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The Trial of Lucy Letby

This one received a much lighter sentence:


She must have had a good lawyer to plead murder down to manslaughter - I think prosecutors probably had doubts about whether they could win at trial more than 20 years after the deaths, especially when Hall had already served time in prison on an apparent wrongful conviction in connection with a hospital fire.

 
It makes one think whether psychologically similar but less dramatic events take place in other areas of work i.e. engineers causing fuck ups they can be responsible for solving or police encouraging crimes.
 
It makes one think whether psychologically similar but less dramatic events take place in other areas of work i.e. engineers causing fuck ups they can be responsible for solving or police encouraging crimes.

Seems to be a disturbing number of firefighter arsonists out there

"There's roughly 100 firefighter arsonists convicted every year in North America and all of them are serial arsonists, which means three or more fires," Nordskog said Monday


 
That'll be all the surgeons out of a job then.

But you can't actually be seriously suggesting that?

I am very serious. I think that suitability assessments should be carried out when it comes to anyone working in life and death situations where an individual has control over someone's life and access to systems and/or equipment that can kill.
 
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I am very serious. I think that suitability assessments should be carried out when it comes to anyone working in life and death situations where an individual has control over someone's life and access to systems and/or equipment that can kill.
Bus drivers, then?
 
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I appreciate the sentiment, Aladdin , but I fear that what you are looking for is beyond our technological ability to deliver. How, precisely, would we go about making this individual assessment? Anything less than a long series of discussions with a qualified consulting psychologist would be inadequate, and I’m not convinced that even that would be enough
 
I am very serious. I think that suitability assessments should be carried out when it comes to anyone working in life and death situations where an individual has control over someone's life and access to systems and/or equipment that can kill.

Any job which gives power over other people is bound to attract people who want to have power over other people. The answer is in the question, it's the same problem in health and social care as there is in the police or prison service or the forces, or even education. I don't have an answer btw but society isn't honestly addressing the issue anyway, nor IMO will we because we aren't ready to deal with it.
 
All the background checking stuff we do is harm reduction, not harm elimination. It has to be balanced against the risk of not having people doing these jobs at all because it'll never be possible to weed out everyone who could be dangerous.

At some point everything comes down to trust. And it's important to remember that we can trust each other. How many people have your life in their hands on a daily basis and you don't even think about it.

In terms of harm reduction, we might do better to fight carelessness than malice. Because we can't eliminate malice but we can move a few very simple levers to reduce carelessness in safety-critical activities. There must be thousands of examples of this just in healthcare. We don't notice them, but we should.
 
Supervision also seems to be something that should be examined. How was she able to do this? How was she able to take a vial of insulin and use it without a check as to why and signing off by second member of staff..

Maybe hospitals are so short staffed that this is impossible to do...
 
I am very serious. I think that suitability assessments should be carried out when it comes to anyone working in life and death situations where an individual has control over someone's life and access to systems and/or equipment that can kill.

Not sure about that - for a start, just because someone is suitable at one point in their lives does not mean they might be suitable after that job (many of which are extremely high pressured and/or repeatedly expose them to considerable emotional and psychological stress) has damaged them for years / decades. Secondly that sort of vetting requires a level of investigation and analysis that really doesn't exist on the scale that would be required, and would (if rolled out en masse as you would have to do) would pose considerable risks of moral corruption to those doing the vetting.

What would be better is having much stronger fault reporting mechanisms, with the culture of organizations changed so that people at every level of it feel empowered and are expected to report issues whenever they occur - with a focus on identifying and dealing with the problem at hand rather than apportioning blame or protecting individuals or the organization itself. A student nurse, a junior PC on a team or a matelot should be able wherever possible to put their hand up if they think there is a problem, it be discussed and if it exists be dealt with, without the whistleblower getting in the mire or (where its an honest error that has been fixed) the person who made a mistake getting punished.
 
Richard Gill thinks Letby didn’t get a fair trial. Richard Gill is not just some random off the internet, he helped overturn the convictions of two other nurses convicted of murdering patients, Lucia de Berk & Daniela Poggiali.

