Dutch Family Justice – the tragic case of José Booij

The following text was originally written by my good friend Brian Sacks, Nov 2010, and published on his blog http://www.briansacks.com/html/a_dutch_tragedy.html. I plan to add a new post in my own blog, with a report of my own experiences in the case, mainly during 2010 – 2011.

For a Dutch translation of the present post, see https://gill1109.com/2022/01/17/nederlandse-familierechtspraak-de-tragische-zaak-van-jose-booij/.

Brian spent a week or two in the Netherlands in July 2010. I joined Brian and José on several sightseeing trips, and Brian recorded numerous conversations with José.

But first, a little more introduction, [by me, Richard]. Since 2014 (when José was detained in the Medway Maritime Hospital in the UK, and not allowed to have any contact with the outside world), nothing has been heard from José by any of her friends and supporters. Her doctors at the Medway Maritime even refused any contact with friends of hers and refused to receive psychiatric reports from the Netherlands.

I suspect she is no longer alive, but she might just still be in the same institution in the UK. Her daughter Julia Lynn, who I do suppose is still alive, is turning 18 this year. She may be living under a different name now and she may not even know her birth name. She has always been legally entitled to know about her birth parents, and she will soon have the rights of an adult. No obligation, of course.

In 2010 José entrusted me with all kinds of things to keep for her daughter. Family photos, diaries, tape recordings, correspondence. Including actually a letter from the Dutch queen [well: the queen’s personal secretary] actually promising to take action. There was little action because José herself became untraceable.

Now, back to Brian, in 2010.

“Hush little baby, don’t you cry
You know your mama was born to die
All my trials, Lord, soon be over”

All My Trials, sung by Joan Baez

As I [Brian Sacks] wrote this [November 2010], José Booij was still alive. As you read it, she might not be. As it is, her face is disfigured and partially paralysed, the result of a suicide attempt that left her in a coma for eight days. And while she may not have been born to die, perhaps her fate was sealed when she was two years old. Simply put, this is her story

  • On 2 December, 2004, José’s six week old baby daughter Julia Lynn (born 21 October, 2004, at the Scheper Hospital, Emmen, province of Drenthe) was forcibly taken from her by the Dutch Bureau of Youth Care, and given to foster parents.
  • Almost forty years previously, José had herself being taken from her own caring mother at age two and raised by abusive foster parents.
  • Examined in the hospital immediately after being taken, Julia Lynn was found to be perfectly healthy, well fed and well cared for. But she was not returned to her mother.
  • Prior to the baby’s removal, José Booij was a successful medical doctor working as an insurance doctor in the North-East of the Netherlands.
  • The trauma and financial consequences of these events and the ones they triggered, as well as numerous court cases, reduced Jose to bankruptcy.
  • Almost two years after Julia Lynn’s removal, José conceived another child by artificial insemination. But because the government had seized José’s assets, and because trauma had left her unable to manage her own affairs, her water supply, electricity and heating were cut off, and as a result she miscarried. Within days she was evicted, and began living on the streets.
  • By way of Belgium, France and Spain, José moved to Portugal, where she re-established herself as a translator. She had a job, a house and a car. But again she was dispossessed by order of the Dutch Justice Department, and thrown out onto the streets.
  • On re-entering Holland in 2009 with the intention of renewing her fight to win back her daughter, she was arrested and locked up at the Delta Psychiatric Centre near Rotterdam. It was merely the latest of the 20 times she had been arrested and nine times that she had been thrown into a mental institution. The Dutch government do not recognise that she is traumatised by their own actions; for them she is simply schizophrenic and psychotic. In no other country is she considered to have these mental problems.
  • She continued to be locked up at Delta, denied contact with the outside world, and injected with antipsychotic drugs, because the psychiatric staff did not believe her story. Only after seven months did the Institute make the necessary phone calls that proved that José was telling the truth. With the help of friends, she left Delta after 10 months in July 2010, and rented an apartment in The Hague.
  • José attempted suicide in November 2010. She had fought to win back her daughter for six years. She had not seen her daughter since March 2005.     

José and her baby Julia Lynn, hours before Julia Lynn was removed by police and child protection authorities

José Booij was born in November 1963, two days after the assassination of President Kennedy. In Britain and America, it was a time of fresh ideas and changing lifestyles. But centuries-old prejudices and social mores still prevailed in The Hague, Holland, where José lived with her mother and sister. When José was two years old she was taken away from her mother, the family falling victim to gossip and prejudice against single motherhood. Despite her mother being well able to take care of her, and despite her mother still keeping José’s sister, José was placed with foster parents.

Her foster parents were a separated couple who hated each other but lived together making a business out of fostering about six children at a time. José tells of a decade of verbal, emotional and physical abuse:

“I was beaten severely in the home and so were the other children. Once, when I was four or five years old, I saw my foster parents smash my foster brother John’s head against the wall. I saw his eyes turn away and saw him slide down the wall leaving a streak of blood behind him. He was a nice kind boy, and of all the other children in the home I liked him the best. They ordered him to beat me up, but he tried to hit me as gently as he could while still convincing them that he had hurt me. I think they knew that we liked each other, and that’s why they ordered him to beat me up. They made me take my glasses off before being hit in case they got damaged.

“He was severely damaged by his experiences. He used to dissociate, like I did, escaping inside his mind, and then they would beat him up because he wasn’t paying attention. As he got older, he started drinking, smoking, and using drugs. He was locked up in a mental institution for 20 years, and he tried to kill himself several times. He was stupid enough to jump from a fourth-floor window and ended up with his back broken. But later on, he did it right and threw himself in front of the train. I admired him for that. He had been tortured his whole life but now he was free”.

