of guilt (civil cases are decided on the balance of probabilities). Whether the accumulated wisdom to be found in these cases would have supported the judges in upholding Letby’s guilty verdicts is another matter. But all this is bye the bye, as the Appeal Court ignored the whole lot.
So what explains the reasoning of the judges? In part they simply took a view diametrically opposed to those of the medical experts cited in the New Yorker, Guardian and Telegraph articles. Thus, they argued that Dr. Evans had been maligned by the defence and, they implied, by a judge who had called his opinion in another case “worthless”. Dr Evans, they argued, had a sound holistic method of diagnosis. Furthermore, it was Evans, they said, who had discovered the insulin evidence (although Dr. Stephen Brearey emphatically claimed that he had); this insulin evidence provided proof of poisoning, and so on. However, the judges’ reasoning also explicitly followed a legal pattern of argument that had been developed particularly when dealing with fraud cases.
Fraud cases are notoriously complicated for jurors to understand, so to make things as easy as possible for them, judges draw the distinction between (a) what is essential to secure a conviction and (b) what is a mere matter of ancillary detail. “Concentrate on the essentials,” the judge tells the jury. “If you are sure that the defendant is guilty on the grounds of these essentials, you do not need to agree over the matters of detail.” The Appeal Court took this distinction and applied it to the medical evidence in the Letby case. The medical evidence contributed to the evidence as a whole, but it was only as part of this whole that it could be said to be essential. Considered in isolation, the medical evidence was a matter of detail; it was not essential to the prosecution case.
This argument comes out when the Appeal Judges explain that Judge Goss was quite right to tell the jury that it could convict Letby of murder and attempted murder even if it was unsure of precisely how she killed or tried to kill the babies. Goss had said:
If you are sure that someone on the unit was deliberately harming a baby or babies you do not have to be sure of the precise harmful act or acts; in some instances there may have been more than one. To find the defendant guilty, however, you must be sure that she deliberately did some harmful act to the baby. (para 155)
Letby’s defence argued that this was a misdirection: that without knowing how Letby killed or tried to kill the babies, one could not be sure that she had done so at all, given the possibility that deaths and injuries might have natural and accidental causes (including substandard care).
The prosecution countered that “they did not have to prove the precise – or any – mechanism by which death was caused or attempted” (para 159). After reminding the Appeal Court judges of famous cases in which murder convictions had been obtained without a body, the prosecution then brought up the distinction so useful to fraud cases, between matters which are essential, “an ingredient of the offence”, and those that are “a merely evidential – or ancillary – issue”.
The appeal judges agree with this distinction (para 160). They explain it using a hypothetical example that if a jury were sure that someone caused actual bodily harm by having “unlawfully punched and/or kicked his victim”, it was a mere matter of detail as to whether it was a punch or a kick or both that caused the injury; there is no need to be precise about it. But then (para 163) they seem to have second thoughts, raising a well-known complication in a real case involving a fatal attack. In this case, the defence’s argument is different according to “whether the fatal blow was a kick (to which the defendant’s defence was identification) or a punch (to which his defence was self-defence)”. Here a punch or a kick is not a mere matter of detail because the jurors might find one defence plausible and the other not. In such a case, therefore, the jury have to decide on the precise blow before they can be sure whether to convict.
The Appeal Court was quite right to raise this complication, as the medical evidence is clearly of this type. The various alleged ways in which Letby killed or harmed babies each had different alternative natural and accidental explanations put forward by the defence. For example, the defence argued that liver damage in the case of Baby O might have been caused inadvertently by CPR, or by insertion of a cannula, whereas air in the stomach may have been an inadvertent side effect of CPAP, and so on. The jurors might find at least some of these accidental or natural explanations plausible. Therefore, in order to be sure to convict, the cause (or causes) of death or of harm for each baby had to align precisely with ones where the jurors agreed that the specific alternatives put forward by the defence could be ruled out.
It is at this point that the Appeal Court judges make a bizarre mistake in their reasoning. They argue the opposite, that the medical evidence in the Letby case was akin to the hypothetical situation where whether it was a punch or a kick did not matter. The jury, they claimed, could exclude all the possibilities put forward by the defence without needing to agree “on the precise act or acts which the applicant committed” (para 165). The judges asserted that the jury could exclude these possibilities by considering not just the medical evidence but the evidence as a whole, including things such as the apparent confession on the post-it note and the “trophies” (meaning the handover notes) (para 164).
