Lucia de Berk

**Lucia de Berk**, aften cried **Lucia de B.** or **Lucy de B** (born 22 September 1961 in The Hague, Netherlands) is a Dutch licenced paediatric nourice, that wis the subjeck o a miscarriage o juistice. She wis sentencit tae life impreesonment in 2003 for fower murthers an three attemptit murthers o patients in her care. Efter an appeal, she wis convictit in 2004 o seiven murthers an three attempts. Her conviction wis controversial in the media an amangst scientists, an wis quaistened bi investigative reporter Peter R. de Vries. In October 2008, the case wis reappent bi the Dutch supreme court, as new facts haed been brocht up that unnermined the previous verdicts. De Berk wis freed, an her case wis re-treed; she wis exoneratit in Aprile 2010.

## Chairges
As a result o an unexpectit daith o a bairn (Amber) in the Juliana Kinderziekenhuis (, JKZ) in The Hague on 4 September 2001, earlier daiths an cardiopulmonary resuscitations wur pit unner mair tent. Atween September 2000 an September 2001 thare appeared tae hae been nine incidents, that earlier haed aw been thocht tae hae been unremairkable but nou war considert medically suspicious. Lucia de Berk haed been on duty at the time o thae incidents, responsible for patient care an delivery o medication. The hospital decidit tae press chairges agin her.

## Life sentence
On 24 Mairch 2003, De Berk wis sentencit bi the court in The Hague tae life impreesonment for the murther o fower patients an the attemptit murther o three ithers. The verdict dependit in pairt on a statistical calculation, accordin tae that the probability wis allegedly anerlie 1 in 342 million that a nourice's shifts wad coincide wi sae mony o the daiths an resuscitations purely bi chance. De Berk wis housomeivver anerlie sentencit in cases whaur, accordin tae a medical expert, ither evidence wis present or in that, again accordin tae a medical expert, nae natural causes coud expleen the incident.

In the appeal on 18 Juin 2004, De Berk's conviction for the seiven murthers an three attempted murthers wis upheld. The creemes wur supposed tae hae taken place in three hospitals in The Hague: the Juliana Bairn's Hospital (JKZ), the Reid Cross Hospital (RKZ) an the Leyenburg Hospital, whaur De Berk haed wirkit earlier. In twa cases the court concludit that thare wis pruif that De Berk haed pushiont the patients. Concernin the ither cases the judges considered that thay cudna be explained medically, an that thay must hae been caused bi De Berk, that wis present on aw thae occasions. The idea that anerlie weaker evidence is needit for the subsequent murthers efter twa hae been pruiven ayont reasonable dout haes been cried chain-link pruif bi the prosecution an adoptit bi the court. At the 2004 trial, asides a life sentence, De Berk wis gien detention wi coerced psychiatric treatment, tho the state creeminal psychological observation unit didna fin ony evidence o mental illness.

Important evidence at the appeal wis tae be the statement o a detainee in the Pieter Baan Center, a creeminal psychological observation unit, at the same time as Lucia de Berk, that she haed said durin ootdoor exercise: "A released these 13 fowk frae their sufferin". Housomeivver, durin the appeal, the man withdrew his statement, seyin that he haed made it up. The news service o the Dutch Broadcastin Foondation (NOS) an ither media that follaeed the process considered the withdrawal o this evidence tae be a muckle setback for Public Prosecution Service (OM). A series o airticles appeared ower the follaein years in seeveral newspapers, includin  *[[Vrij Nederland]]* an the *[[Volkskrant]]*, raisin douts anent the conviction.

The case wis next brocht tae the Netherlands Supreme Court, that ruled on 14 Mairch 2006 that it wis incorrect tae combine life impreesonment wi subsequent psychiatric detention. Ither complaints wurnae taken intae consideration, an the evidence frae a re-analysis bi a Strasbourg laboratory wisnae considered relevant. The Supreme Court gied the matter back tae the Court in Amsterdam tae pass judgement again, on the basis o the same factual conclusions as haed been made afore. Some days efter the rulin o the Supreme Court, De Berk suffert a stroke an wis admittit tae the hospital o Scheveningen preeson. On 13 Julie 2006, De Berk wis sentencit bi the Court o Appeal in Amsterdam tae life impreesonment, wi nae subsequent detention in psychiatric care.