Throughout José’s decade in the home, her real mother had been trying to win her back and to visit her, but the foster parents had prevented this. Finally, she engaged a lawyer and managed to have the home checked out by a competent inspector from the Bureau of Youth Care. As a result, the home was shut down, but by now her mother was a broken woman. Fifteen years after José had been taken from her mother, she received an apology from the Dutch government.

José spent the remainder of her high school years living in a total of twenty other foster homes, a few weeks at a time in each. In school, she worked hard and read assiduously. In each new home, she observed the interactions between adults and children. “I watched how the parents acted, how the children responded, and how it all made everyone feel. So I learned how people behave, but I kept my distance because I felt so different from them. I felt like somebody from a different planet”.

José overcame her disadvantaged upbringing to win a place to study medicine at the University of Groningen, starting in 1985. She was a successful student but by the time she was twenty-five she was finding that her individuality was causing problems with her medical trainee colleagues. “They started to pressure me to conform in the way I dressed. My clothes were too chic for them. I had to stop varnishing my toenails, using make-up, wearing rings and earrings. They said I should cut my hair. I felt that I needed help to deal with the prejudice I was being subjected to, and that is when I came to consult Dr Bakker”. Also at some point in her medical studies, José started having dissociative spells, drifting mentally into her own world and snapping back with no memory of the preceding moments. Dissociation is a common response to childhood trauma.

Dr Beata Bakker was a well-known psychologist who had developed a technique called “Constructional Behavioural Therapy” focussing on future behaviour rather than past history. Dr Bakker convinced José that, although she was suffering depression linked to her childhood traumas, she was not permanently damaged by them and they need not affect her future.

In the years that followed, it seemed as if Dr Bakker’s assessment was correct. José qualified as a doctor, built a successful career and travelled the world. She spent a year practising medicine in the Agogo Hospital in Ghana, where her work included research into malnutrition in babies.

But sixteen years after José first consulted Dr Bakker, her childhood traumas revisited her in a very literal sense. In September 2004 José gave birth to a daughter, Julia Lynn, resulting from a brief relationship with musical instrument maker Peter de Koningh. Just six weeks later, on December 2, 2004, agents of the Bureau of Youth Care forcibly removed the new baby from José’s home in Elim, Drenthe, and took her to Bethesda Hospital in nearby Hoogeveen. Almost three decades after José had been taken from her mother, her newborn baby had now been taken from her.

Not only José, but also her neighbour Marijke Eijpe at #113 (now occupied by a Mr. Hutterd) have left Elim forever

It is important to look at the reasons that Julia Lynn was taken, and the supporting evidence. Concerns had been first raised by a neighbour and then by the district nurse, over José’s psychiatric health and the baby’s feeding regimen. The family doctor, asked for his assessment, diagnosed José as ‘borderline’. On the strength of these reports, submitted to the General Child Abuse Hotline (AMK), the Council of Child Protection ordered the child’s removal from the home.

But none of these points were based on any reasonable evidence. Julia Lynn was examined in the hospital and found to be perfectly healthy, well-fed and well cared for. Nevertheless, she was put into foster care because of the Council of Child Protection’s concerns about José’s psychiatric state and because of their objections to José breastfeeding rather than bottle-feeding.

The neighbour’s motivations in raising concerns need to be questioned. José maintains that there had been long-standing ill-feeling between them. She states that the neighbour owned the land adjacent to José’s house and was obliged to build an access road, but refused to do so. José also says that during her pregnancy this neighbour had already threatened to have the baby taken away from her.

The doctor’s diagnosis of ‘borderline’ was shaky indeed. He had only seen Miss Booij on, at most, two brief visits to mother and baby. He admitted that he only made the diagnosis under pressure from the AMK. He was not allowed to testify in court and then for two years refused to answer any questions from the judges about the case. Various psychiatric assessments subsequent to the removal stated that Booij did not have any psychiatric disturbance at all. Booij has stated, “The one time that the doctor saw me was when he came to the house and said that the government agency was going to bring the baby to the hospital to check her out. He stated that something in connection with my breastfeeding was not in order – the neighbour had reported that. I screamed that they had to go away. I stood in front of my baby’s bedroom to protect her. They went away and two hours later there were five police cars in my front garden. Police officers entered my house, threw me on the floor and ran away with my baby”. 

Concerns over the feeding appear similarly flimsy. José was breastfeeding on demand every three hours rather than bottle feeding to the district nurse’s specified four hour schedule. She was falling foul of Holland’s rigid policy in favour of bottle feeding, and this was subsequently brought up against her in court. The nurse stated, “I saw Booij getting thinner, she was getting increasingly exhausted and confused. If anything had happened and I had not done anything, then I would have been sorry”.

This response hints at what may have been the real reason for the removal. There had been a number of child murders in North Holland in the recent past. The Council of Child Protection, and its agency the Bureau of Youth Care, had been aware of the families involved and their problems but had not prevented the tragedies. This had resulted in a determination by these agencies to prevent such a thing from happening again. Cees Wierda, the Director of the Bureau of Youth Care (Drenthe region) responsible for the case, stated that murders of babies in recent days had certainly played a role in the decision to remove the baby. “It has increased our workload and we must minimise risk”.

Perhaps only such a climate of reaction and fear can account for a healthy and well cared for baby being removed from a competent and loving mother in an advanced Western country such as Holland.

 – – – –

During the weeks following the baby’s removal, José was locked up by the police several times for a few days at a time over allegations made by neighbours. Her neighbours dug a ditch around her house to prevent her from being able to reach it. Finally, José was locked up for several weeks over alleged threats and only released on condition that she never return to her house. She sold her house at a loss that rendered her bankrupt. Her car was now the only roof over her head.

