Lucia de Berk
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Lucia de Berk (born The Hague, Netherlands 22 September 1961), in the Dutch media generally called Lucy de B. or Lucia de B., is a Dutch nurse who was convicted to a lifelong imprisonment in 2003. She was held responsible for the death of several hospital patients who had been entrusted to her care which were determined to be murders by the Justice department (7 murders and 3 attempted murders). Her conviction is controversial among the media and scientists and has been questioned by Peter R. de Vries.
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[edit] The case of Lucia de B.
As a result of an unexpected and unexplained death of a baby in the Juliana Children's Hospital (JKZ) in The Hague, The Netherlands, on 4 September 2001, earlier deaths and resuscitations were scrutinized. Between September 2000 and September 2001 there appeared to have been nine such medically unexplained incidents. Lucia de Berk had been on duty at the time of all those incidents, and was responsible for patient care and delivery of medication. The hospital decided to start a prosecution against the licensed child nurse.
[edit] Convicted for life
On 24 March 2003 de Berk was convicted by the court in The Hague to lifelong imprisonment for the murder of four patients and for the attempted murder of three others. The verdict depended in part on a statistical calculation, according to which, allegedly, the probability is only 1 in 342 million that a nurse's shifts would coincide with so many of the deaths and resuscitation purely by chance. De Berk was however only sentenced for cases where, according to some medical expert, other evidence was present or in which, again, according to some medical expert, no natural cause could explain the incident.
In the appeal on 18 June 2004 de Berk was sentenced guilty to seven murders and three attempts to murder in three hospitals in The Hague; the Juliana Child Hospital (JKZ), the Red Cross Hospital and the Leyenburg Hospital where de Berk had worked earlier. In two cases the court found proof that de Berk had poisoned the patients. Concerning the other cases the judges of the court found that they only could be explained when they where caused by Lucia de Berk, this is later on called chain link evidence. In appeal de Berk also gets TBS with coerced psychiatric treatment, which is an uncommon combination with a life long imprisonment. The Court of Justice finds the sentence necessary because of the possibility of a future pardon. In that case de Berk still has to serve the TBS with the coerced psychiatric treatment, before she would be free to enter society.
After dealing with the case by the court on 24 March 2003 a witness, who had been in the Pieter Baan Center, a forensic psychiatrical institute, at the same time with Lucia de Berk, stated that she had said during ventilating: "I have released these 13 people from their suffering". During the appeal the man withdrew his statement. He said that he had made it up. By the media, e.a. the Dutch Broadcasting Foundation (NOS) that followed the process, the withdraw of this evidence was considered as a setback for Public Prosecution Service (OM). This is because this witness was the only omitted hard evidence and had thus disappeared. Several other media, among which the Vrij Nederland and the Volkskrant, started to doubt the correctness of the sentence in the years that followed. The question was asked if the court had not selectively hand-picked her evidence.
Against the ruling of the Court of Appeal Lucia went in to cassation. The Supreme Court decided that on 14 March 2006 the combination of a lifelong prison sentence and TBS is not possible. This was rejected because there is no tradition of consecutive sentencing in the Netherlands. And would be consecutive because in the Netherlands a life long imprisonment is till death or a pardon. All other complaints, among which the selected evidence where rejected, by the Supreme Court. The Court was not allowed to judge over the evidence. Some days after ruling of the Supreme Court de Berk was struck by a cerebral infarction, and was admitted in the hospital of the Scheveningen prison. On 13 July 2006 de Berk is sentenced again by the Court of Appeal in Amsterdam to live long imprisonment.
[edit] Doubts
Concerning the conviction of de Berk there exist a number of doubts by some people. An philosopher of science Ton Derksen who wrote along with his sister, an geriatrician Metta de Noo-Derksen, a book concerning the matter: "Lucia de B. a reconstruction of a judicial misleading" (Lucia de B. een reconstructie van een gerechtelijke dwaling). The doubts about the conviction of the nurse are related particularly to the chain link proof used by the court and the medical and statistic proof.
[edit] Chain link evidence
Of the seven murders laid at the account of de Berk there were two which were considered proven by the court. According to the court de Berk had poisoned these patients. The court had applied a system of so-called chain link evidence. This means that if the two murders were proven then it is assumed proven that the other five suspected deaths had been caused by de Berk.
