Certainty Is Not Justice: Blame, Power, and Institutional Fear in the Case of Lucy Letby

There are moments when the criminal justice system does not uncover truth so much as manufacture relief. The case of Lucy Letby may be one of them.

This is not an argument about innocence. It is not a denial of harm, grief, or the profound suffering of bereaved families. Rather, it is an argument about certainty: how it is produced, why it is embraced, and what it enables once it hardens into fact. More specifically, it asks what degree of certainty allows institutions to avoid confronting harm when it occurs within their walls.

When babies die in a hospital, uncertainty becomes intolerable. It threatens professional authority, destabilises institutional legitimacy, and fractures public trust in systems designed to protect the most vulnerable. In such moments, the demand is not merely for explanation, but for resolution. Criminal justice is exceptionally effective at providing this. A conviction offers moral clarity. A sentence restores order. A named perpetrator allows the system to breathe again.

But resolution is not the same as understanding. And certainty is not the same as justice.

The Seduction of Singular Blame

The concentration of blame on a single individual is not accidental; it is functional. When harm emerges from complex institutional environments, individual culpability performs essential political and organisational work. It transforms diffuse failure into manageable deviance. It renders systemic risk into personal pathology. It offers a story with a beginning, a middle, and an end.

Once responsibility is located in a single body, other questions quietly recede.

Who authorised staffing models that placed neonatal care under sustained pressure? Who designed governance systems that failed to respond effectively to escalating risk? Who received concerns, delayed action, or offered reassurance where intervention was required? Who normalised unsafe conditions as regrettable but acceptable?

These are not abstract or peripheral questions. They are questions of accountability that become conspicuously underdeveloped once criminal guilt is localised. The more absolute the attribution of individual blame, the less necessary it becomes to interrogate institutional harm. Criminal justice, in this sense, does not merely punish; it protects. It draws a boundary around culpability that shields organisational actors, managerial decisions, and regulatory failures from sustained scrutiny.

This is not an argument that individual wrongdoing and institutional failure are mutually exclusive. They are not. Yet the criminal justice system repeatedly behaves as though accountability were a finite resource, as though holding one person responsible exhausts the need to examine others. This is not justice; it is containment.

Law’s Demand for Certainty in a World of Uncertainty

The case sits at the outer edge of what law can legitimately claim to know. Neonatal medicine is not a field of forensic certainty. It is probabilistic, interpretive, and deeply contextual. Outcomes are shaped by multiple interacting variables: prematurity, infection, resourcing, staffing ratios, clinical judgement, and organisational culture. Causation is frequently complex and contested.

Yet the courtroom demands decisiveness. Juries are asked to resolve scientific uncertainty not by grappling with its limits, but by selecting the narrative that appears most coherent. Once a prosecutorial story takes hold, uncertainty is reframed as concealment, coincidence as pattern, and ambiguity as intent.

This is not a failure of jurors, nor an allegation of bad faith. It is a structural mismatch between law and knowledge. The adversarial legal process struggles to accommodate epistemic humility. It rewards closure rather than caution, plausibility rather than provisionality.

In cases of technical complexity, verdicts risk becoming reflections of narrative coherence rather than scientific certainty. History offers sobering lessons about the dangers of such overreach, particularly where expert disagreement reflects genuine uncertainty rather than incompetence.

Gender, Moral Shock, and the Collapse of Doubt

The cultural power of this case cannot be disentangled from gender. Feminist criminology has long demonstrated that women who transgress caring roles are constructed as uniquely deviant, not merely criminal, but monstrous. The figure of the “killer nurse” constitutes a profound moral rupture, generating shock of a particular intensity.

This moral framing accelerates certainty and collapses complexity. In such cases, doubt itself becomes suspect. To ask how guilt was established is easily reframed as a question of whether justice should exist at all. Analytical inquiry is recast as moral failure.

This dynamic performs important ideological work. It reassures us that harm results from aberration rather than structure, from individual evil rather than institutional design. It allows systems to distance themselves from failure by attributing danger to the exceptional individual rather than to the ordinary operation of strained environments.

The issue is not scrutiny, but asymmetry, scrutiny that is absolute in one direction and absent in others.

The Questions that Refuse to Go Away

Who else was not held to account?

If the deaths resulted from systemic failure, where is accountability for governance, resourcing, and oversight?

If concerns were raised and mishandled, where is the responsibility for that failure of response?

If institutional conditions amplified risk, why does criminal justice fall silent at the organisational threshold?

These questions are not speculative. They arise directly from the institutional context in which the deaths occurred, a context later criticised for serious failings in leadership, staffing, and escalation processes. Yet criminal justice remains overwhelmingly focused on individual pathology rather than organisational harm.

This reflects a broader and well-documented pattern. Harm produced within institutions is routinely individualised in ways that protect senior decision-makers, regulators, and systems from meaningful accountability. Criminal law is highly effective at punishing individuals and strikingly ineffective at confronting structural violence.

To insist that others could, and arguably should, have been held to account is not to deny harm or absolve individuals. It is to recognise that justice loses credibility when it stops precisely where power begins.

Certainty as Institutional Relief

There is comfort in finality.

Appeals exhausted.

Charges concluded.

The case closed.

Closure offers reassurance not only to the public but to institutions themselves. It allows organisations to mourn without reckoning, to punish without reform, and to move on without asking whether the conditions that produced harm have meaningfully changed.

History teaches us that the gravest miscarriages of justice are rarely born of malice. They emerge from fear, pressure, and the need for reassurance in the face of intolerable uncertainty. They arise when systems prioritise legitimacy over humility, and closure over reflection.

When certainty becomes comforting rather than evidential, it should make us deeply uneasy.

The most unsettling possibility raised by this case is not simply that the wrong person may have been punished, though that possibility must remain open, but that criminal justice was mobilised to absorb institutional failure rather than expose it.

If justice cannot ask who else bears responsibility, it risks becoming not a mechanism of accountability, but a technology of reassurance, one that sacrifices complexity for closure and doubt for order.

This is not a call for exoneration.

It is a call for courage.

The courage to sit with uncertainty.

The courage to resist narrative closure.

The courage to recognise that harm produced within institutions cannot be meaningfully addressed by isolating one individual and declaring the system absolved.

The danger is not doubt.

The danger is mistaking certainty for justice.

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Author’s Positioning Note

This article is written as a piece of public criminology. It does not seek to determine guilt or innocence, nor to diminish the suffering of those affected. Rather, it interrogates how certainty is produced within criminal justice responses to harm occurring in complex institutional settings, and how accountability is often narrowed to individual actors while broader organisational responsibility remains under-examined.

The argument forms part of a wider body of work concerned with institutional harm, epistemic risk, and the limits of criminal justice in addressing failures that emerge within healthcare, custodial, and regulatory systems. The questions raised here are intended as a provocation, an invitation to critical reflection rather than closure, and will be developed further through subsequent academic analysis.