Was this evil?

The following story is edited from the BBC News website

http://news.bbc.co.uk/go/pr/fr/-/1/hi/wales/7631234.stm: 2008/09/23 14:33:28 GMT

http://news.bbc.co.uk/go/pr/fr/-/1/hi/wales/7631734.stm: 2008/09/23 15:55:25 GMT

A 32-year-old woman has been found guilty of murdering her four-year-old disabled daughter.

Joanne Hill, from Connah's Quay, in Flintshire, had admitted drowning Naomi in the bath last year but denied murder due to diminished responsibility. Hill was jailed for life with a minimum term of 15 years. Chester Crown Court was told she had been unable to cope with Naomi's mild cerebral palsy.

Naomi's father Simon Hill described his wife's actions as "evil".

During the two-week trial, the jury heard hard-drinking Hill was ashamed of Naomi's condition, which meant the little girl had to use callipers to help her walk.

Judge Elgan Edwards told Hill there was no excuse for what she did. He said the aggravating features in the case were the vulnerability of Naomi and the breach of trust between a mother and daughter. He said: "You killed your own daughter because you could not cope with her disability. You had other pressures upon you, a disintegrating marriage and you decided to kill your own daughter by drowning her."

Because of the murder conviction Hill will not return to a secure unit but go straight to prison, the judge said. He commented on Hill's "sad" history of mental health problems and said he hoped she would be transferred back to hospital very soon. He added: "This has been a very sad case. Sad for you, for your husband, for the child you killed. "There can be no excuse for what you did."

On 26 November, 2007, Hill collected Naomi from a child-minder and took her home. The court heard how Hill had run a bath, adding bubble bath and came down for a glass of wine. When the bath was full, Hill put her daughter in the bath and drowned her by holding her head under the water for up to 10 minutes. The post-mortem examination found Naomi had died by drowning and also found facial haemorrhages which pointed to the girl's head being forcibly held under water with her face against the surface of the bath. Hill then dressed the little girl and put her in her car together with a bottle of wine before her husband returned home from work. She then drove around for eight hours.

The following day, Hill arrived at the Countess of Chester Hospital with her dead daughter in her arms, shouting for help.

The court heard how it was unclear what Hill was doing in the eight hours leading up to her arrival at hospital with Naomi dead in her arms. Police established she visited a petrol station at about 2330 BST that night and the jury were shown CCTV footage of her smiling and joking with the sales assistant.

Speaking after Hill was convicted by a unanimous jury, her husband Simon said: "Joanne is a non-swimmer with a fear of water. To be held under water is her biggest fear. "What she did to my princess Naomi was evil. There's not a minute that goes by without me wishing that [Naomi] was still here. She was my constant companion, she was my best friend, she was my little princess."

Hill's mental health issues first became apparent in the early 1990s when, aged 17, she saw a child psychiatrist for anxiety and repetitive thoughts. In 2000, she attempted suicide and throughout the year she was prescribed a medication for anxiety, depression and sleeplessness. In January 2003, shortly before Naomi was born, Hill was diagnosed with chronic anxiety and immediately afterwards, suffered a severe form of post-natal depression.

In a statement North Wales NHS Trust said a full review was to be conducted under the control of the Flintshire Local Safeguarding Children's Board. "Until these formal processes have concluded it would be inappropriate for the trust to make any detailed comment and the trust is also bound by the rules of patient confidentiality," the statement read.

A spokeswoman for the disability charity Scope, which focuses on people with cerebral palsy, said they were "saddened and appalled by this case". "Naomi's death is a tragedy," Alice Maynard said. "However, this case raises the wider issue of how many disabled parents still don't get the support they need in bringing up children and how society continues to portray disability in a negative light, creating shame and stigma around impairment. "Tragically, in this instance, this combination of factors proved lethal."

The jury in the trial of Joanne Hill, who has been convicted of murdering her disabled daughter, had a crucial decision to make about the 32-year-old's state of mind.