## Douts
A committee o support for Lucia de Berk wis formit that continued tae express douts anent her conviction. Philosopher o science Ton Derksen, aidit bi his sister, geriatrician Metta de Noo-Derksen, wrate the Dutch leid beuk *Lucia de B: Reconstruction o a Miscarriage o Juistice*. Thay doutit the raisonin uised bi the court an the medical an statistical evidence that wis presentit. See an aw the Inglis-leid airticle Derksen an Meijsing (2009).

### Chain-link pruif
O the seiven murthers an three attemptit murthers finally attributit tae De Berk bi the court, the court considered twa pruiven bi medical evidence. Accordin tae the court, De Berk haed pushiont thir twa patients. The court then applee'd a sae-cried chainin-evidence argument. This means that gin the seeveral attemptit or actual murthers haed aaready been established ayond raisonable dout, then hintle weaker evidence than normal is sufficient for tae establish that a subsequent aicht "suspicious incidents" are murthers or attemptit murthers carriet oot bi the same defendant.

For the twa murthers fand pruiven bi the court in The Hague, mony experts dae no exclude a natural cause o daith. In the case whaur digoxin pushionin wis allegit, an supposedly detectit bi independent measurments in twa Dutch laboratories, the method uised in thae laboratories did no exclude that the substance foond wis actually a relatit substance naturally producit in the human body. The Strasbourg laboratory uised a new method, a test o heich specificity an sensitivity, an did no support the digoxin owerdose hypothesis. In the seicont case, the intoxication coud hae been an owerdose caused bi a faulty prescription. For baith childer, it wis no clear hou an whan De Berk wis able tae admeenister the pushion. Regardin the digoxin case, the prosecution gae a detailed reconstruction o the timin. Housomeivver, ither pairts o the evidence discardit bi the prosecution showed bi the time-stamp on a certaint monitor that at the allegit moment o pushionin De Berk wis no wi the patient at aw, an that the specialist an his assistant wur wi the patient at that time.

The prosecution initially chairgit De Berk o causin thirteen daiths or medical emergencies. In court, the defence wis able tae shaw definitively that De Berk coud no hae been involvit at aw in several o thir cases. For instance, she haed been awa for several days; the idea that she wis thare wis due tae admeenistrative errors. Furthermair, aw daiths haed been registered as natural, wi the exception o the last event. Even that last event wis initially thocht tae be a daith bi natural causes bi the doctors responsible for the bairn, but athin a day, on bein connectit bi ither hospital authorities wi De Berk an her repeatit presence at recent incidents, it became classifee'd as an unnatural daith.

### Statistical arguments
The court made hivy uiss o statistical calculations tae achieve its conviction. In a 2003 TV special o *[[Nova (Dutch TV series)|NOVA]]*, Dutch professor o Creeminal Law Theo de Roos statit: "In the Lucia de B. case statistical evidence haes been o enormous importance. A dae no see hou ane coud hae come tae a conviction athoot it". The law psychologist Henk Elffers, who wis uised bi the courts as expert witness on statistics baith in the oreeginal case an on appeal, wis interviewed on the programme an aw an statit that the chance o a nourice wirkin at the three hospitals bein present at the scene o sae mony unexplained daiths an resuscitations is ane in 342 million.

This value wis wrangly calculatit. If ane wishes tae combine p-values (richt tail probabilities) o the statistical tests based on data frae three separate wairds, ane must introduce a correction accordin tae the nummer o tests, as a result o whilk the chance becomes ane in a million.

Biased reportin meant that this lawer figur wis invalid. Events wur attributit tae De Berk ance suspicions began tae faw on her, whilk coud no hae haed onything tae dae wi her in reality. The statisticians Richard D. Gill an Piet Groeneboom calculatit a chance o ane in twinty-five that a nourice coud experience a sequence o events o the same teep as Lucia de Berk.