The Lucy Letby case

Lucia de Berk - Wikipedia
Italian nurse acquitted of murder after statistical analysis

Not sure about most of that, and there is a really odd disclaimer on one of the sites he links to ("Please note: Science on Trial and its contributor(s) are not affiliated, associated, authorized, or in any way connected with Dr Richard Gill and/or his affiliates. None of the scientific content or work on this website was created by or prepared by Dr Gill. No money or financial contributions made to Dr Gill are in any way associated with Science on Trial and its contributor(s) and we do not endorse Dr Gill to collect donations for any cause, by using the information contained on this website") which raises a few flags.

I think though he is right to suggest that the defence may not have been up to much. "Unexplained" clusters of baby deaths are not unknown in the recent history of the NHS (Bristol and East Kent), and it might have been better to adopt that as an overall defence whilst pointing out the lack of actual evidence.
 
In the airline industry it took a number of very bad crashes for the culture to change; Pan Am/KLM at Tenerife North, the Staines crash and a number more were 100% down to the captain being so very senior that the first officer either being too junior to feel able to speak up or for the captain to listen to them. This changed and now a captain that fails to listen to their first officer will get in deep shit. Another thing that changed is no-fault investigating of crashes, of course if there was deliberate actions to make it crash that would be a thing, but by a general no-fault policy that allowed lessons to actually be learned and changes implemented. Everything we've heard about the NHS so far shows they are very far from protecting junior staff who blow whistles and so on.
 
Richard Gill thinks Letby didn’t get a fair trial. Richard Gill is not just some random off the internet, he helped overturn the convictions of two other nurses convicted of murdering patients, Lucia de Berk & Daniela Poggiali.

The Lucy Letby case

Lucia de Berk - Wikipedia
Italian nurse acquitted of murder after statistical analysis
If you read that blog post then it's worth reading this reply too (link takes you direct to the reply, not the blogpost):
 
I appreciate the sentiment, Aladdin , but I fear that what you are looking for is beyond our technological ability to deliver. How, precisely, would we go about making this individual assessment? Anything less than a long series of discussions with a qualified consulting psychologist would be inadequate, and I’m not convinced that even that would be enough
Airline pilots undergo psychological screening and pilot murder-suicide is still a leading cause of fatal aviation accidents.
 
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I appreciate the sentiment, Aladdin , but I fear that what you are looking for is beyond our technological ability to deliver. How, precisely, would we go about making this individual assessment? Anything less than a long series of discussions with a qualified consulting psychologist would be inadequate, and I’m not convinced that even that would be enough
Fair enough..
 
Seems to be a disturbing number of firefighter arsonists out there

"There's roughly 100 firefighter arsonists convicted every year in North America and all of them are serial arsonists, which means three or more fires," Nordskog said Monday

Firefighting as a profession (i.e. which the victim of the fire paid for, on the spot, before any water was sprayed on the fire) famously arose in Ancient Rome.
 
In the airline industry it took a number of very bad crashes for the culture to change; Pan Am/KLM at Tenerife North, the Staines crash and a number more were 100% down to the captain being so very senior that the first officer either being too junior to feel able to speak up or for the captain to listen to them. This changed and now a captain that fails to listen to their first officer will get in deep shit. Another thing that changed is no-fault investigating of crashes, of course if there was deliberate actions to make it crash that would be a thing, but by a general no-fault policy that allowed lessons to actually be learned and changes implemented. Everything we've heard about the NHS so far shows they are very far from protecting junior staff who blow whistles and so on.
Particular issue for airlines from some countries where a younger subordinate must use more respectful language to an elder (so can’t quickly and clearly say something in a direct manner)
 
Particular issue for airlines from some countries where a younger subordinate must use more respectful language to an elder (so can’t quickly and clearly say something in a direct manner)


Tenerife crash; boss of KLM got the call, first thing he did was ring his chief pilot, got his wife who said he was working, flying down to the Canaries...
 
Supervision also seems to be something that should be examined. How was she able to do this? How was she able to take a vial of insulin and use it without a check as to why and signing off by second member of staff..