This is controversial, because in the two murders found proven by the court a natural cause of death is not excluded, according to some experts. Discussion raged over two points regarding the poisonous substances found in the bodies - whether the substances are naturally produced by the body and if measuring techniques in the post-mortem have been correctly applied. In the case where there would be digoxin poisoning the measurements give that the found amount of digoxin, according to Gold standard, a specificity and sensitivity test, could be completely body-own. In the other case it could be a overdose by a faulty recipe. But by both children the question is how and when Lucia was able to give the poison. In one case the time-table of a monitor let see us that at the moment of the poisoning two doctors were making their consult on the patient. According to the first charge of Public Prosecution Service de Berk was held responsible for thirteen deaths. At closer look however it appeared that de Berks involvement could not be proven in a number of these cases. De Berk had for example no service on the day that the patients died. Further it is striking that for all deaths, with exception of the last case, in first place, a natural cause of death was given by a doctor. Some other cases were qualified as medically unexplainable, after the last deaths, and in a number of cases even years later. This practice is deemed controversial by doctors.
[edit] Statistic proof
There exists no hard proof against de Berk. She was not caught "red-handed," and has always denied guilt. Among other things, the court made heavy use of statistical calculations to find its conviction. The chance of a nurse working at the three hospitals being present at so many unexplainable death cases and reanimations is estimated at one in 342 million. The relevance of this number is controversial. It seems that the hospital and the OM had the perception in advance that the dying had been done by a nurse; one wants to examine only still by this way. Also operating from the idea that in the event that all nurses would be, however, innocent become, services random are divided concerning the nurses. The multiplying of chances concerning three departments, was wrong: to combine p values (overshooting chances) for three departments one must introduce a correction p values combined for the numbers, as a result of which the chance becomes one in a million (Fisher's method for combination or independent p-values). In the appeal the Court of Justice no longer used a chance calculation. However the judge continued the use the statistical data implicitly. It was considered obvious that so many incidents could not have ocurred by chance. Derksen told the commission Buruma (Posthumus II) that the number of suspected incidents which occured during Lucias shifts where too large, and the number by other nurses where too small. The indicter appraisal had, as it happens, systematically chosen (or an incident suspicious is or not) that unfavorable was for Lucia, where one sometimes specialist a prefers b above specialist, sometimes the other way around, and sometimes another c... . With because of this adapted figures increases the chance up to roughly speaking one on fifty. Going out of only degree of "innocence" variation between nurses, also A.F. de Vos still presented, becomes the chance one on nine.
[edit] The Diary
De Berk's diary also played a role in her conviction. On the day of death of one of her patients (an elderly lady in a terminal stage of cancer) that she had 'given in to her compulsion.' She also wrote that she had a 'very large secret,' and wrote she was concerned about 'her tendency to give in to her compulsion.' De Berk stated that this referred to her passion for laying tarot cards, whereas the court decided it was evidence that she had euthanased the patients. De Berk explains herself that she did this in secret, because she did not find it found this correct in the clinical setting of a hospital. According to the court the laying of the cards does not rhyme with a compulsion and also with perhaps an expression of fatigue such as she describes it at the same time. The daughter of de Berk, Fabiënne, explained in an interview on the television program Pauw & Witteman that some of her mother's notes in the diary's are 'pure fiction,' which she wanted to use for a thriller.
[edit] The Dutch Forensic Institute rapport (NFI)
During the lawsuit of 13 July 2006 the Public Prosecution Service comes up with a report of a laboratory in Strasbourg. This just is after the treatment of the appeal. The report had been laying in a drawer of the Dutch forensic institute (NFI) for two years. According to Public Prosecution Service the report contains no new facts, but according to de Berk's defence the report proved that there was not a mortal digoxin intoxication in the first case. Because the Court of Justice has only got something to say about the sentence concerning the penalty and concerning the used evidence in the previous trials the report does not play no role during this trial.
[edit] Commission Posthumus II
By Ton Derksen, the case has been appealed for research at the Commission Posthumus II. This commission examines closed cases and looks if there is no case of judicial misleadings. The reason for this is that the medical experts who excluded a natural cause during the trail had all of the relevant information, such as the report which was in a drawer of the NFI for two years the. This request has been granted on 19 October 2006 by the Access Commission of the Commission Evaluation Criminal Matters (Posthumus II). The commission Posthumus II will especially look at the two following matters.
- Or that in the time that Lucia the Berk worked at the different hospitals there where more unexplainable deaths when Lucia de Berk was present or not and if the judges knew this.
- Moreover if the witness specialists where informed of all of the details on the causes of death of the different victims.
The commission will pass no judgement concerning the question of guilty or not guilty but she could give a recommendation that the case of de Berk has to be re-examined. The recommendations of the commission are generally followed.