Hill, of Connah's Quay, Flintshire had killed four-year-old Naomi but the jury had to decide whether she was ill on the day she killed her daughter.

The defence case rested on proving that Hill, who had a history of mental health problems, was suffering "an abnormality of mind" when she drowned Naomi in the bath.

But Michael Chambers QC, for the prosecution, said Mrs Hill's behaviour in the months and days leading up to the killing had been considered normal and rational.

He said Hill should be found guilty of murder, rather than manslaughter by reason of diminished responsibility, because she had made a "deliberate and conscious" decision to kill her daughter.

Naomi was disabled, having mild cerebral palsy, and Hill could not cope with it, claimed the prosecution.

But deciding whether somebody is mentally ill at a particular time is a complex task.

During the trial at Chester Crown Court, Dr Aideen O'Halloran, a consultant forensic psychiatrist, said Hill's behaviour in the weeks leading up to Naomi's death indicated she was having a relapse of her mental health condition.

The court was told Hill had a history of mental health problems which first became apparent in the early 1990s when she was 17 years old and saw a child psychiatrist for anxiety and repetitive thoughts.

In 2000, Hill twice attempted suicide and throughout the year she was prescribed medication for anxiety, depression and sleeplessness.

In January 2003, shortly before the birth of Naomi, Hill was diagnosed with chronic anxiety and the following April, she had a "hypermanic" episode.

After Naomi was born ten weeks prematurely in a "difficult" birth, Hill suffered a severe form of postnatal depression, although she did respond to treatment.

On Boxing Day 2006 she suffered a severe relapse and left the family home to be cared for by her parents.

Once again Hill recovered, returning to work part-time in the March and full-time a month later.

In June, doctors decided there was no need for further involvement by her local Mental Health Team and in August her case was closed, although she remained under the care of her GP and on several types of medication.

In November, it was recorded that she was drinking heavily, increasing the risk of depression and the likelihood that she would stop taking her medicine.

Later that month she killed Naomi.

Dr O'Halloran concluded that Hill was suffering from depression and was able to "disassociate" her feelings, a combination that was "an abnormality of the mind" in her view.

But Dr Paul Chesterman, a consultant forensic psychiatrist, told the jury Hill's actions had not suggested a mental disorder at the time of the killing last year.

Hill had enjoyed a night out and had sex with a workmate on the Thursday before Naomi was killed, behaviour that Dr Chesterman said was "incompatible" with clinical depression.

Away from the trial, Gordon Huntley from the charity Wrexham Mind office sympathised with the jury's difficult task.

"When it comes to mental health it's far more difficult. When it's a physical illness, it's quite visible," he said.

"With mental health it's not quite so easy because the person doesn't necessarily understand what's going on themselves.

"It can be really difficult for jurors to come to any sort of understanding, let alone decision, about why somebody might want to do something like that."

And the complexity of the issue can lead to very different conclusions, even from experts, about a person's state of mind.

"I don't always agree with some of my colleagues in health on occasions," said Mr Huntley.

"I work closely with them and I'm quite friendly with a number but they do face quite difficult decisions in terms of what is happening to an individual.

"'What diagnosis do I give them and therefore what treatment can I give them or is available, is it the right one?'

"It's quite difficult and can be quite a lonely position for them to carry that burden."

Mr Huntley said it was also incredibly difficult to predict whether somebody with a history of serious mental health problems was likely to commit an extreme act.

"The stigma that people face with mental health issues is significant but it's not warranted, but unfortunately there are incidents that lead to tragic circumstances," he said.

"While for the vast majority, that's not the case, there are some of those events and sometimes people fall through the gaps."

Antibiotic resistance: culprit identified

A news story supplied by Reuters at:

http://www.planetark.com/dailynewsstory.cfm/newsid/47795/story.htm

highlights the danger to human health perpetrated by the dairy industry.