From this point onwards, José’s life spiralled inexorably downwards. Not only had her baby been taken from her, but also the belief that the traumas of her childhood were consigned to the past. On the contrary, they surfaced uncontrollably, making it impossible for her to respond rationally to events as they unfolded. Contacts with the Bureau of Youth Care inevitably resulted in outbursts of anger. Her lawyer at that time, Jaap Groen stated, “Youth Care has treated Miss Booij from the start as if she was demented. The way things were done would not have done her psychiatric health much good, and I don’t think that is a great surprise.”

Estate agent Henk Kroezen and his wife were friends of José who gave her emotional and practical support in the weeks after Julia Lynn was taken. According to Kroezen, “My wife took her in straight away at the beginning to the Council of Child Protection to see her baby daughter, but José made everything quite impossible there. She got so extremely angry with Child Protection”. Regional Youth Care Director Cees Wierda said in 2006, “We would like to talk about the conditions under which the mother can communicate with the baby, but this is impossible with this mother”.

 – – – –

Julia Lynn’s removal became the subject of a traumatic, confusing and expensive sequence of court trials. At her first significant trial, José was confronted with what could be considered stark primitive prejudice. She relates, “The judge [mrs GW Brands-Bottema; family court in Zutphen, and at the time also president of the Dutch union of protestant country women] told me that I was too slim, too fragile and that being slim was a sign of being too stressed. My gynaecologist told the judge that this was completely untrue and that I was perfectly healthy. Her subsequent reward for this was to be dismissed from her post. The judge also said that a man should be the head of the family and that I was a bad mother because I worked. She told me that I had to give up my career as a medical doctor to stay at home and look after my baby and that I should have a husband. I had been intending to take my baby to a day-care centre so that I could resume my career when my maternity leave came to an end, but the judge told me that this was not acceptable. There was just one judge, and this was her first case. I felt that she hated me because I had a career and a baby. Her message to me was that I could have one or the other, but not both. My lawyer protested against the judge using simple prejudice as a justification for my baby being taken away, but the judge flatly stated that she made the decisions in her court. This was a closed court; no journalist or outsider is allowed in the court in Holland. There is no jury system in Holland. There is no stenographer, you are not allowed to make tape recordings or write down a transcript of the proceedings. The courts accept without question anything a government representative says. They took as proof that I was insane the fact that many years earlier I had received counselling from Dr Bakker. They didn’t understand that you could go into counselling because you wanted to develop and grow”.

The Appeal Court in Leeuwarden ruled that the Bureau of Youth Care was incompetent and should have no further involvement with the baby. But this and subsequent trials over the following two years did not lead to the baby being returned. Typically each trial called for a further investigation and simply postponed making a decision. Typically also, nothing would come of the called-for investigation. Furthermore, as far as the Justice Department was concerned, the passage of time effectively destroyed the possibility of the child bonding with the mother. José has definite views on why she has been denied justice: “In Holland, there is no separation of powers. The judges are not independent, they are appointed by the Minister of Justice, they work for him and they take direction from him. The agencies that took away my baby are part of the Ministry of Justice. The judges said that this case must be kept out of the newspapers. It is clear that they wanted me shut away and my case hushed up”. José herself was becoming more and more desperate and traumatised.

José had met up with her mother again after her baby had been taken. She had felt she needed to ask her mother how she had managed to stay alive after she herself had been taken all those years ago. Her mother’s answer was to have another baby. This was the same answer that Dr Bakker had also given José.

José decided to try for another baby by artificial insemination and became pregnant again in August 2007. But she was now in desperate financial circumstances. Her trauma had left her incapable of managing her own affairs, and a lawyer was supposedly looking after them on her behalf. The government had frozen her bank account and confiscated her income, which by this stage was a disability allowance. At the end of October 2007, José wrote to the Queen of Holland, telling her that she was pregnant and being threatened with eviction, and asking for help. But José miscarried a few days later, exactly twelve weeks and a day after conception, as a consequence of her water supply, electricity and heating having been cut off. A few days after this she was evicted and began living on the streets.

José fled the country shortly afterwards. She stayed for a short time in Belgium and then in France and Spain. Each embassy that she asked for help would ring up the Dutch authorities, who would tell them that José was mad and should be locked up. Finally, José arrived in Portugal and ended up staying for two years. She says, “When I got to Portugal I needed to find a job, and found one very easily working as a translator. I rented a house and had a new life. But then they evicted me in Portugal. The police came knocking on the door with a warrant: ‘Order of the Dutch Justice Department: Miss Booij is not paying her debts in the Netherlands, so take away her possessions in Portugal’. So I was thrown back into the streets again”.

In the summer of 2009, José returned to Holland with the intention of renewing her fight to win back her daughter and was immediately arrested. She was locked up at the Delta Psychiatric Centre near Rotterdam by order of a judge, on the basis of being schizophrenic and psychotic; she had been telling a story about a baby and a letter to the Queen. It was merely the latest of twenty times she had been arrested and nine times that she had been thrown into a mental institution. In no other country is she considered to have these mental problems.

She continued to be held at Delta in a locked cell and injected with antipsychotic drugs because the psychiatric staff did not believe her story. She was denied contact with the outside world. Only after seven months did the Institute make the necessary phone calls, to Beata Bakker and Richard Gill, that proved that José was telling the truth. Richard Gill is a professor of statistics at Leiden University, who knew José and was aware of her story. With the help of Professor Gill and others, José was able to leave Delta in July 2010 and rent an apartment in the Hague.

In October 2010, José returned to Portugal and accumulated a quantity of diazepam medication. On returning to Holland in November, she attempted suicide by overdose of diazepam.

