Science on Trial

Many people have expressed reticence surrounding the recent announcement by the Manchester Crown court on Monday. I wish to clarify the position that Science on Trial is taking.

As many know, I am a British citizen, who lives and works in California, USA. On September 3rd 2023, Science on Trial, Inc was incorporated as an entity in The State of California, United States. Science on Trial, Inc is now governed under Local, State and Federal laws, as a Scientific Consulting Platform. This step was taken as a precaution, in light of the threats of arrest, prosecution and imprisonment, I received by Cheshire Constabulary, in following my ethical duty (as a scientist) to advise the court that the investigation performed by the police was unscientific, unreliable and based upon faulty scientific reasoning.

This act of incorporation, in California, means that SoT can continue to post content on its blog and message boards without fear of reprisal. SoT and the content posted by its members is protected under Section 230 of the Communications Decency Act (CDA). Section 230 of the CDA is a pivotal piece of Internet legislation in the United States, passed into law as part of the Telecommunications Act of 1996. Its central provision protects online platforms from being treated as the publisher or speaker of third-party content. This means that platforms like social media sites, blogs, and news websites cannot be held legally responsible for content their users post, with some exceptions, such as those that call for violence or law breaking activities.

The core principle of Section 230 is summarized in its key provision: "No provider or user of an interactive computer service shall be treated as the publisher or speaker of any information provided by another information content provider."

This protection has been vital for the growth and freedom of the Internet, enabling platforms to host user-generated content without fear of endless lawsuits.

SoT does not encourage users to post content that violates any laws within the jurisdiction that you reside. However, we will endeavour to ensure that users of our website are free to speak on matters that concern them without fear of reprisal providing that they act in good faith to represent information which they believe to be keeping within the law. As an entity incorporated outside of the UK we are required to adhere to those local, State and Federal laws which all entities in the US are governed by.

What next?

Science on Trial will continue to report on the poor scientific standard which is endemic to our criminal justice systems. And we will not yield to pressures by those who abuse their authority to stifle engagement with the manner by which scientific information is contorted, distorted, and even manufactured in the criminal justice system. Science on Trial will endeavour, wherever necessary, to shine a light on those injustices that are carried out by our governments, and institutions through the misrepresentation of science. If we cannot discuss something as fundamental as peer reviewed research in an open venue for fear of prejudicing the outcome of a trial, we must be prepared to ask ourselves, just who is to be prejudiced by such activity?

We should not, in the scientific community, nor any other community for that matter, be silenced when we become witness to injustice. These injustices may have occurred through error, ignorance or malice, but it matters not what the origin is, it is more important that the horror has occurred. In the case of Lucy Letby a retired medical doctor was permitted to act way beyond his expertise by engaging in flawed and unreliable investigative techniques, and he did so at the request of Cheshire Constabulary. Recent news reports reveal that Cheshire Constabulary undertook no independent investigation prior to taking the CoCH Consultants at their word. Within less than 24 hours they had committed to investigating mass murder, without a shred of evidence, and where it is apparent that not a single doctor even reported their concerns to the Coroner!

Scientific Integrity and Peer Review

In a recent interview, following the conviction of Lucy Letby, Dr David (Dewi) Evans, the NCA's top expert into the deaths at the Countess of Chester Hospital stated:

"If you inject the large volume of fluid or fluid and air into the stomach, the stomach becomes distended. This makes it more difficult for the baby to breathe. Because the diaphragm is unable to move up and down, and you will get a sudden deterioration. And this is something I've never seen before and never seen since. But that was a condition that was easier to prove."

Dr Evans admits he has never seen what he is claiming, and yet he claims to be able to detect that which he has never seen, and where such a claim is never described in any published scientific article. My experience, of being threatened by the Cheshire Constabulary reveals that the criminal justice system in England and Wales, is of the view that any scientist who can speak truth to a claim that Dr Evans cannot support, through experience or reference, is in contempt of its proceedings. I rather think that the law provides that Dr Evans' conduct is that which should be subject to thorough scrutiny and not that of any individual who seeks to expose his flawed and apparently manufactured scientific claims.

Moreover, any person who wishes to detail facts established from peer reviewed scientific articles cannot be in contempt of court. These articles reflect a published body of work, and any expert witness is required to make the court aware of the body of evidence of which they derive their claims. Further, any expert witness is required to detail the method they used in developing their expert opinion.

