In August 2023, Lucy Letby, a former neonatal nurse, was convicted for seven counts of murder. She was convicted on many counts of attempted murder, placing her among the most infamous individuals in modern British criminal history. Letby is now serving consecutive life sentences with no possibility of parole. Her case has generated international discussion—not only about the evidence presented at trial, but what her conviction would mean for so many others like her. As the guilty plea details continue to surface, major questions about the validity of that evidence come to light. This speaks to the larger systemic problems in our healthcare ecosystem.
The prosecution’s case relied heavily on a graph that illustrated Letby’s presence during every infant death in a neonatal unit between June 2015 and June 2016. It’s the reason for the “Texas sharpshooter fallacy” illustrated by this graph. It’s a cognitive bias that makes people prone to seeing patterns where there are none. Controversies surrounding this new evidence have led many to make comparisons to past cases in the Netherlands and Italy. In each of those situations, comparable allegations levied against their nurses resulted in fatal miscarriages of justice. Critics have pointed out that all of these examples resulted from an assumption that “a coincidence can’t be a coincidence.”
The Evidence Presented
This graph – the lynchpin piece of evidence used against Letby – lies at the center of this tempest. Law Professor Burkhard Schafer has even claimed that the police were merely competent in determining potential culpability through statistical coincidence. Critics claim that the graph fails to consider other key elements influencing mortality rates in the neonatal unit. They argue that systemic problems with our healthcare system take center stage, and for good reason.
Letby’s conviction rested heavily on the testimonies of consultants, whose views were only suspicious based on her presence during the fatalities. There was therefore an extraordinary lack of physical or forensic evidence that would connect Letby to the injury of any babies. This absence of objective, verifiable proof creates profound questions about the forensic integrity of the prosecution’s case.
“It was just a way of me getting my feelings out onto paper.” – Lucy Letby
Psychologists have condemned notes made by Letby as “useless as evidence. These viewpoints invite further questions about her writings. Are these confessions of culpability, or do they just capture her mindset at that time? This uncertainty only complicates the acting prosecution’s narrative to her conviction.
Systemic Issues at Play
Dr. Neena Modi, a prominent neonatology professor at Imperial College London, highlighted that some infant deaths could have been prevented through better medical practices. She noted drivers’ high speeds, their distractedness, and their increased attacks on people walking as some of the key drivers of these tragic outcomes. Misdiagnosis and inappropriate treatment were significant factors.
“There was a combination of babies being delivered in the wrong place, delayed diagnosis and inappropriate or absent treatment.” – Dr. Neena Modi
This admission suggests that Letby’s work environment was almost certainly a central factor in the deaths that led to her conviction. It is creating intrigue over the circumstances and influences she encountered while serving as there. This reality presents a legitimate question about accountability in all institutions, including the National Health Service (NHS). Chronic underfunding has resulted in overworked staff and impacted the quality of care for vulnerable patients.
Burkhard Schafer added that it was vital to target systemic problems in institutions such as the NHS. This need is acutely felt after years of fiscal distress. Specifically, he worried that such systemic issues might complicate or worsen cases involving more vulnerable patients—like those in the neonatal care units.
“Finding a systemic problem in an organisation like the National Health Service, after decades of underfunding, where you have overworked people cutting little corners with very vulnerable babies who are already in a risk category.” – Burkhard Schafer
The Role of Expert Testimony
Dr. Shoo Lee, a respected Canadian neonatalist, has weighed in on the matter, arguing that expert testimony presented during the trial misinterpreted his research. Dr. Lee’s team was a remarkably diverse group of 14 renowned pediatric and neonatal specialists. Collectively, they formed a new lens to assess the case against Letby. In fact, their findings undermine almost all the assumptions used to convict her at her trial.
Legal experts and advocates for criminal justice reform are concerned. Most concern is around the dependence on statistical coincidence as opposed to more direct evidence. The critics caution that this conviction could establish a very troubling precedent. They are worried about doctors being falsely charged based on terrible data interpretations.
Throughout the ordeal, Letby’s defense team has painted her as an innocent participant in these events, stressing repeatedly that she did not kill those infants. In much of what she said publicly, she has described her own confusion and despair about her circumstances.
“I haven’t done anything wrong.” – Lucy Letby
Against this backdrop of chaos, Letby’s own emotional reflections paint a more complicated picture. Her testimony oscillates between self-justification and admission of blame. This inconsistency only calls into question the severity of her current mental state amid this stormy period.
“I killed them on purpose because I’m not good enough to care for them.” – Lucy Letby