José had fought to win back her daughter for six years. She has not seen her daughter since March 2005.

– – – –

Newspaper coverage in Holland

Daily News of the North 02 February 2006 (on pages 1 and 3)

Mother has not been able to see her baby for 10 months

Elim and The Hague: A 42-year-old woman has not seen her baby for 10 months. The relationship between the Child Protection Agency in the Drenthe region of North Holland and the mother has been so disturbed that communication is taking place via her lawyer. Fifteen-month-old baby Julia Lynn has already been a year with a foster care family.

The child was taken away from the mother José Booij because the Child Protection Agency had doubts about her psychological state. “It is Kafka in minature”, says lawyer J. Groen. “It hasn’t been shown anywhere that she is disturbed. On the contrary, there are declarations by various psychiatrists that she does not have any psychiatric disturbance at all”. The then six-week-old baby Julia Lynn was taken away from Booij on 2 December 2004 from her little farmhouse at Elim. This happened after a report of child abuse was given by a neighbour and concerns were expressed by the local district nurse. The doctor made a diagnosis of ‘borderline’ without having seen her, it appears from his own dossier. Booij has not seen her baby since March. “This is most improper,” says lawyer Groen. “if you don’t trust the mother, then surely you should at least organize a visit?”

Director Cees Wierda of the Bureau of Youth Care says that he questioned the mother many times without response. He invited the mother to discuss conditions for the mother to be able to have some communication with her child. “No communication is possible if the mother does not accept help”, he said.

The court in Leeuwarden has supported the decision of the bench in Assen to have the baby taken away from home. Lawyer Groen will try to get the decision reversed by the Supreme Court. Groningen lawyer Marion Stroink has set up disciplinary procedures against the local family doctor and the local district nurse.

Doctor and district nurse make serious mistakes

Daily News of the North 02 February 2006

Council of Child Protection doubts the psychiatric health of the mother

The apparently completely healthy baby Julia Lynn was taken away from her home on 2 December 2004. The mother has now not seen her baby for 10 months. What went wrong between the Bureau of Youth Care Drenthe, and the mother? By John Grisham and Anita Pepping

Elim: Agents and workers of the Bureau of Youth Care walk into a converted farmhouse in Elim and take baby Julia Lynn away. It is Thursday, 2 December 2004. The six-week-old baby is taken immediately to Bethesda Hospital, Hoogeveen. The reason is that the baby was not receiving the right feeding. Also, the safety of the child was in danger. In the hospital, however, the paediatrician sees a healthy, well-fed and well cared for baby. Medical investigations do not reveal any signs that anything harmful has been done to the little girl. Nonetheless, the healthy baby was taken away and given to a foster mother because the Child Protection Agency has doubts about the psychiatric state of the mother José Booij. “This is incredibly sad”, says estate agent Henk Kroezen from Hollandscheveld, referring to the case of. Miss Booij, who is now living in The Hague. Kroezen and his wife had taken care of the woman for weeks after her baby had been taken away from her home. “My wife took her in straight away at the beginning to the Bureau of Child Protection to see her baby daughter but José made everything quite impossible there. She got so extremely angry about Child Protection”.

With this removal of Julia Lynn from her home, some terribly bad mistakes have been made, according to Groningen lawyer Marion Stroink and her Hague colleague Jaap Groen. “José Booij hasn’t seen her baby daughter for 10 months because Youth Care, Drenthe and the Council of Child Protection won’t admit their mistakes”.

What were these mistakes?  Groen: “Youth Care has treated Miss Booij from the start as if she was demented”. Immediately after Julia was taken away from home, José was completely hysterical several times and threatened suicide. Groen said, “The way things were done would not have done her psychiatric health much good, and I don’t think that is a great surprise.”

Director Cees Wierda of the Youth Care Drenthe, says, “We would like to talk about the conditions under which the mother can communicate with the baby, but this is impossible with this mother”. According to Wierda, murders of babies in recent days have certainly played a role in signalling whether a child should be taken out of home or not. “It has increased our workload and we must minimise risk. Therefore we need the help of the mother”.

Groningen: Lawyer Marion L. Stroink is referring the district nurse and family doctor of Miss Booij to the regional medical disciplinary tribunal. The reason is that the nurse overstepped her authority by presenting the General Child Abuse Hotline with all kinds of unsubstantiated assumptions about the mental state of Miss Booij. In the dossier of the family doctor there is not a single objective observation on the growth and development of Julia Lynn. But such a declaration should have been issued, since without this information, the police cannot take away the child. Several times, the family doctor did not respond in time to the requests of the medical disciplinary board.

Jeugdzorg (Bureau of Youth Care): This has the task of taking care of problem children and problem families. Jeugdzorg carries this out as mandated by the court, and acts under the auspices of the Raad voor de Kinderbescherming, the Council for Child Protection.

Biological father

Julia Lynn was born resulting from a very short relationship between José Booij and her friend. Booij does not want to have any contact with the father anymore. The father has accepted the child as his own and from time to time he sees his daughter via the Bureau of Youth care.

Daily News of the North 04 February 2006

Neighbors quarrel ends in baby’s custodial placement

The Jan Slotswijk in Elim. a long muddy path with two farms attached to it. It is quiet, it is remote. Two neighbours are arguing. José Booij and Marijke Eijpe. Booij threatens to poison Eijpe’s horses. In the meantime, Marijke calls the general practitioner, the GGz and the General Reporting Center for Child Abuse with reports about Booij. She wouldn’t be able to take care of her child. It is the beginning of a nightmare for Booij. Her baby is taken out of the house. A conflict arises with Bureau Jeugdzorg Drenthe and Booij has not seen her baby for ten months. How did it come to this? By Bram Hulzebos en Anita Pepping

“Look, it is simple”. You shouldn’t touch animals and small children,” says Marijke Eijpe on her farm. At the Jan Slotswijk in Elim, Eijpe keeps a few horses and ponies. At the end of the path that runs past her house, José Booij moved into a small cottage more than three years ago. The mutual contacts were not too cordial, but according to Eijpe also not particularly bad.

