The case of Lucy Letby, a serial killer masquerading as a nice neonatal nurse at Countess of Chester Hospital in Northern England, is so horrific as to beggar belief.
On Aug. 18, the 33-year-old Letby was convicted of murdering seven babies and attempting to murder six others between June 2015 and June 2016. She was sentenced to life imprisonment without the possibility of parole.
Over the past few days, the British media has also reported on other mysterious infant deaths when Letby was present, suggesting that the total number of murders from a woman who has become known as the worst serial killer of children in British history was not fully accounted for.
Perhaps the closest equivalent to this United Kingdom case came some years before and dealt with a similarly vulnerable population but one at the other end of life’s journey.
A primary care physician based outside Manchester, Harold Shipman, was found guilty in 2000 of murdering at least 15 patients under his care. Shipman’s victims were elderly people who, of course, trusted him. But Shipman was a killer, not a healer, quietly murdering his victims either by dispensing a lethal dose of drugs or prescribing familiar medicine in quantities that led to a fatal overdose.
But while the medical profession in both cases went to considerable lengths to obscure what they really were doing, both were able to profit from a kind of built-in bias. Not every newborn survives, even in good hospitals, and we’re conditioned to think that there sometimes might be an air of mystery about their fate. Similarly, we are conditioned to believe that old people can die suddenly. As a consequence of those pervasive lines of thoughts, Shipman and Letby evaded discovery for enough time to kill more people.
In both cases, family members have demanded answers as to why it took so long. There is no question that part of the problem was that those who had misgivings about the sudden rise in deaths had to overcome the general assumption that medical professionals are to be trusted.
What are the lessons here on this side of the Atlantic?
For one, effective medical teamwork requires looking out for malevolent colleagues. However rare they may be, the Shipman and Letby cases prove they do exist. For another, family members deserve, and should demand, full disclosure about what happened to loved ones who die while medical professionals are present. While death can be shrouded in the unknown, that must not be allowed to prevent families being sure they are comfortable that what transpired was inevitable. And, for a third, medical directors and other hospital administrators must cultivate open door policies so whistleblowers are willing to come forward with any misgivings.
Much of that requires often harried medical professionals to build in more redundancies, as well as peer checks and balances. Nobody wants to be under the constant scrutiny of their peers, but these were life-or-death matters, and a normal human reluctance to consider the worst enabled the loss of innocent life and unspeakable anguish.
Pride must be swallowed and systems rebuilt and maintained so it never happens again. Anywhere.