How such non-medical evidence rules out the possibility that, say, bruising on the liver is the result of CPR, the judges do not explain. But perhaps this lacunae helps to explain their own thinking. The judges sound rather tired of trying to get their heads around the case. They write virtuously of having to read “a vast volume of material” (para 17). No wonder it was tempting, even if mistaken, to categorise the medical evidence as an ancillary matter; the tiresome business of going through all the medical evidence bit by bit could thereby be disposed of by the Appeal Court judges, just as it could be by the jury at the trial. It was just a matter of detail. It was the whole thing that made Lucy Letby guilty.
In a case involving so many alleged victims, this reasoning would be highly suspect even if the non-medical evidence was strong. In fact, the other evidence was remarkably weak: the handover notes, the Facebook searches, the roster chart, all were cherry picked. The swipe data, on who was and who was not present at each incident, has had its accuracy called into question by the retrial.
The only substantial evidence against Lucy Letby is the post-it note, in which she wrote “I am evil I did this.” This, the prosecution claimed, provided the case against her “in a nutshell”.
The post-it note provides real evidence, but what this evidence means is ambiguous. When isolated individuals are remorselessly pursued by powerful authorities, they often do confess to things, as ‘witches’ confessed to flying on broomsticks. And if we are to believe the note, which part of it are we to believe? It cannot all be true, because in the very same note, Letby said that she had done nothing wrong, and that the police investigation was founded on slander, discrimination and victimisation. Given all that we now know, it is surely far more likely that it is this part of the note that puts the case against Letby in a nutshell.
Dr. Peter Hayes was for many years a Senior Lecturer in Politics at Sunderland University. With academic research interests cutting across medicine and law, he authored numerous publications in both medical and legal journals.
Stop Press: Several former Cabinet ministers have expressed concern over the conviction, with the issue likely to be raised in Parliament, according to the Telegraph. The Royal Statistical Society has also announced it will “convene a meeting”, stating that it is aware of “concerns” from RSS members and the wider community regarding the use of statistical evidence in the case.
To join in with the discussion please make a donation to The Daily Sceptic.
Profanity and abuse will be removed and may lead to a permanent ban.
Guilty or not, the case is useful for distracting attention from the Unmentionables.
You have a point M A k and if true it confirms the evil and depravity infesting the establishment.
The most telling passage for me is this:
“The judges sound rather tired of trying to get their heads around the case. They write virtuously of having to read “a vast volume of material” (para 17). No wonder it was tempting, even if mistaken, to categorise the medical evidence as an ancillary matter; the tiresome business of going through all the medical evidence bit by bit could thereby be disposed of by the Appeal Court judges, just as it could be by the jury at the trial.”
I rather suspect this is what has overtaken these judges. Basically yet another version of CGAF, too lazy and quite possibly not bright enough to go through pages of medical evidence. Far easier to condemn a poor girl to a lifetime of prison rather than do a job properly.
The real criminals are still free and masquerading as doctors in our hospitals.
That’s exactly it Hux, and they brook no dissent in the Stalinist National Harms Service.
Even hunger can do it.
https://www.discovermagazine.com/the-sciences/justice-is-served-but-more-so-after-lunch-how-food-breaks-sway-the-decisions-of-judges
This case stank from the beginning.
The reason we have cases like this and the Post Office scandal is too many dodgy barristers and judges – particularly judges who were dodgy barristers. And one dodgy judge or barrister is too many.
How is it none of the prosecuting barristers noticed there was something wrong about so many people supposedly dipping their fingers in the Post Office till?
And what about the judges?
Don’t pretend none of them noticed something was amiss?
Medical evidence has a history of being dodgy too and so have the experts who give it – not all mind – but enough and one is too many.
Don’t forget Roy Meadow who invented the Munchhausen’s Syndrome by Proxy theory which was without any scientific basis and trashed in the High Court. And then he gave evidence of a one in a billion or so chance of two children in the same family dying suddenly when the probability was less than one in two thousand – it being more likely that such children might be genetically disposed to dying of sudden death.
And of course we cannot trust anything in medical journals as three British Medical Journal editors proved here: How the case against Andrew Wakefield was fixed – in eight steps
There is free to read explanatory text on each page with five free to view/listen videos and podcasts, with also a paid option.
Euripides has still not been sued by the BMJ and he claims he never will be as it is all true.