In a nutshell, the antibiotics that are fed to cows remain active in bovine manure. Germs and microbes in the soil become resistant to the antibiotics. As a result, the current array of antibiotics becomes progressively less effective. In the United States, during 2005, 19,000 people died of MRSA. In the UK, MRSA has been instrumental in testing to breaking point the effectiveness of the National Health Service and the credibility of the government.

Were the dairy industry to be wound down, the rate at which antibiotic-resistant germs evolve will slow down.

Spreading germs

I am in bed with a cold. Nothing more than a cold, but a miserable cold: sore throat, coughing, sneezing, headache, aching joints, lethargy, dyspraxia, poor concentration and a profound loss of charitable sentiment. It is not 'flu, and I have not been in bed all day. I have, however, felt lousy all day, and for the past few days. I have been unproductive in terms of my paid work, and have done none of the household jobs I had lined up for the Christmas / New Year break. Plans to take my family out on a trip have had to be cancelled. This cold has been 'expensive'.

I was 'given' the cold. It was passed on to me by someone who had been suffering a heavy cold. They knew they were infectious, and they did little to avoid infecting me.

On the streets of Tokyo, we saw people wearing cotton face masks. From a UK perspective one could easily assume that these people were fearful about catching an infection. However, these were people with respiratory infections who wished to avoid spreading their germs. I find their considerate behaviour easy to respect. In Britain it is not acceptable to wear a cotton face mask except in hospital. If I were to wear one to the supermarket tomorrow, I would be stared at, and it would be assumed that I was unhappy about the hygiene of the shop, its staff or its customers. At work, several weeks ago, I asked whether I might discourage counselling clients who were suffering from a heavy cold or seasonal 'flu from attending counselling, risking the counsellor being off work sick for a few days and thereby denying counselling to other clients. I was informed that it was not policy to discourage clients, infectious or otherwise, from attending counselling. I have never contracted mumps. Being the age I am, the MMR (measles, mumps and rubella) vaccination was way after my time. I am, therefore, at risk of being infected with mumps by anyone who, wittingly or otherwise, exposes me to the disease. I do not understand why it is permissible for my health to be put at risk by people who are unwilling to take responsibility for not spreading infection. (In the spring of 2007, students at Dalhousie University, in Halifax, Nova Scotia, irresponsibly spread mumps across the breadth of Canada because they knowingly ignored quarantine restrictions.) For some reason, spreading germs in the UK is not something about which one takes personal responsibility. As my counselling supervisor recently said about contracting diseases carried by clients: "It's just one of those things." I am permitted to spread almost any germs, including STDs, I wish with impunity. Although there may be some exceptions, such as typhoid and its celebrated carrier, Mary Mallon, according to a Wikipedia article on quarantine: "The last federal order of involuntary quarantine, prior to the 2007 tuberculosis scare, was issued in 1963." Of course, the one virus of which so many people in Britain are fearful to the point of discriminatory prejudice is HIV, transmission of which is largely limited to sexual contact, blood transfusions and needle-stick injuries. In contrast, earlier in the year I read the statistics about food poisoning from ready-prepared food, such as in cafes, restaurants and the chiller cabinets of shops and supermarkets: they are horrific. Many of these infections are personal hygiene related, are easily preventable, and can be fatal. The term 'caveat emptor' (let the buyer beware: the buyer takes all the risks) appears to be applied in Britain a good deal more widely than simply buying things.

Although the threat of an H5N1-based 'flu pandemic seems to have passed, at least for the time being, the level of personal danger posed by the virus would have driven many people in Britain to the extremity of wearing cotton face masks. It goes without saying that it would be the healthy who would be wearing them.

Were the situation to be different, I should prefer the social ethic to be that anyone who was infectious did, as a matter of course, whatever was necessary to prevent the spread of their infection, isolating themselves if necessary. This would inevitably involve hand-washing, and the widespread use of disinfectant hand gels. It may involve the public use of cotton face masks, like in Japan.