Philip Dawid, Professor o Statistics at the University of Cambridge (UK), statit that Elffers  "made vera big mistakes. He wis no sufficiently profeesional tae ask whaur the data came frae an hou accurate the data wur. Even grantit the data wur accurate, he did some statistical calculations o a vera simplistic natur, based on vera simple an unrealistic assumptions. Even grantit these assumptions, he haed nae idea hou tae interpret the nummers he got". Professor DasGupta, a toxicologist frae the University of Houston, (Texas, US) commentit on the complete lack o toxicological evidence wi regaird tae the claimit digoxin intoxication.

The uiss o probability arguments in the De Berk case wis discussed in a 2007 *[[Nature (journal)|Nature]]* airticle bi Mark Buchanan. He wrote:

At the initiative o Richard D. Gill, a petition for a reopenin o the Lucia de Berk case wis stairtit. On 2 November 2007 the signaturs wur presentit tae the Meenister o Juistice, Ernst Hirsch Ballin, an the State Secretary o Juistice, Nebahat Albayrak. Ower 1300 fowk signed the petition.

### Diary
Lucia de Berk's diary played a role in her conviction an aw. On the day o daith o ane o her patients (an elderly lady in a terminal stage o cancer) she wrote that she haed 'gien in tae her compulsion'. She wrote on ither occasions that she haed a 'vera great secret' an that she wis concerned aboot 'her tendency tae gie in tae her compulsion'. De Berk haes statit that thir wur references tae her passion for readin tarot cairds, whilk she explains she did secretly acause she did no believe it appropriate tae the clinical settin o a hospital. Housomeivver, the court decidit thay wur evidence that she haed euthanisit the patients. Accordin tae the court, the readin o cairds daes no accord wi a 'compulsion' nor wi 'aiblins an expression o fatigue', as she describit it at the time. De Berk's dochter Fabiënne statit in an interview on the televeesion programme *Pauw & Witteman* that some o her mither's notes in the diaries are 'pure fiction' whilk she intendit tae uise in writin a thriller.

### Dutch Forensic Institute report
Efter the appeal proceedins wur closed, but afore the judges delivered thair verdict, the Public Prosecution Service receivit, via the Netherlands Forensic Institute (NFI), a report frae a forensic laboratory in Strasbourg on the evidence for digoxin pushionin. The report subsequently lay in a drawer o the NFI for twa years, but it did turn up in time for the feenal evaluation o the case afore the Supreme Court. Accordin tae the Public Prosecution, the report contained nae new facts, but accordin tae De Berk's defence the report pruivit that thare wis no a lethal concentration o digoxin in the first case. The Supreme Court accepts the facts reportit bi the judges at the appeal court, an is concerned anerlie wi jurisprudence an correctness o the sentence, gien thae facts. The report tharefore wis no admittit intae the feenal considerations o the sentence gien tae De Berk.

### Posthumus II Commission
In general, in the Dutch legal seestem, cases are no re-opened unless a new fact, cried a *novum*, is foond. New interpretations bi experts o auld facts an data are generally no considered a *novum*.

In spite o this, Ton Derksen submittit his an Metta de Noo's research on the case tae the Posthumus II Commission. This ad hoc, nan-permanent commission examines selectit closed cases an leuks for evidence o errors in the polis investigation indicatin "tunnel veesion" an misunnerstaundin o scienteefic evidence. Derksen pyntit oot that the medical experts who haed ruled oot the possibility o daith bi natural causes haed no been gien aw relevant information, that the hypothesis o digoxin pushionin wis dispruiven, in pairticular bi the Strasbourg analysis, an that the statistical data wur biased an the analysis incorrect, an the conclusions drawn frae it invalid. The commission annooncit on 19 October 2006 that this wis ane o the few cases it wad consider in detail. Three men, recruitit bi the Public Prosecution service frae the full Posthumus II committee, considered the follaein matters, haein been instructit tae focus on possible blemishes in the creeminal investigation:

*Whether thare wur unexplained daiths whan Lucia de Berk wis no present an aw, unkent tae the public prosecutor.
*Whether the expert witnesses wur gien aw relevant available information.
*Whether scienteefic knowledge nou threw a different licht on the digoxin quaisten.