Maybe hospitals are so short staffed that this is impossible to do...
I’m not sure nurses in acute trusts are offered regular supervision. :( Certainly from hearing from a nursing colleague who moved from physical to mental health, the need for regular supervision was a new thing for him.

Re: NICU in particular, there is an interesting psychological commissioning document talking about the need to ensure staff have access to reflective spaces and psychological support as well as the parents.
 
I understand the desire that ‘this never happens again’ but I’m not sure why it’s being discussed across the media as something that’s possible. Every few years (or far more frequently if you include everywhere outside the UK) is a story of a killer nurse or doctor. And those are just the ones which come to light. There must be many more that never will, even if it’s just a patient here and there rather than many of them.
 
Supervision also seems to be something that should be examined. How was she able to do this? How was she able to take a vial of insulin and use it without a check as to why and signing off by second member of staff..

Maybe hospitals are so short staffed that this is impossible to do...

Who would supervise the supervisors though?! I know you're trying to come up with some solution, but these are random ideas that aren't practical - or even likely to stop things like this happening even if they were.

People can't be supervised (by which I assume you mean checked in everything they do rather than the supervision that happens now for education and skills development) in hospital or other healthcare situations.

Insulin isn't a controlled drug, it was probably kept in a locked room but one everybody working there probably had access to. I would guess it was unlikely she was signed off to access it (and it almost certainly wasn't prescribed by a HCP) and just got hold of it herself without any checks being needed, which would be completely impractical and pointless anyway.
 
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You also won’t find many people willing to work in an environment where their every move is watched and reported and recorded. We have to have some trust and faith in others. We can safeguard sure, but if those put in charge to implement the safeguards don’t listen to those raising the alarm, then all the safeguards in the world are arguably pretty irrelevant. That’s the issue here for me. And this problem of those trying to raise the alarm and being ignored by those more senior can be seen all over the place (the Rotherham CSE scandal, the many abuses of power within religious institutions etc).

So what is going on? What is it that makes those in such positions act in the way they do? Why does the interests of the institution become more important to them than the vulnerable users of it? These are the sorts of questions I think should be explored and investigated.
 
Not sure about most of that, and there is a really odd disclaimer on one of the sites he links to ("Please note: Science on Trial and its contributor(s) are not affiliated, associated, authorized, or in any way connected with Dr Richard Gill and/or his affiliates. None of the scientific content or work on this website was created by or prepared by Dr Gill. No money or financial contributions made to Dr Gill are in any way associated with Science on Trial and its contributor(s) and we do not endorse Dr Gill to collect donations for any cause, by using the information contained on this website") which raises a few flags.

I think though he is right to suggest that the defence may not have been up to much. "Unexplained" clusters of baby deaths are not unknown in the recent history of the NHS (Bristol and East Kent), and it might have been better to adopt that as an overall defence whilst pointing out the lack of actual evidence.

To be fair the science on trial site looks pretty cranky itself.
 
So what is going on? What is it that makes those in such positions act in the way they do? Why does the interests of the institution become more important to them than the vulnerable users of it? These are the sorts of questions I think should be explored and investigated.

Yeah that's the end of the spectrum that needs dealing with; prompt reporting, timely and robust investigations, etc. and why they failed or were ignored.

The NHS makes a big noise about whistleblowing and incident reporting, Trusts have people in that role exclusively, what the fuck went wrong here?
 
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Yeah that's the end of the spectrum that needs dealing with; prompt reporting, timely and robust investigations, etc. and why they failed or were ignored.

The NHS makes a big noise about whistleblowing and incident reporting, Trusts have people in that role exclusively, what the fuck went wrong here?
There's likely to be an inquiry, isn't there? But let's not get too one-sided without knowing the details of what management knew when, because the other side of the question is: what's the evidence threshold for suspending, investigating etc an employee? Whatever it is, it needs to also work in cases where there's nothing to the rumours/allegations. It doesn't seem to be the case that Letby was just ignored - she was eventually arrested, and the police initially released her without charge, so it's far from black-and- white.
 
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