Diet and health

Of course I am what I eat. If I eat junk then my bodily functions get junked. If I eat poisons my body gets poisoned. If I drink carcinogens I get cancer. This is not rocket science. It is, however, experienced as extremely challenging to people who, wedded to unhealthy habits, deny evidence that demonstrates their habits to be unhealthy. Under the hot African sun an ostrich may be wise to bury its head for a while in the sand. To leave its head buried indefinitely, however, leads inevitably to death. The British news media exist not even in a parallel universe, but in a universe that at times appears to be perpendicular to reality. In keeping with "Up Yours, Delors", "Gotcha" and "Freddy Starr Ate My Hamster", the British news media can be relied on to deride any suggestion that might enpale the deepest ultramarine of political, cultural, social and scientific status quos. (When Murdoch supported Blair in 1997, Murdoch already knew what most of us then did not.) "Bonkers nanny state claims Earth is round" "Boffins claim phlogiston does not exist" "Pinko bishops say Earth goes round sun" If alcohol is a mild carcinogen, then alcohol is a mild carcinogen. If eating mammals too often leads to a variety of cancers and to heart disease, then it probably makes good sense not to eat mammals very often, or even not at all. As I understand it, Canute/Knut did not believe that he would stop the tide: he was demonstrating that not even he could stop the tide. Third, the food, drink and drugs manufacturers. "Would you like to try this lead-based make-up?" "How about this mercury-based medicine?" "Smoking tobacco will improve both your health and your image."
I am happy that money raised from taxes should be spent on promoting healthy living. I do not understand why money raised from taxes is used to promote healthy living at the same time as money is spent promoting those same products. This is like permitting an arsonist to continue to spray petrol onto a fire that firefighters are trying to extinguish.
Manifesto for immediate action:
1. ban all advertising (including sponsorship) of food related to mammals
2. ban all advertising (including sponsorship) of alcohol
3. ban any retail outlet (including supermarkets) from selling alcohol for consumption off the premises, with the exception of licensed, sole-purpose premises (off-licenses), and prohibiting the sale from those licensed, sole-purpose premises of anything that is not explicitly identified in legislation as alcohol-consumption-related (specifically: confectionery, snack foods and soft drinks)
4. ban any retail outlet from selling tobacco with the exception of licensed, sole-purpose premises (tobacconists), and prohibiting the sale of anything that is not explicitly identified in legislation as smoking-related (specifically: confectionery, snack foods, soft drinks, newspapers and magazines)
5. require anyone importing alcohol into the UK, or entering the UK with alcohol (no exceptions) to be in possession of a wholesale or retail license to sell alcohol
6. require anyone importing tobacco into the UK, or entering the UK with tobacco (no exceptions) to be in possession of a wholesale or retail license to sell tobacco.

In case the above appears extreme, it is worth noting that there are places in the world where the sale of alcohol is either banned (such as in some Musim countries) or restricted in a manner similar to that described above (such as in Scandanavia and parts of Canada). There is legislation in most countries about which drugs may be retailed, and control of the way in which those drugs are advertised and retailed. There is legislation in many countries restricting the import without an appropriate license of any quantity whatsoever of a wide variety of foodstuffs (try taking a sandwich into the US through JFK).

There are many people employed in industries relating to the production and distribution of tobacco, alcohol and food derived from mammals. These people will lose their jobs. New jobs must be found for them. Part of the UK, EU and world economies are based around these products, and there will be a reduction in economic activity. New opportunities must be found and exploited. There is very much to be done in the world: spreading education; building developing economies out of their poverty; improving the natural environment; developing and exploiting energy sources that are less destructive of the natural environment; finding ways to rescue archaeology, cultures and languages that are being eclipsed by the modern world; seeking out new ways and places to live; seeking out new pharmaceutical products; improving the quality of the housing in which people live; spreading and embedding new technology; helping people to get fit and lead healthier lives.

