“I killed them on purpose because I’m not good enough to care for them…”
“I am a horrible evil person…”
These were some of the dark sentiments found among Lucy Letby’s notes when she was first arrested on suspicion of murdering numerous newborns over a one-year period. Following her recent conviction, questions are being asked regarding the failure to intervene earlier after colleagues raised initial concerns surrounding Letby’s proximity to each death:
“The failure of hospital executives to take urgent action cost the lives of at least two babies – two triplet brothers, murdered within 24 hours of each other – and prolonged Letby’s attacks on other newborns at the Countess of Chester hospital in north-west England, senior doctors believe.” [2]
As more details are revealed behind what amounts to ‘crimes without parallel in modern Britain’,[3] this article intends to focus slightly further afield, both historically and institutionally, to explore the premise upon which malevolent criminality of this nature can be perpetrated – in plain sight – without recourse to swift and immediate ramifications. Lessons do not appear to have been learned following the equally disturbing cases of former paediatric nurse, Beverley Alitt, currently serving 13 life sentences for the murder and attempted murder of children, and Harold Shipman. He continues to haunt our collective memory as one of the most prolific serial killers in recent memory, responsible for the murder of hundreds of patients.[4]
Playing God?
Unlike Harold Shipman, Letby’s motivations behind such heinous crimes are not entirely clear and psychoanalysis of her case will likely continue into the foreseeable future. Shipman however:
“…had a “God complex”… It was like he was deciding whether to let people live or die, almost like mercy killings.” [5]
When examining the cases of serial killers, we are often fascinated by the more macabre details, particularly when the perpetrators have appeared unassuming – indeed, demure in their character. Letby is the latest character to have successfully disguised her malevolent intent despite concerns raised by medical professionals at the time. Unfortunately, our enthrallment does not extend to continuing malpractice, conducted on industrial scales, toward others who are unable to articulate their fears and legitimate sceptism or, as is often the case today, cannot afford better healthcare:
“…we cannot divorce the motivation for medical interventions from the capitalist motivations of the pharmaceutical industry; creating medicines, particularly those that target a specific demographic, has become a lucrative business.” [6]
Even celebrated personalities held classist and racially superior beliefs regarding population control:
“Philosopher Bertrand Russell, too, suggested that the state might improve the health of the population by fining the ‘wrong’ type of people for giving birth.” [7]
Charles Darwin’s younger cousin, Francis Dalton, (considered the father of eugenics,) also opined:
“…that the poor seemed to be outbreeding the rich, and he saw the poor as poor for the simple reason that they were congenitally unfit. Responsible action was necessary to address the problem and ensure genetic progress. On the one hand, the rich needed to step up their baby-making game. On the other, society’s dregs, particularly those described as mentally feeble, physically weak, and criminal types, needed convincing to have fewer children. Managing reproduction was the linchpin of eugenics…” [8]
A Brave New World or Invasion of the Body Snatchers?
Aldous Huxley’s novel, written in 1931, described a futuristic world state, “…whose citizens are environmentally engineered into an intelligence-based social hierarchy…” The novel foresaw, “…huge scientific advancements in reproductive technology, sleep-learning, psychological manipulation and classical conditioning that are combined…” [9]
More alarming than individual assumptions about playing God with people’s lives is that of the state presuming it can do so at societal levels, creating a dystopian reality difficult to ignore or escape. We should be under no illusion that the abuses of power and level of criminality witnessed in cases such as Letby’s could not have occurred without the premise of systemic complicity in the name of science and healthcare, supported governmentally. There is certainly no smoke without fire:
“Only in 1974 did the American state of Indiana repeal legislation that had made it legal to sterilise those it considered undesirable. Investigations by reporter Corey Johnson in 2013 uncovered that doctors working for the California Department of Corrections and Rehabilitation had continued the practice, sterilising as many as 150 women inmates between 2006 and 2010, possibly by coercing them into having the procedure.
In Japan, a Eugenic Protection Law introduced in 1948 to sterilise those with mental illness and physical disabilities and prevent the birth of ‘inferior’ offspring was repealed only in 1996.” [10]
Some will argue that these scandalous practices are largely a thing of the past, however, the reverberations that continue across many healthcare institutions today can counter such assertions. Legal challenges echo the level of injustice meted out to indigenous and minority communities as they attempt to adjust to the devastating impact on existing and subsequent generations:
“A judge in Quebec has given the go-ahead for a class action lawsuit over the forced sterilisation of Indigenous women in the Canadian province. Two Atikamekw women…brought the lawsuit against three doctors they accuse of performing or coercing women into sterilisation procedures in a small, remote town in northern Quebec…
He ruled that all Atikamekw women who were forcibly sterilised at that location from 1980 onwards could be included in the action. Partners, caregivers, children, grandchildren and other rightful heirs are also included.” [11]
To reiterate, the adverse effects upon those targeted by state and healthcare institutions are perpetual, corralling communities into the type of dystopian nightmares described above. Guilaine Kinouani elucidates the extent of ignominy faced:
“Injustice turns us into robots. Injustice despairs us. Injustice wounds us deeply. No amount of psychological support can ever help an entire group thrive without addressing unjust social structures and racial injustice.” [12]
Furthermore,
“There is no glory in adapting to injustice and inhumanity, contrary to what mental health practices often tell us. Each time we socialise ourselves into accepting injustice we cut ourselves off from parts of our humanity.” [13]
It is important to note that the Shipmans, Alitts and Letbys of this world would probably have come under scrutiny far earlier if the existing healthcare infrastructure had not been established upon such inherently flawed foundations. The fact there is increasing public demand for senior hospital management to be investigated for corporate manslaughter following Letby’s conviction speaks for itself when considering the gross negligence surrounding her case.[14]
Race Science: A Sprint or a Marathon?