That changed when Booij turned out to be pregnant. The biological father was soon out of the picture. Marijke Eijpe started to worry. About hygiene, about the strange behaviour of her neighbour in her eyes. Would Booij be able to take care of the child? “She said she wanted to give birth on a table unaided,” Eijpe says, turning her eyes to the sky. “She was a doctor, she said, and had worked in Africa. She had it a bit high on the ball.”

Booij’s pregnancy progressed and Eijpe became increasingly worried. She called the GP in Hollandscheveld, the General Reporting Center for Child Abuse (AMK) and the Mental Healthcare Foundation (GGz) Drenthe. “I saw it go wrong, but she refused any kind of help.”

It appears from the GP file that, as a result of the reports from the neighbour, there is a lot of discussion about Booij and her baby between GGz, AMK and the GP. The file states that neighbours fear that Booij might be paranoid or psychotic.
This ultimately leads to the baby being removed from the home on Thursday, December 2, 2004, by a number of officers. Incidentally, without the baby or Booij being examined by a doctor from the AMK or GGZ (mental health care).

“It’s all been invented behind my back,” says an angry José Booij (42) from her flat in The Hague, where she now lives.

The relationship between the two neighbours does not get any better after that Thursday. ”She called me names for everything and threatened to kill my horses. I was terrified,” says Marijke. One bad day, the argument escalated so badly that the police had to intervene. Booij had hit the neighbour with her car. “She wanted to kill me.”

Estate agent Henk Kroezen from the neighbouring Hollandscheveld – who had sold the house to Booij – made various attempts at mediation between the two women. But it was in vain. José Booij took it seriously against the neighbour that her daughter had been taken away from her. Kroezen: ”We took José in for a few weeks to take care of her. My wife went with her a few times to the Youth Care Bureau, but she threw her own glasses in there. She could go on like that.”

Kroezen arranged a rental home in Smilde and was looking for subtenants for Booij’s house in Elim. “She then suspected me of withholding the rent and kicked us. She has now put her house up for sale through another real estate agent. Stink for thanks. In retrospect I thought: we shouldn’t have done it. It was not a nice period, but we thought she was so pathetic. It is and remains a sad story. I cannot estimate whether she is dangerous for the baby. There are the most terrible stories circulating, but the times we saw her with the baby, she was sweet and caring. It is a beautiful baby.”

Immediately after the out-of-home placement, the Youth Care Agency came into the picture, but the care providers were not exactly welcomed with open arms by Booij. Now, twelve months later, Booij’s anger has barely cooled. “They took my child from me. I want satisfaction,” she says. Two lawyers assist her in several procedures to ensure that contact with her 15-month-old daughter Julia Lynn is restored. “Youth care does not dare to admit that huge blunders were made at the beginning of the procedure,” says Booij’s lawyer Groen from The Hague.

What particularly disturbs Groen is that the investigation by the Child Protection Board into Julia Lynn’s situation suggests that Booij has a psychological problem. “While there are now statements from three psychiatrists that nothing is wrong with her.”
Director Cees Wierda of Bureau Jeugdzorg Drenthe is not impressed by this. ”Mrs Booij is handy enough to find a few psychiatrists who are willing to declare that there is nothing wrong with her. Moreover, that does not mean that there is a risk-free parenting situation.”

Wierda is firmly convinced that the fact that Booij has not seen her baby for ten months is not due to Youth Care. At the end of December, a meeting had been arranged at the Youth Care Office in Hoogeveen. Booij went to Hoogeveen with a lawyer from The Hague, but he already knew that something would go wrong in the meeting. Booij had already said to the lawyer in advance: “Note, Julia is not there and Youth Care has a shitty excuse.”

Youth care director Wierda: ”The foster mother was fifteen minutes late. But Mrs Booij did not want to wait for that. She has been roaring and ranting at the station. Then I wonder: if it’s worth so much to you to get your child back, why don’t you get over your anger?” José Booij ultimately did not see her daughter, but her lawyer took a few photos.

One thing is clear for Youth Care Drenthe: “Every tantrum from Booij is another indication for us that the baby is not safe with her.” At Bureau Jeugdzorg Drenthe they are more or less at their wits’ end. Wierda: “We had reason to believe that the child was not safe with her mother in Elim. The judge shares that concern. We now have to remove those risk factors.” Booij has been invited several times for discussions with Youth Care. But as long as she gets a red haze when she hears the word Youth Care and refuses all help, there is a problem. Wierda: “If she does not want to cooperate in removing risk factors, the problem lies with the mother.”

According to lawyer Groen, José Booij completely suppresses her motherly feeling. Logical, he thinks. “It’s an idiotic thing. Youth care continues. Just because a few children have been killed at their hands, it doesn’t mean that all mothers just kill their children.”
The basis on which Julia Lynn was removed from home is paper-thin, says lawyer Jaap Groen. ”Statements of neighbours with whom Booij had a fight, a story of the district nurse that is very incriminating but hardly makes any sense. And a statement from a GP who had only seen Mrs Booij twice.”

Groen tries to have the decision of the judge in Assen and the Court in Leeuwarden to remove Julia Lynn from her home annulled by the Supreme Court.

The Groningen lawyer Marion L. Stroink is now trying to demonstrate to the regional medical disciplinary committee that the district nurse and the general practitioner have gone way beyond their limits. “The GP, in particular, made a fool of himself by declaring that the mother is borderline, even though he has only seen her twice.”

