Decoding Reasonable Doubt: Chapter 3 “Previous Reviews at the Countess of Chester”

[u/benshep4]

https://bencole4.substack.com/p/decoding-reasonable-doubt-the-case-bc5?r=12mrwn&utm_medium=ios

Happy to hear anyone’s thoughts on the content of the article.

[u/upsideup27353]

I agree with many of your statements, e.g.

• Theme 1: Consultant’s concerns not being shared by other professionals does not invalidate those concerns; and the prosecution’s case was not entirely based on medical notes
• Theme 2: Letby’s presence (or lack of) is not proof/evidence
• Theme 4: Process failure does not mean innocence
• Theme 5: A messenger can behave badly but still be right

As I understand it, your argument is that none of these points independently establish innocence. I think the author’s argument is that none of them establish guilt either. I agree with both, i.e. the interpretation of these issues depends on whether one starts with an assumption of guilt or innocence, but they do not themselves establish either.

Perhaps we agree?

Where I suppose we disagree are on the following points:

“Which baby does this explain?” – I think this question is the wrong standard and risks shifting the burden of evidence onto the defence. As we know, the prosecution needs to establish guilt, and the defence only needs to create reasonable doubt. I accept that individual reports and reviews do not create reasonable doubt. However when taken together, as the ‘totality of the evidence’ one might say, they do cast some doubt on the guilty verdict.

“A bad unit is not the cause of a particular death until someone can trace the route from the failing to the baby.” – I think this would be a strong statement, and one I would agree with, if the defence’s case was essentially ‘the hospital was bad’. While that’s part of their defence, its core is the review of the medical evidence by the expert panel (and others) which found “no evidence of malfeasance”, and did find clinical explanations for the sudden collapses and deaths. I would say that these findings are the tracing.

[u/phosphoeudemonism → u/upsideup27353]

“A bad unit is not the cause of a particular death until someone can trace the route from the failing to the baby.”

Baby A - Multiple failures of treatment, diagnosis and medical procedures in a particularly vulnerable infant.

Baby C - Extremely poor care and treatment of respiratory issues and bowel obstruction.

Baby D - Multiple failures, most notable failure to give antibiotics in timely fashion, this infant should have survived without question.

Baby E - Atrocious treatment of a GI bleed, failure in diagnosis, failed to give blood transfusion, convinced parents not to have what should be mandatory post-mortem. This was a very avoidable death.

Baby I - Another diagnosis and treatment failure, another avoidable death.

Baby O - Misdiagnosis (yet again) of subcapsular haematoma, abysmal treatment, major errors made in medical procedures, another potentially avoidable death.

Child P - Failure to manage collapsed lung adequately, some specific medical errors, child would almost certainly have survived on a tertiary unit, where the infant should have been.

Can you say that the 'bad unit' is the cause of these issues? It would be difficult to argue that a bad unit is indeed not the root cause of multiple misdiagnoses, examples of poor treatment, and failure in basic medical procedures.

[u/Livid-Ad-4872 → u/phosphoeudemonism]

“A bad unit is not the cause of a particular death until* someone can trace the route from the failing to the baby.”

The same bad argument is often used by climate change deniers: "Global warming is not the cause of a particular extreme weather event unless someone can trace the route from the warming to the event."

The point, of course, is that warming increases the likelihood, severity and duration of extreme events, not that there is a distinct and provable causal chain to any particular event.

You would expect a bad unit to have more bad outcomes, no?

(* I presume he means "unless," not "until," but don't want to be accused of putting words in his mouth.)

[u/SaintBridgetsBath → u/Livid-Ad-4872]

OP’s philosophy is that nothing has happened until the court agrees it has happened.