When experimentation, clinical trials and research were being conducted on slaves, indigenous populations and social classes considered below white imperialist classifications, like eugenics, few considered the consequences and impact of such social engineering today:
“Race science assumes that whiteness is a useful scientific category denoted by skin colour, and that all others can be measured in comparison to this singular group of people…
Medicine and healthcare is taught the way it is practised. Only a few bodies have ever historically mattered: usually those of white, male, able-bodied and heterosexual people.” [15]
As Annabel Sowemimo highlights:
“We can no longer deny that health inequalities and uneven power relations exist…” [16]
She goes on to assert:
“…the oppressive records of some medical institutions and individuals has had a significant impact on how those whose histories include medical exploitation continue to interact with healthcare professionals, and if they choose to access healthcare at all.” [17]
Double Standards or Double Jeopardy?
The contradictions between Letby’s case and the earlier proceedings of Dr. Hadiza Bawa-Garba are further examples of disparities insofar as they relate to ethncity. In 2015, Dr. Bawa-Garba was found guilty of the manslaughter of a 6-year-old boy as a result of ‘serious neglect’ and given a 24 month suspended sentence.[18] She had been working a 12-hour shift without a break and while this does not mitigate negligence on her part, miscommunication was among the other significant factors that contributed toward the child’s unfortunate death. She was initially struck off the medical register but reinstated following a subsequent appeal.[19]
The response towards Dr. Bawa-Garba was swift, and rightly so. However, when comparing this to the treatment afforded Letby, the disparities are glaring. Dr. Bawa-Garba’s professional record leading up to this tragedy was exemplary. She was:
“…a specialist registrar in year six of her postgraduate training (ST6) with an ‘impeccable’ record. She had recently returned from maternity leave and this was her first shift in an acute setting.” [20]
Suffice it to cite Barrister Tahir Khan’s observations regarding the contradictions between each case. It would be difficult to ignore the racial permutations surrounding the two:
“The juxtaposition of the legal outcomes in the cases involving Lucy Letby and Dr. Hadiza Bawa-Garba casts a revealing light on the glaring discrepancies that persist in the treatment of individuals within the medical field, often influenced by attributes such as appearance, gender and ethnicity. In the face of adversity, both professionals encountered a vastly different trajectory of justice, shedding light on the deep-seated biases that continue to permeate our institutions.” [21]
Conclusion
Academics, healthcare institutions and professionals within the medical field continue to petition communities for myriad research endeavours. Unsurprisingly, they are met with sceptism and distrust, especially after what transpired during and after the recent Covid pandemic. Community research entities have emerged to bridge the gap between corporate medical and government statutory agencies, and local communities, representing grassroots concerns while simultaneously conducting ethical research projects contracted on behalf of healthcare institutions. It is a difficult balancing act to maintain and only a few are able to successfully navigate between what often amounts to conflicting expectations:
“Today, it is incredibly difficult to recruit marginalised groups into medical trials. The uptake of newer medical treatments among people of colour is usually significantly lower than among white people.” [22]
Additionally,
“Iatrophobia is described as the fear of medical institutions, which leads to patient avoidance of medical institutions and interactions with medical practitioners. Iatrophobia is not just restricted to those that are racially marginalised or indigenous populations, but also groups who feel that they may be routinely stigmatised or unlikely to receive equal medical treatment.” [23]
If Letby was able to commit these types of atrocities for so long, then previous historic abuses, some of which have been described in this article, established the precedent for such criminality, Indeed;
“Medicine has been routinely weaponised by doctors as a tool to ensure subordination and maintain social hierarchies. It has, throughout history, been another tool of oppression for people of colour.” [24]
The reassuring phrase many of us are familiar with hearing from doctors is similar to the words uttered by Letby to a mother arriving at neonatal to feed her newborn; ‘Trust me, I’m a nurse.” [25] Only this time, she was disguising her monstrous intentions.