Were western societies to progress in the simple ways described above, the move would represent further steps towards a more wholesome existence.

Infanticide (de facto)

Guidance recently issued to hospital paediatric units by the BMA (British Medical Association) upset me. It is proposed that UK babies born at 22 weeks or earlier should not be resuscitated because their chances of survival are only one per cent, and the likelihood of a surviving child being disabled is high.

Had I only a one per cent chance of living, I would take it without hesitation. I find it hard to believe that few people would say differently. If my daughter had a one per cent chance of survival, I would do all in my power to provide her with that chance.

It would appear obvious, therefore, that the issue for the BMA is not about the chances of survival but that the cost of intensive neonatal medical care is considered too high to make the expense worthwhile. I accept that there are prices that may not be worth paying for a human life, or even the chance of a human life: the sacrificial death of other people; a Chernobyl-scale environmental disaster; or the destruction of a national art gallery or national cultural / world heritage site. However, people, companies and governments the world over spend millions of pounds, euros, dollars and yen on armaments, on base entertainment and on conspicuous consumption. Whilst it would be fair to argue over the merits or otherwise of goods and services bought and sold the world over, a medical policy of refusing to save the life of a prematurely-born child in order to economise on resources seems to be turning medical ethics upside down.

I do not believe that whether a child is likely to be born disabled should be a consideration regarding whether to save the child's life. If the issue is about cost, the financial expense of caring for that child through life would be a drop in the ocean compared to building and launching a military satellite, making a blockbuster movie, or a constructing a cruise liner. However, maybe there is an implicit belief that the life of a disabled child is a life blighted. ("The child would be sensorily impaired, be in constant pain, and have a poor quality of life. We'd be doing it a favour, putting it out of its misery. Were it a dog we'd have little hesitation about putting it down.") It would be interesting to find out the differential suicide rates for disabled and able-bodied people: I doubt that there is much difference (I am ready to be corrected). Maybe the BMA's concern is for the inconvenience to blameless parents of being saddled with a child requiring medication several times each day; additional attention to needs; specialist care, equipment and schooling.

I have a strong belief that societies the world over are better, richer, more humane societies because of the engagement required of them to care for children and young people, older people, people with a learning disability, physically disabled people, people whose health is frail, emotionally vulnerable people, people who live on the edge. Societies that most of all prize and reward strength and excellence, and strive towards conceptual ideals and ideas of perfection, risk losing touch with warm humanity. It seems to me that the UK is already quite some way along that cold path.

I recognise that for many people the term 'family' is problematic, perhaps because of abuses that have taken place within their family. However, I like the term when used more broadly to refer to a group of people who struggle together to make life work. To quote from Lilo and Stich: "Family means no-one gets left behind." For me, that means no-one.

About my father and his death

My father, John, was born on 2 January 1936. Fascism was in its ascendancy in continental Europe. His father, Jim, was in the British army, and lived in Marylebone, central London, UK. Rene had lived with her family in Harrow, north west London. Jim and Rene moved into a flat in Marylebone, and before Jim left the UK in 1939 to fight for his country, they had a second son, my uncle. However, Jim was already married with two daughters. When he returned to the UK, after the war, Jim returned to his wife and daughters.

I wonder what it was like on that doubtless cold, probably miserable, January day, seventy years ago. How frightening it must have been for Rene to give birth to her first child having little certainty about how the baby was to be supported.

***

Aged 48 years, my father had his first heart attack in January 1984. It very nearly killed him. A year or two before he had bought a small, unexceptional terraced house, in which he was now living, in Enfield, north London, UK. He had recently started in a new, though somewhat menial, office job in nearby Palmer's Green. He remarried in spring 1983, at a civil ceremony in Liskeard, Cornwall, UK, at which I was a witness. Anne Stevenson wrote them a wedding poem that was subsequently published in The Times. Their first, her second, his third, daughter was born in December 1983. That first heart attack was also the start of his life.

