What motivates a serial killer?

Judge - Lucy Letby, on each of the seven offences of murder and the seven offences of attempted murder, I sentence you to imprisonment for life. Because the seriousness of your offences is exceptionally high, I direct that the early release provisions do not apply. The order of the court, therefore, is a whole life order on each and every offence, and you will spend the rest of your life in prison.

Judge, Mr Justice James Goss, sentencing British nurse, Lucy Letby, who was found guilty of killing and attempting to kill multiple newborns in northern England.

Much of the commentary on the case has dwelled on why Lucy Letby did what she did. But David Wilson, professor emeritus of criminology at Birmingham City University and a leading authority on serial killers, argues that getting inside the minds of serial killers is unhelpful. Instead, he says, in trying to reduce the risk of a repeat, we should focus on who their victims tend to be and the environments in which they tend to operate…

David - Most of my research has been trying to explain that serial killers reveal vulnerabilities in society which allow them to continue to kill for the length of time that they do and Letby was an outlier. In terms of the research I've conducted about nurses who'd kill in a hospital setting, most of whom, according to my research will be caught within three months, she was able to avoid detection for 12 months. And the vulnerabilities surely that Letby reveals is that she didn't have horns on her head. She was seen as nice Lucy Letby, and that therefore meant that alarm bells didn't ring quickly enough or for long enough to stop her from killing.

Chris - You said in a piece you wrote for one of the broadsheets earlier in the week that like most of the serial killers I've worked with and studied, Letby's been silent about what might have driven her to kill. But what detectives have produced, which is quite intriguing on searching her house, were pages and pages of notes all about what her motivations were, et cetera. Is that unusual?

大卫,这是不寻常的,我也不觉得particularly significant. I've read most of those notes and I didn't find them particularly compelling in revealing what might have been a trigger for her wanting to kill. It seemed to me that every serial killer I've worked with or studied either is very silent and uncommunicative about their motivation, or indeed one particular serial killer I worked a great deal with. We talk endlessly about his motivation, but not necessarily with any great insight or indeed offspring any help in thinking through what one should do to stop similar serial killers. So I find the whole motivation question for me is one that is obviously intriguing to many people, but ultimately isn't going to allow us to really think through what we should be considering about stopping other nurses in a hospital setting from killing vulnerable patients.

Chris - Are the media and to a certain extent also books and novels and films and TV and so on, are they being a bit misleading then because they're almost using 'getting inside the mind of a serial killer' and all that kind of thing as a plot device in order to move the narrative on or or to create that sort of tension that makes it watchable and in fact, that is not, you're saying, how these guys tend to operate?

David - That's absolutely correct. As far as I am concerned and indeed I've spent an entire career, I think, having an academic and an interpersonal debate with FBI profilers who are constantly trying to get into the mind of a serial killer. And I keep arguing, well, I've spoken with many, many serial killers and either they're quiet or they talk endlessly but don't tell me anything. And so it's far more important, it seems to me, looking at the groups who are vulnerable to attack.

Chris - What do we do then about making the situation safer without, at the same time, the burden of overregulation? A number of doctors have been interviewed on this subject and they've said, look, in the wake of what happened to Harold Shipman, there was a very strong reaction to regulate the medical profession. Many people say none of what doctors are now going through in terms of annual validations and so on would catch Harold Shipman if he was still operating today.

David - I think that's a fair point. I also think that it's important to bear in mind that the research that I conducted with a colleague about nurses who are going to kill in a healthcare setting from the 1970s through to the mid 20 teens, worldwide, we found a total of 16 such nurses. Now that tells you this is a very, very rare phenomenon and therefore the chances of it happening again are also incredibly rare. It does seem to me that she continued to kill for longer than those nurses that would be part of the sample that I uncovered who were, by and large, caught within three months. And that does take us back into why red flags didn't fly and fly for longer in her case. And that has to do with the fact that she was very well integrated into her team. She didn't make them feel uneasy. She had appropriate qualifications. She didn't seemingly spend two inappropriate amounts of time talking to the families of the babies who had died, killed by her. But at least two of the consultant paediatricians alerted the hospital managers to their concerns about what was happening to the neonatal unit and no action was taken or action wasn't taken until it was too late. Now, there has to be a lesson that's learned from that - hospital managers should have taken seriously what a number of paediatricians were saying about the spikes in death, which were significantly higher than the previous year before Letby started to work on the neonatal unit.

Chris - But what you've just said is almost the same as when a person goes through various disclosure and barring checks, for example, to see if they have some kind of criminal past that they've swept under the carpet or kept in the closet. A lot of these tests and things assume that someone comes with a pre-made track record that you can find that discloses them as a problem. Many of these people come with a clean bill of criminal health and they're going to look like shining examples of practitioners.

David - Well, that's really interesting that you say that because that's actually not what my research uncovered at all. Of the 16 nurses who killed in a hospital setting, virtually all of them had some kind of problematic history in a previous unit, and often they were moving on precisely because they were making people in that unit or that hospital feel uneasy. And one of the main messages of the research was that hospital administrators had to take up their references, the references of people, nurses who were moving from one hospital or one unit to another, and who were moving regularly because they were making people uneasy. But there was such pressure in the healthcare systems that the temptation was not to take up their references because those administrators were just simply so grateful that they had got a pair of hands to fill the vacancy. And so some of the basic things still need to be done, it seems to me, and therefore, rather than thinking up clever and evermore bureaucratic processes, maybe what we've just got to do is do the basic things correctly.