The statements of the GP and nurse challenged by Booij’s lawyers have completely misled the AMK, then the Child Protection Board and then two judges, Groen and Stroink say.

Both houses at the Jan Slotswijk in Elim are now for sale. Neighbour Marijke would like to return to the west. “Too much has happened here.”

Rowena, Savannah, Daniel and Damaris

In recent years, several children who were in contact with youth care have been murdered. Rowena and Savanna and last summer Daniel and Damaris, who were killed in Tolbert. Cees Wierda, director of Bureau Jeugdzorg Drenthe, confirms that these murders play a role in identifying whether or not to place a child out of the home. ”There is an increased focus on our functioning.”

After the murders in Tolbert, the number of reports of (alleged) child abuse in Drenthe rose by 25 percent. “Not all reports turned out to be justified.” Youth Care Drenthe is working on a qualitatively better risk assessment. “Booij is a difficult case. If you find a heavily soiled child somewhere between opened beer cans with cocaine-sniffing parents on the couch, it’s more obvious.”

What went on before the out-of-home placement

She said she wanted to give birth on a table unaided

This overview, based on a GP file, shows that there was a lot of talk and speculation about the safety of Julia Lynn without Booij’s knowledge.

Midwife calls the GP. Booij is not coming to a pregnancy check-up. Booij tells the obstetrician that she didn’t know about the check-up. She had another midwife.

Neighbour calls doctor. She is concerned about Booij’s ‘paranoid and psychotic’ state. GP advises the neighbour to report to a mental health institution. A colleague of the doctor visits, but does not meet one in the least confused or psychotic Booij.

Apparently, the neighbour called the GGZ. A mental health worker turns his attention to the general practitioner. Then they also call General Reporting Center for Child Abuse (AMK) with the general practitioner.

Neighbour calls GP again about her concerns about Booij. The GGZ employee also calls again. He refrains from measures

Another neighbour calls a doctor. She has heard disturbing reports about Booij from Booij’s neighbour.

Birth Julia Lynn in the Scheper Hospital in Emmen.

Doctor comes to visit. Booij asks for cleaning assistance from the Regional Indication Body (RIO) for two hours a week. Instead, RIO employees drop by every day and stay there for seven hours. Every part of the day a different helper comes. The district nurse also comes daily.

AMK calls the doctor. To intervene or not, is the question.

The GP and social worker agree to remove Julia Lynn from her home if the baby does not improve within two days. The district nurse calls the GP. She’s worrying. The GP concludes that Booij is exhausted, unable to provide adequate care. He diagnoses borderline.

On the basis of data from the GP of the 30th, a number of agents and employees of Youth Care pick up Julia Lynn. In the Bethesda Hospital in Hoogeveen, the baby appears to be perfectly healthy. Yet the baby goes to a foster mother. She remains there to this day.

Daily News of the North 4 February 2006

Youth care intervention Drenthe ends in nightmare

José Booij is completely through with it. Her then six-week-old daughter Julia Lynn was taken away at the end of 2004 and came under the supervision of Youth Care. The beginning of a Kafkaesque nightmare.

Groningen: For almost a year, José Booij has not seen her now one and a half-year-old daughter Julia Lynn. Cause: the seriously disrupted relationship with Bureau Jeugdzorg Drenthe.

The girl was taken from Booij in December 2004. Booij still lived (without Julia Lynn’s father) in Elim at the time. The neighbour was concerned and called the doctor. The district nurse was also concerned.

In the end, the Child Protection Board had the girl removed, because there were doubts about Booij’s mental condition. The family doctor in Elim had made the diagnosis borderline – without seeing Booij, incidentally.

Psychiatrists later stated that Booij was fine, but that did not lead to the baby’s return. This to the frustration of Booij, who was increasingly angry at the employees of Youth Care Drenthe. Every tantrum was an indication to Youth Care that the baby would not be safe with Booij. “First you drive someone crazy,” says M.K. van den Berge, lawyer for Booij, ”and then you say that she cannot care for a child worry because she is crazy.”

In the long run, contact with Youth Care Drenthe continued exclusively through Booij’s lawyer. Booij has now been able to get it done at the court in Leeuwarden that Bureau Jeugdzorg Drenthe is no longer allowed to interfere with Julia Lynn. In addition, she tries to overturn the decision to have the baby removed from the home at the Supreme Court. “There is no defense in that case,” says Booij’s lawyer. “So if the decision is overturned, there’s a good chance that the girl will finally go back to the mother.” Time is running out, according to Van den Berge. The child will soon be two years old. After that it is difficult for a child to to get attached.”

“Apparently, they have no confidence in the Youth Care Agency.”

Cees Wierda, director of Youth Care Drenthe, is not happy with the court ruling in Leeuwarden. This is very unusual and also undesirable. The judge has given us a task that we are supposed to perform.”

Wierda had hoped that Jeugdzorg Drenthe would get another chance to get the assistance started.” It is implicitly stated in the judgment that Bureau Jeugdzorg is unable to solve the problem.

Daily News of the North 11 November 2006

“If anything had happened to Julia, I would now be sorry”

Background: Medical disciplinary tribunal looking at removal of baby

“I saw Booij lose weight, she became more and more exhausted and confused’

Julia (now 2 years old) was taken away from home because her mother was too confused. But didn’t that happen too fast? By Bram Hulzebos

Groningen: A year ago, José Booij was still fighting fit. Yesterday she was sitting like a pathetic little bird opposite the Medical disciplinary bench. She is living a nightmare. Her two-year-old baby daughter was taken away from her house in Elim in December 2004 because the Council of Child Protection had doubts about Booij’s psychiatric health. Booij submitted a complaint against the district nurse and her family doctor from the village of Hollandscheveld, because they provided information to the General Child Abuse Hotline (AMK). An anonymous report had come in about Booij. The AMK checked the complaint with the district nurse. Booij believes that the district nurse has violated her professional code of client confidentiality. Moreover, the nurse submitted incorrect information. However, the nurse is not conceding anything. She was worried about Booij and her daughter. “I saw Booij getting thinner, she was getting increasingly exhausted and confused. If anything had happened and I had not done anything, then I would have been sorry”.

