Horror, Fear and Trust in a Neonatal Unit

This week, closing evidence was presented in the long-running trial of Lucy Letby, a nurse who is accused of murdering seven newborn infants (and attempting to murder 10 more) in a neonatal intensive care unit in Chester between 2015 and 2016. In the coming weeks, the jury will consider and then return their verdict on the charges. That verdict will bring some closure to a criminal investigation that has taken more than four years, and a trial that has lasted nine months. It may (though may not) provide some relief for the grieving families whose babies died seven or eight years ago.
Yet, whatever verdict is reached, there are likely to be profound wider repercussions for all those who work in the care of very sick infants and children, and for many many other parents and families.
As someone who works in newborn intensive care, I have found the Letby case too awful, too close to the bone to follow closely. I do not know and (without access to all the evidence) cannot judge what conclusion the jury should reach. However, there are, ultimately, only two possibilities, both of which are horrendous.
Guilty.
The idea that a health professional working in the care of critically ill babies would deliberately and repeatedly attempt to kill infants is, quite literally, beyond comprehension. At least for me, it is impossible to imagine what would lead someone to do such a thing. Health professionals in neonatal units work closely in teams, in a relationship of trust, united by our shared commitment to the support of babies and families. We depend on each other – mutual support that makes it possible to provide care in highly stressful situations. If Letby is guilty, that very obviously represents the ultimate betrayal of her responsibilities to her patients and their families. However, beyond Chester, that conclusion will ripple across hospitals in the UK and beyond. It will shake to the core the trust between doctors and nurses and importantly between families and professionals. It will cause widespread distress and disquiet across neonatal units.
by Dominic Wilkinson
All of that is to say that the end of this case will not be the end of its effects. Trust is a precious commodity in healthcare. It may be in short supply in neonatal units in the wake of this case.
Not guilty.
The opposite possibility is almost as distressing. If Letby is innocent, that means that a health professional committed to the care of infants has been subject to a prolonged period of intense public and police scrutiny and attention. Her career and her life appear to have been irretrievably damaged. For health professionals, this raises the prospect that any of us could be vulnerable to similar accusations, to having our lives similarly turned upside down.
Wider effects 
Beyond professionals, and families of children who are currently in hospital, the Letby case will seriously and negatively impact another group – those who have lost a child or newborn infant. Many bereaved parents will have found the intense media attention to the tragic events in Chester has painfully stirred up memories and questions around their own child’s death. They may have had unanswered questions at the time, or they may now be re-examining events in the light of Letby, wondering whether they can believe the things that they were told and the answers that they were given. Even if (as will be the case for many or all of these) everything possible was done to care for their child and no malicious actors were present – how will they be able to know with certainty?