In October 2007, the commission released its report an recommendit that the case be re-opened. Thay concludit that the case haed been seriously marred frae the stairt bi tunnel veesion. In pairticular, the same persons, chosen frae close circles o the hospital authorities rather than on the basis o recognisit relevant expertise, haed first helpit the hospital in its internal investigations, then haed advisit the polis, an feenally haed appeared afore the courts as independent scienteefic experts. Thay notit that thare wis strang disagreement concernin whether or no bairn Amber haed dee'd o digoxin pushionin. On 2 Aprile 2008, De Berk wis released for three month acause efter re-examination o the daith o the last "victim", a natural daith coud nae langer be ruled oot.

## Case reopened
On 17 Juin 2008, the Advocate-General o the Supreme Court, G. Knigge, made a request for the Supreme Court tae reopen the case. On 7 October 2008 the court accedit tae his request, acknowledgin that new facts uncovered bi Knigge substantially undermined earlier evidence. In pairticular, an independent team o medical researchers wi access tae aw available medical information haed reportit tae Advocate-General Knigge that the daith whilk spairkit the case appears tae hae been a natural daith. The key toxicologist o the earlier trials haed greed wi the new medical fyndins, pyntin oot that at the time o the trial, the court haed anerlie gien him pairtial information aboot the medical state o the bairn. De Berk's statements aboot her doins on the nicht o that bairn's daith haed been shawn tae be correct an aw; indeed, durin the period in whilk the courts haed earlier concludit that she must hae admeenistered pushion, the bairn wis actually bein treatit bi a medical specialist an his assistant.

De Berk wis alloied tae remain free while awaitin a retrial at the Court o Arnhem, whilk first adjourned while further investigations wur made. The public prosecution haed asked for extensive new forensic investigations, but this request wis turned doun bi the court. Instead it commissioned further independent medical investigations intae the cases o twa mair o the childer, again allouin a multidisciplinary medical team access tae aw possible medical data concernin the childer. At a session on 9 December 2009, the court statit that new integral medical investigations o the last nine month haed confirmit that the cases o Amber, Achmed an Achraf wur aw natural daiths/incidents. Thir wur the anerlie cases whaur thare wis previously claimit pruif o De Berk's culpability.)

The appeal hearin endit on 17 Mairch 2010. Witnesses heard on the feenal day statit that the daiths at the Juliana Childer's hospital wur natural, whiles caused bi wrang treatment or baed hospital management, an whiles unexpectit acause o faulty medical diagnosis. The behaviour o the nurses, includin De Berk, durin a couple o medical crises turned oot tae hae been swift an effective, savin lives on several occasions. The Public Prosecution capitulatit, formally requestin the court tae deliver a no guilty verdict.  On 14 Aprile 2010, the court delivered the no guilty verdict.

## Compensation
On 12 November 2010, it wis revealed that De Berk haed receivit an undisclosed amoont o compensation frae the Meenistry o Juistice. The news wis first broadcast bi a local TV station in the Wast o the Netherlands. It wis later confirmit bi the meenistry tae the Dutch news agency ANP.

## References

## Bibliografie
*Buchanan, Mark. "Statistics: Conviction by numbers." *[[Nature (magazine)|Nature]]*. 445, 254-255 (18 Januar 2007) | ; Published online 17 Januar 2007

## Freemit airtins
#Site on statistical aspects of case , bi Richard D. Gill, Professor o Mathematical Statistics at Leiden University.
#English summary  o steid o Dutch committee for Lucia de B. bi Metta de Noo an Ton Derksen 
#Three reasoning instincts and the fabrication of facts: the case Lucia de B. , bi Ton Derksen