Also, the role of Booij’s doctor was held up to the light. He sent Booij’s patient record to the AMK. In it, the word “borderline” had been written down. “A psychiatric diagnosis that requires quite a lot of research”, said the president of the disciplinary board. And this doctor certainly hadn’t carried out a thorough investigation in two small visits to mother and child. The file of the doctor gives the green light to take Julia out of home. Normally at this point, some help should have come.

But in this case it went terribly wrong. Booij was so enraged that there was no reasonable contact possible with the Bureau of Youth Care Drenthe, which had carried out the decision of the Council of Child Protection. Almost every contact ended in tears or conflict and the end of the story is that Booij has still not seen her daughter for over one and a half years. Youth Care Drenthe saw every outburst of anger as confirmation that there really were reasons to worry about her psychiatric health.

Booij did not stay until the end of the session. She ran out in the middle in distress. The disciplinary tribunal will give its decision in two months.

Daily News of the North 20 December 2006

Child justifiably away from mother

Disciplinary court: GP and nurse acted correctly. By Arend van Wijngaarden

Groningen: According to the medical disciplinary court in Groningen, the general practitioner and district nurse who helped ensure that the daughter of José Booij from Elim was taken away from her in 2004, behaved correctly. The disciplinary committee has declared Booij’s complaints against both doctors unfounded.

A district nurse and a GP from Hollandscheveld passed on their concerns about the upbringing of the now 2-year-old Julia in 2004 to the General Reporting Point for Child Abuse (AMK), which asked them about it after an anonymous complaint.

Both were concerned about the mother’s state of mind. She was mentally confused, had money worries and became exhausted. She stopped feeding the baby at night, punished the baby by ignoring her and expressed fear of harming the child.

After complaints from the doctor and nurse, the baby was taken out of the house by the police by order of child protection, much against the mother’s wishes. She submitted complaints to the medical disciplinary committee that the doctor and nurse should not have made the reports.

The disciplinary committee has ruled that it is precisely the task of a district nurse and a doctor to warn if they have the idea that something is seriously wrong with the upbringing of a child. It was common practice for doctors and nurses to report cases to confidential physicians of the AMK, and the guidelines have even been tightened.

If the best interests of the child are at stake, this takes precedence over the rights of the parent.

Condemned by statisticians?

A Bayesian analysis of the case of Lucia de B.

de Vos, A. F. (2004).

Door statistici veroordeeld? Nederlands Juristenblad, 13, 686-688.

Here, the result of Google-translate by RD Gill; with some “hindsight comments” by him added in square brackets and marked “RDG”.

Would having posterior thoughts
Not be offending the gods?
Only the dinosaur
Had them before
Recall its fate! Revise your odds!
(made for a limerick competition at a Bayesian congress).

The following article was the basis for two full-page articles on Saturday, March 13, 2004 in the science supplement of the NRC (with unfortunately disturbing typos in the ultimate calculation) and in “the Forum” of Trouw (with the expected announcement on the front page that I claimed that the chance that Lucia de B. was wrongly convicted was 80%, which is not the case)

Condemned by statisticians?
Aart F. de Vos

Lucia de Berk [Aart calls her “Lucy” in his article. That’s a bit condescending – RDG] has been sentenced to life imprisonment. Statistical arguments played a role in that, although the influence of this in the media was overestimated. Many people died while she was on duty. Pure chance? The consulted statistician, Henk Elffers, repeated his earlier statement during the current appeal that the probability was 1 in 342 million. I quote from the article “Statisticians do not believe in coincidence” from the Haags Courant of January 30th: “The probability that nine fatal incidents took place in the JKZ during the shifts of the accused by pure chance is nil. (…) It wasn’t chance. I don’t know what it was. As a statistician, I can’t say anything about it. Deciding the cause is up to you”. The rest of the article showed that the judge had great difficulty with this answer, and did not manage to resolve those difficulties.

Many witnesses were then heard who talked about circumstances, plausibility, oddities, improbabilities and undeniably strong associations. The court has to combine all of this and arrive at a wise final judgment. A heavy task, certainly given the legal conceptual system that includes very many elements that have to do with probabilities but has to make do without quantification and without probability theory when combining them.

The crucial question is of course: how likely is it that Lucia de Berk committed murders? Most laypeople will think that Elffers answered that question and that it is practically certain.

This is a misunderstanding. Elffers did not answer that question. Elffers is a classical statistician, and classical statisticians do not make statements about what is actually going on, but only about how unlikely things are if nothing special is going on at all. However, there is another branch of statistics: the Bayesian. I belong to that other camp. And I’ve also been doing calculations. With the following bewildering result:

If the information that Elffers used to reach his 1 in 342 million were the only information on which Lucia de Berk was convicted, I think that, based on a fairly superficial analysis, there would be about an 80% chance of the conviction being wrong.