Distrust, suspicion, fear and anger are the prevailing sentiments among communities that have been historically targeted by a system established to exploit them. The latest case, where the most vulnerable in our societies – newborn babies – can be exposed to fatal risks, underscores the necessity to overhaul the healthcare system. Sowemimo’s recommendation would be the most appropriate place to commence this much needed process:
“To understand how our modern systems of medicine and health are constructed today, we need to examine the origins of some of the flawed science on which it was built, and the socio-political circumstances under which many early scientific discoveries took place.” [26]
[1] Halliday, J: ‘Lucy Lethby: Police found note saying, ‘I killed them on purpose,’ The Guardian, 13th October 2022: https://www.theguardian.com/uk-news/2022/oct/13/lucy-letby-police-found-note-saying-i-killed-them-on-purpose-court-hears
[2] Halliday, J: ‘Trust me, I’m a nurse’: Why wasn’t Lucy Letby stopped as months of murder went by?’ The Guardian, 19th August 2023: https://www.theguardian.com/uk-news/2023/aug/19/trust-me-im-a-nurse-why-wasnt-lucy-letby-stopped-as-months-of-went-by
[4] Draper, J: ‘Carers who kill: Lucy Letby joins a gruesome list of medical monsters, from Harold Shipman to Beverley Allitt’, The Independent, 19thAugust 2023: https://www.independent.co.uk/news/uk/crime/beverley-allitt-harold-shipman-lucy-letby-b2395899.html
[5] Peplow, G: ‘Lucy Letby: Inside the mind of a serial killer – the psychology behind healthcare murders,’ Sky News, 19th August 2023: https://news.sky.com/story/lucy-letby-inside-the-mind-of-a-serial-killer-the-psychology-behind-healthcare-murderers-12941902#:~:text=%27Dr%20Death%27%20Harold%20Shipman,complex%22%2C%20says%20Dr%20Das.
[6] Ibid, https://amzn.eu/gPpWnY8
[7] Saini, A: Superior: The Return of Race Science: https://amzn.eu/cPF7wKU
[8] Ibid, https://amzn.eu/azNDGvB
[9] Huxley, A: ‘Brave New World,’ Wikipedia: https://en.wikipedia.org/wiki/Brave_New_World [accessed 26th August 2023]
[10] Sowemimo, A: ‘Divided: Racism, Medicine and Why We Need to Decolonise Healthcare’: https://amzn.eu/6Yp20PY
[11] Linderman, T: ‘Quebec judge gives go-ahead for lawsuit over sterilisation of indigenous women,’ The Guardian, 23rd August 2023: https://www.theguardian.com/world/2023/aug/23/quebec-judge-gives-go-ahead-for-lawsuit-over-sterilisation-of-indigenous-women?CMP=Share_iOSApp_Other
[12] Kinanoui, G: ‘Living While Black: The Essential Guide to Overcoming Racial Trauma,’: https://amzn.eu/aS6MdoL
[13] Ibid, https://amzn.eu/48hsxEj
[14] King, J: ‘Police urged to investigate Lucy Letby hospital execs for corporate manslaughter,’ Metro, 20th August 2023: https://metro.co.uk/2023/08/20/police-urged-to-investigate-lucy-letby-hospital-execs-19362950/?ito=article.app.share.appbar.generic
[15] Sowemimo, A: ‘Divided: Racism, Medicine and Why We Need to Decolonise Healthcare,’ https://amzn.eu/5dE2Uet & https://amzn.eu/hwLPozM
[16] Sowemimo, A: ‘Divided: Racism, Medicine and Why We Need to Decolonise Healthcare,’ https://amzn.eu/0oFMe50
[17] Ibid, https://amzn.eu/6lgakqf
[18] BBC News: ‘Leicester doctor guilty of manslaughter of Jack Adcock, 6,’ BBC News, 4th November 2015: https://www.bbc.co.uk/news/uk-england-leicestershire-34722885
[19] BBC News: ‘Jack Adcock manslaughter: Convicted doctor fit to practice,’ BBC News, 2nd July 2021: https://www.bbc.co.uk/news/uk-england-leicestershire-57700681
[20] Pulse: ‘Bawa-Garba: timeline of a case that has rocked medicine,’ Pulse, 10th April 2019: https://www.pulsetoday.co.uk/analysis/regulation/bawa-garba-timeline-of-a-case-that-has-rocked-medicine/
[21] Khan, Tahir: LinkedIn post [accessed 25th August 2023]
[22] Sowemimo, A: ‘Divided: Racism, Medicine and Why We Need to Decolonise Healthcare,’ https://amzn.eu/cer0vV4
[23] Ibid, https://amzn.eu/hmDT8nV
[24] Ibid, https://amzn.eu/iaNFhdy
[25] Halliday, J: ‘Trust me, I’m a nurse’: Why wasn’t Lucy Letby stopped as months of murder went by?’ The Guardian, 19th August 2023: https://www.theguardian.com/uk-news/2023/aug/19/trust-me-im-a-nurse-why-wasnt-lucy-letby-stopped-as-months-of-went-by
[26] Sowemimo, A: ‘Divided: Racism, Medicine and Why We Need to Decolonise Healthcare,’ https://amzn.eu/5dE2Uet