My father's final, fatal heart attack struck some eight years later, when he was aged 56. He was now living in an attractive, stone-built cottage that he and his wife had bought and renovated on the edge of Bodmin Moor in Cornwall. He was working as a counsellor and counselling trainer; he was reading and writing a lot; he was able to spend time walking on Bodmin Moor, time learning about the local history and natural history of eastern Cornwall, time on his small-holding, time raising his daughter. During those eight years, he lived more, and more richly, in ways that were meaningful to him, than he had been able to live in the preceding 48 years. He had become interested and interesting, someone who had something to say, someone I could relate to. On the one hand it seems to me desperately sad that six sevenths of his life were dirt-poor, unfulfilling or deeply unhappy, and often all three. On the other hand I am thankful that he was able eventually to find happiness, and also that it was the final stage of his life that was the most enjoyable, fulfilling and personally rewarding for him.

He died on a Monday morning. His death was sudden and unexpected. Whilst his health since the first heart attack had required management, the triple-bypass operation had been successful. He had an ischaemic heart attack in 1991, and was subsequently subjected to hospital tests ("testing to destruction" he called it - I wonder if he was, in fact, correct). However, to all appearances, he could have lived a further ten years.

I was teaching at the time, and received a telephone call informing me of his death. For some reason I was not surprised. My co-tutor assumed responsibility for the class as I prepared to leave. I drove home, packed a few things, and set off for Cornwall: 400 miles, door-to-door. Several abiding images: sitting alone in a motorway service station drinking a mug of coffee, thinking about the bleak telephone call that told me of his first heart attack eight years before; an empty neon-lit motorway at midnight swooping down into Bristol; the narrow country lanes of eastern Cornwall, always so full of primroses and promise, now devoid of meaning, their sole and barren purpose to lead me to my father's dead body. It was something after two in the morning when I arrived.

I spent time with him, alone, reflecting on my experience of his life, my experience of my life with him, this experience of sitting in a room with the dead body of my father, this experience of sitting in a room with a dead body. His body had been laid on the bed, a loving, if practical, gesture, about which there was something calming, and amplified by the apparent peacefulness of his repose. I should have found it disturbing had his body shown indications of pain. I never doubted that he was dead, even though I expected to. His body looked lifeless, in the same way that the engine of a car recovered from having been swept out to sea is far beyond any hope of repair. His body appeared separated from life, like a spacewalking astronaut whose umbilical was accidentally, catastrophically, severed. I could see that my father was now beyond my reach, further receding as each moment passed. Although I debated the issue this way and that, I had no desire to touch his body for I was clear that I wished that my last and lasting memory of his physical presence should not be one that was cold and alien, but instead was visually warm and homely. Not everyone is offered my advantage of choice, and I remain sure, and thankful, that I made the right decision for me, about him, at that time.

We held a public funeral for him in Bodmin one morning the following week, playing tapes of music meaningful to him, such as from Mahler's Das Lied von der Erde. A huge number of people were in attendance, almost all from his life since his move to Cornwall after his first heart attack. In the afternoon we held a more intimate gathering in the tea rooms at Lanhydroc. His body had been cremated, and we scattered his ashes in places that had become important to him: up on the moors, and in the local woods and rivers. Each event involved acknowledging and accepting the reality of his death and embracing the pain of loss. I realise now that inevitable tectonic movement was taking place in the dynamics of family relationships, for since his life had restarted my father had become the hub connecting people. Without him the old model would no longer function. I was also at a watershed in my comprehension of him as a person: no longer able to check things out with him, no longer able to interact with him, in the main all that I shall ever understand about him is already within me. I have spent the past twelve years slowly getting to know what kind of a person he was and what kind of a life he led, both before and after that first heart attack.

Now that I am entering that same age-window, I cannot help but be aware that the ages at which he had his various heart attacks seem so young, premature, and frighteningly close-to-hand.