When one reads the so-called “confession” on the post-it note it sounds less like a confession and more like the confused rambling of somebody under immense stress as a result of the investigation and the allegations against her. As the author says, accused people under such stress can not only admit to things they haven’t done but actually start to believe they’ve done them. Given the flawed medical evidence, absence of witnesses, absence of forensic evidence, absence of any prior criminal behaviour, absence of mental health issues, and her good reputation among the nurses, then I think the note was not a confession of anything.
I understand the infamous shift rota was a major plank in the “evidence” against her, even though it was presented devoid of context. I go to my local supermarket often. If somebody drops dead in the shop does that make me guilty of murder? That seems to be the level of logic applied in the Lucy Letby case. I really hope and pray that poor woman doesn’t give up hope.
Yes, I agree. I read the post-it note shown in the article in the Telegraph. It certainly gave the impression of someone who was at their wits end with the sadness of all the things she was having to deal with.
She was well-liked by the other nurses and the “statistics” that were presented as another piece of “evidence” have been torn apart by many eminent statisticians as utterly flawed.
I also gleaned from the DT article that the medics who took the matter to the police (or gave evidence – I forget which) have been given life-long anonimity protection.
Anyone who is convinced she is guilty should maybe read ll about poor Sally Clarke –
https://www.markedbyteachers.com/university-degree/law/the-case-of-sally-clark.html
But don’t mention the FACT that her son was jabbed a matter of hours before he died.
The Judge would not allow evidence of that, after hearing expert evidence from… bigpharma.
As I started to read this article, the Matthew Eappen case came into my mind (UK au pair working in US accused of shaking baby and causing death, sometime in the mid 1990s). I wonder now if he was vaccine damaged.
The au pair was Louise Woodward. She was accused of shaking the baby violently, causing brain injury. The defence presented medical evidence showing that the head injury was three weeks old – the bones had started to heal. The jury decided to convict anyway. The judge reduced the conviction from murder to manslaughter and released her.
American juries convict in over 95% of cases, regardless of the evidence; whenever someone in the US is arrested, their defence lawyer will advise negotiating a plea bargain, because nobody gets a fair trial.
The evidence regarding Matthew Eppen was that he had already had a fractured wrist which was an old injury. Louise Woodward was not accused of that but it begged the question – who did it?
It was a question never investigated before or during or after the trial.
It is one of those pieces of evidence conveniently ignored – like the supposed blood sample of Henri Paul, driver of the car which crashed and lead to the deaths of Dodi Al Fayed and Diana Princess of Wales.
The blood sample was clearly switched from a recent suicide as it had extremely high levels of alcohol and lethal levels of carbon monoxide.
The evidence and video evidence of Henri Paul showed he was sober prior to getting into the car.
The blood sample vanished so could not be checked against Henri Paul’s DNA.
It disturbs me when the talking heads (JHB is one of the worst for this) say things like “X was found guilty in a court of law….” as if that was the end of it.
You’d think those experienced in news presenting or journalism in general would be MORE open to the idea that injustices happen and not all that rarely.
This whole case feels very dodgy; I hope all the digging that’s going on (Norman Fenton did a good interview with someone about this case) will raise public awareness because nothing else will shift the wigged ones.
A few months ago I read a very detailed analysis of this case (apologies, I don’t recall the source). It convinced me there were significant problems at the unit that combined were contributing to the mortality rate. For one thing the alleged actions of Lucy would have to have been done in a location in full view of anyone walking past but there was also a lot of data about a sequence of errors that led to each fatality.
I believe this poor woman has been found guilty lest the truth of the situation tarnish the reputation of our impeccable NHS.
If people were to start doubting its sacrosanct status they may feel less inclined to keep funding it ip to the hilt.
It also sounds like her defence team perhaps missed a few tricks that would have placed some doubt in the minds of the jury.
That’s my view, for what it’s worth.
Detailed analysis of the Letby case here that I think some are referring to here … https://lawhealthandtech.substack.com/archive
Thanks for brining attention to this case. From the start doubts were raised,
Did the anonymous grasser,s have to appear in court I wonder ?
A very poor decision made by a broken judicial system. I am sorry for Lucy. She was a scapegoat for a broken NICU. An underperforming dept of the nhs.
“If you are sure that someone on the unit was deliberately harming a baby or babies you do not have to be sure of the precise harmful act or acts; in some instances there may have been more than one. To find the defendant guilty, however, you must be sure that she deliberately did some harmful act to the baby. “
So we have not really progressed much from the bad old witch burning days .
She’s a witch
Are you sure?
Yes
Ok, burn her.
There is very little evidence against her and she has been made a scapegoat for the failings of the CoC Hospital.. I live near there and it has always had a poor reputation.