The crimes of convicted UK serial killer Lucy Letby shocked the world, devastated the families of her victims and undermined confidence in a healthcare bureaucracy that allowed her to continue killing and harming babies, long after she should have been detected and stopped.
The failings at the Countess of Chester Hospital, in the north of England, where she worked, were undoubtedly human.
Central to the tragedy was a refusal by senior decision makers to believe that a woman trained to care for grievously ill, newborn babies was capable of murdering and injuring them.
Of course, there is no completely foolproof way to ensure that disturbed and deranged people can never inveigle themselves into situations where they can perpetrate harm. Human nature will always ensure that the most deceitful perpetrator has an advantage over even the most sceptical gatekeeper.
Letby exploited not only the naiveté of a credulous employer, but also the hospital's craven refusal to countenance the possibility that it had a serial killer on its staff, through fear of the reputational damage that would ensue.
Healthcare professionals who kill patients are thankfully extremely rare but this case has implications for hospitals and health authorities throughout the world.
The forthcoming public enquiry will consider all of these issues and it will, in time honoured fashion, publish a series of recommendations aimed at mitigating against a repeat of the Letby case.
Doubtless, many of the proposed changes will concern tightening procedures around recruitment, management, and clinical oversight – but, given the limitations of altering human nature, how effective can they truly be?
Could medical technology have been better deployed to detect what Letby was doing? And could advances in artificial intelligence (AI) and diagnostics hold the key to preventing a repeat of her grim campaign of carnage?
One of the first questions the inquiry will consider is Letby's character. Was she a one-off, or was there anything in her past, or in the patterns of her behaviour, to indicate that she was capable of murder?
While the crimes and victims of Letby are rare, it is doubtful that a form of psychological profiling could have identified any risks in employing her, according to Dr Marissa Harrison,a professor of psychology at Penn State Harrisburg.
In a profile of 'typical' female serial killers (FSK) compiled by Harrison and her team for The Journal of Forensic Psychiatry & Psychology in 2015, nearly 40% were nurses, nurses' aides, or other healthcare workers.
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