Nurse Letby case and the idea of being evil

JUSTICE James Goss called the killings “cruel, calculated, callous, cynical” as he awarded nurse Lucy Letby 14 life sentences recently for the murder of seven infants and the attempted murder of six others in England. Their broken families serve life sentences, too — of enduring pain and distress. Profound questions are triggered by Letby’s admission, “I am evil”. What did she mean?

Many serial killers precede her. Harold Shipman killed 218 elderly patients, midwife Miyuki Ishikawa slaughtered 103 newborns and the notorious Charles Sobhraj killed many tourists before he was arrested in India. Psychiatrists, philosophers, criminologists and theologians speculate endlessly on the nature of evil.

But we sense it instinctively. I felt it on seeing thousands of bloody corpses in Rwanda (1994), acres of mass graves in Srebrenica after 1995, or hundreds of burning villages in Darfur in 2004. Contrastingly, I did not sense evil after the Indian Ocean tsunami that killed around 2,30,000 people in 2005.

Evil is, therefore, not due to a wrathful god but human-made. It is present in the bottomless darkness and despair when all decency and humanity are extinguished.

Why do people commit evil deeds? Psychiatrists will be kept busy studying Letby’s mind, but studies of other mass killers indicate no clear pattern. Most are average people, just like us. Philosopher Hannah Arendt, who resisted the Nazis, talks of the “banality of evil”. It lurks in us all, awaiting the right opportunity to express itself. Countless demagogues, from Hitler to Cambodia’s Pol Pot, have relied on this to urge their followers to follow them.

Judge Goss described Letby as “intelligent and knowledgeable” and certainly not crazy, however perverted her conduct. In my interactions with war criminals — from Afghanistan to Sierra Leone — I also found them chillingly sane while executing their fiendish schemes. Conversing with genocide-indicted Presidents — Slobodan Milosevic of Serbia and Omar al-Bashir of Sudan — shocked me, such was their compelling incitement to evil.

That is logical: anyone can lash out randomly, as we know from the 600 mass shootings that trouble the US each year. But to orchestrate mass evil requires exceptionally intelligent people, whether hospital killers or genocide perpetrators.

How do we tackle evil? Traditionally, punishment has five purposes: deterrence, public protection, rehabilitation, retribution and restitution. How could this work for Letby?

Her permanent incarceration means that rehabilitation is pointless. And she has nothing to offer parents in restitution, even if their horrendous losses could be financially compensated.

The public protection argument has little substance — the nurse was only a threat to fragile infants in specialised settings and got removed from that, although too late. Her sentencing will not deter others.

Therefore, Letby’s life sentences signify retribution. Society expects her to be banished forever, such is the desire for vengeance. The UK has no capital punishment, else she would have surely been hanged. But execution provides no deterrence: 53 countries retaining the death penalty are not less vulnerable to evil.

Is awarding 14 whole-of-life sentences the way to tackle evil? Taking away all hope of release — however improbable — is inhumane under international law. That’s one reason why former Liberian President Charles Taylor received a 50-year sentence from the Special Court for Sierra Leone for crimes against humanity. He can at least hope for freedom when he is 114 years old.

The International Criminal Court’s guideline specifies a maximum sentence of 30 years. So far, its longest penalty has been 25 years for 61 war crimes and crimes against humanity by Dominic Ongwen of Uganda’s Lord’s Resistance Army.

However, this is a small minority of criminals against humanity. Most egregious offenders enjoy impunity and a broken geopolitical order means that abuses by despots and tyrants are the norm.

If punishment does not guarantee stopping evil, how do we manage it? There is no easy solution, but Letby’s case offers a clue.

Her murderous spree could have been interrupted earlier if managers had acted on warnings that rising neonatal mortality was linked to her. Thus, Letby’s killings were abetted by institutional failure as hospital executives protected their own reputation rather than patients. That has happened often, as when 170 children perished due to surgical failures in Bristol. Outrageously, a culture of fear is deliberately engineered in such cases by harassing or sacking any employee daring to speak up, despite whistleblower protection legislation.

Similar institutional self-protection is visible everywhere — as when lakhs of people were affected by the Bhopal gas tragedy, unethical pharmaceutical conduct that killed thousands in the US opioid epidemic, or the United Nations corruption scandal.

Hospitals like Letby’s and agencies serving humanity like the UN are staffed by caring people. So, it appears that for evil to flourish, it is only necessary for good people to look away. That happens far too commonly, as when women in Manipur were raped by a mob while the police initially refused help, an incident that PM Modi described as shameful and unforgivable.

I went through similar emotions as the UN coordinator in Sudan. I witnessed the evil of mass rapes in Darfur, followed by frustration at the UN deciding to ignore my warnings. My shame is that by not acting early, we failed to prevent many of the 3,00,000 deaths in that genocide.

Genocide is a special evil — a horrible crime that was nameless before Raphael Lemkin invented that label in 1944 amid the Holocaust. Then US President Bill Clinton swore “never again” in repentance at American failure during the 1994 Rwandan genocide. But it has happens again and again: apart from Rwanda and Darfur, genocides have occurred in Bangladesh, Cambodia and erstwhile Yugoslavia, and against the Rohingyas in Myanmar, Yazidis in Iraq, Uyghurs in China and Tigrayans in Ethiopia.

We should not be surprised. When institutions charged with the most sacred task of protecting citizens against evil — be it hospitals or international organisations — don’t try, evil is bound to recur.

Tragically, our laws and institutions often fail when needed the most. When that happens, the only bulwark against evil is our own moral selves. If evil arises in the hearts of humans, that is where the defences of humanity must be built.

Standing up for good and against evil demands immense courage to always do the right thing, come what may. It is ultimately a personal responsibility that cannot be subcontracted to anyone else.