“factors which the court may take into account in determining the reliability of expert opinion, and especially of expert scientific opinion, include: 'whether the expert's methods followed established practice in the field and, if they did not, whether the reason for the divergence has been properly explained.’”

Criminal Practice Directions CPD V Evidence 19A Expert Evidence 19A.5

It is apparent that the methodology employed by Dr Evans in his work with the NCA was little other than reading through clinical records. Furthermore, his method did not involve the identification of any new information or evidence, nor did it include any assessment of similar events, either in clinical practice or with regard the significant body of evidence surrounding unplanned extubation (UE) of endotracheal tubes in the neonatal population.

In the world of clinical research, UE in neonatal units is an understood phenomena, which has been heavily researched and reveals that agitation was a leading cause of UE in the neonatal population (Kambestad et al., 2020). Importantly, nursing overtime, something that was common at the Countess of Chester Hospital (CoCH) is associated with an increased risk of UE in the neonatal population (Le Blanc et al., 2022). This information was not evidence included at the trial of Lucy Letby and as such it can be widely disseminated!

Scientific Evidence? What Evidence?

There appears to be no evidence relating to the claims made by Dr Evans with regard to most of the claims used to prosecute Lucy Letby. Even his air embolus claims fly in the face of logic, as he refers only to two x-rays to determine air embolism as a cause of death in seven different babies. The rash he states as symptomatic of air embolism is incorrect, as there is no rash associated with venous air embolism, it is associated with arterial air embolism, and that is a separate and distinct phenomena, not associated with sudden collapse. Though, Dr Evans, stated as follows:

"...and these were both babies where I'd made a clinical diagnosis of death via air embolus."

Dr David (Dewi) Evans, interview with Dr Raj Persaud

There is no branch of medicine, anywhere, in which a retired paediatrician, who has not practiced medicine for 15 years, can make a clinical diagnosis on a deceased individual. In order to make a diagnosis one must minimally examine the patient, and conduct additional tests. That did not happen in these cases. Dr Evans was a medical doctor, one cannot 'diagnose' individuals with a cause of death; that is the role of the pathologist. In this case the pathologist did not believe that the two x-rays were sufficient to determine air embolism, in either the patients who were x-rayed or through the extrapolation of x-rays from one child to a completely unrelated child, as was done in this case.

It is hard to imagine that any person could be found talking about the evidence in the first trial, as there was no scientific evidence. There was just Dr Evans' understanding of human biology, which apparently, in many domains remains unsupported by any real evidence.

It seems best to end on a quote from one of the contributors to the Scientific Method, Francis Bacon:

"Surely every medicine is an innovation, and he that will not apply new remedies must expect new evils; for time is the greatest innovator, and if time of course alters things to the worse, and wisdom and counsel shall not alter them to the better, what shall be the end?"

(For those who wish to read genuine scientific evidence on unplanned extubation of endotracheal tubes, which commonly occurs in NNUs, below are peer reviewed articles that are not used as evidence anywhere in the trial of Lucy Letby.)

References

Kambestad KK, Huack A, Nair S, Chapman R,

Chin S, Langga L, Mounger E, Guerrero E, lyer NP.

The Adverse Impact of Unplanned Extubation in a Cohort of Critically III Neonates. Respir Care. 2019 Dec;64(12):1500-1507. doi: 10.4187/ respcare. 06721.

Klugman D, Melton K, Maynord PO, Dawson A, Madhavan G, Montgomery VL, Nock M, Lee A,

Lyren A. Assessment of an Unplanned Extubation Bundle to Reduce Unplanned Extubations in Critically III Neonates, Infants, and Children.JAMA Pediatr. 2020 Jun 1;174(6):200268. doi:10.1001/jamapediatrics.2020.0268.

Le Blanc G, Jabbour E, Patel S, Kazantseva O,

Zeid M, Olivier F, Shalish W, Beltempo M.

Organizational Risk Factors and Clinical Impacts of Unplanned Extubation in the Neonatal Intensive Care Unit. J Pediatr. 2022

Oct;249:14-21.5. doi: 10.1016/ j.jpeds.2022.06.012.