This article is about this great contrast. It is not an indictment of Elffers, who was extremely modest in the court when interpreting his outcome, nor a plea to acquit Lucia de Berk, because the court uses mainly different arguments, albeit without unequivocal statements of probability, while there is nothing which is absolutely certain. It is a plea to seriously study Bayesian statistics in the Netherlands, and this applies to both mathematicians and lawyers. [As we later discovered, many medical experts’ conclusions that certain deaths were unnatural was caused by their knowledge that Lucia had been present at an impossibly huge number of deaths – RDG]

There is some similarity to the Sally Clark case, which was sentenced to life imprisonment in 1999 in England because two of her sons died shortly after birth. A wonderful analysis can be found in the September 2002 issue of “living mathematics”, an internet magazine (http://plus.maths.org/issue21/features/clark/index.html)

An expert (not a statistician, but a doctor) explained that the chance that such a thing happened “just by chance” in the given circumstances was 1 in 73 million. I quote: “probably the most infamous statistical statement ever made in a British courtroom (…) wrong, irrelevant, biased and totally misleading.” The expert’s statement is completely torn to shreds in said article. Which includes mention of a Bayesian analysis. And a calculation that the probability that she was wrongly convicted was greater than 2/3. In the case of Sally Clark, the expert’s statement was completely wrong on all counts, causing half the nation to fall over him, and Sally Clark, though only after four years, was released. However, the case of Lucia de Berk is infinitely more complicated. Elffers’ statement is, I will argue, not wrong, but it is misleading, and the Netherlands has no jurisprudence, but judgments, and even though they are not directly based on extensive knowledge of probability theory, they are much more reasoned. That does not alter the fact that there is a common element in the Lucy de Berk and Sally Clark cases. [Actually, Elffers’ statement was wrong in its own terms. Had he used the standard and correct way to combine p-values from three separate samples, he would have ended up with a p-value of about 1/1000. Had he verified the data given him by the hospital, it would have been larger still. Had he taken account of heterogeneity between nurses and uncertainty in various estimates, both of which classical statisticians also know how to do too, larger still – RDG]

Bayesian statistics

My calculations are therefore based on alternative statistics, the Bayesian, named after Thomas Bayes, the first to write about “inverse probabilities”. That was in 1763. His discovery did not become really important [in statistics] until after 1960, mainly through the work of Leonard Savage, who proved that when you make decisions under uncertainty you cannot ignore the question of what chances the possible states of truth have (in our case the states “guilty” and “not guilty”). Thomas Bayes taught us how you can learn about that kind of probability from data. Scholars agree on the form of those calculations, which is pure probability theory. However, there is one problem: you have to think about what probabilities you would have given to the possible states before you had seen your data (the prior). And often these are subjective probabilities. And if you have little data, the impact of those subjective probabilities on your final judgment is large. A reason for many classical statisticians to oppose this approach. Certainly in the Netherlands, where statistics is mainly practised by mathematicians, people who are trained to solve problems without wondering what they have to do with reality. After a fanatical struggle over the foundations of statistics for decades (see my piece “the religious war of statisticians” at http://staff.feweb.vu.nl/avos/default.htm) the parties have come closer together. With one exception: the classical hypothesis test (or significance test). Bayesians have fundamental objections to classical hypothesis tests. And Elffers’ statement takes the form of a classical hypothesis test. This is where the foundations debate focuses.

The Lucy Clog case

Following Elffers, who explained his method of calculation in the Nederlands Juristenblad on the basis of a fictional case “Klompsma” which I have also worked through (arriving at totally different conclusions), I want to talk about the fictional case Lucy Clog [“Klomp” is the Dutch word for “clog”; the suffix “-sma” indicates a person from the province of Groningen; this is all rather insulting – RDG]. Lucy Clog is a nurse who has experienced 11 deaths in a period in which on average only one case occurs, but where no further concrete evidence against her can be found. In this case too, Elffers would report an extremely small chance of coincidence in court, about 1 in 100 million [I think that de Vos is thinking of the Poisson(1) chance of at least 11 events. If so, it is actually a factor 10 smaller. Perhaps he should change “11 deaths” into “10 deaths” – RDG]. This is the case where I claim that a guilty conviction, given the information so far together with my assessment of the context, has a chance of about 80% of being wrong.

This requires some calculations. Some of them are complicated, but the most important aspect is not too difficult, although it appears that many people struggle with it. A simple example may make this key point clear.

You are at a party and a stranger starts telling you a whole story about the chance that Lucia de Berk is guilty, and embarks joyfully on complex arithmetical calculations. What do you think: is this a lawyer or a mathematician? If you say a mathematician because lawyers are usually unable to do mathematics, then you fall into a classical trap. You think: a mathematician is good at calculations, while the chance that a lawyer is good at calculations is 10%, so it must be a mathematician. What you forget is that there are 100 times more lawyers than mathematicians. Even if only 10% of lawyers could do this calculating stuff, there would still be 10 times as many lawyers as mathematicians who could do it. So, under these assumptions, the probability is 10/11 that it is a lawyer. To which I must add that (I think) 75% of mathematicians are male but only 40% of lawyers are male, and I did not take this into account. If the word “she” had been in the problem formulation, that would have made a difference.

The same mistake, forgetting the context (more lawyers than mathematicians), can be made in the case of Lucia de Berk. The chance that you are dealing with a murderous nurse is a priori (before you know what is going on) very much smaller than that you are dealing with an innocent nurse. You have to weigh that against the fact that the chance of 11 deaths is many times greater in the case of “murderous” than in the case of “innocent”.

The Bayesian way of performing the calculations in such cases also appears to be intuitively not easy to understand. But if we look back on the example of the party, maybe it is not so difficult at all.

The Bayesian calculation is best not done in terms of chances, but in terms of “odds”, an untranslatable word that does not exist in the Netherlands. Odds of 3 to 7 mean a chance of 3/10 that it is true and 7/10 that it is not. Englishmen understand what this means perfectly well, thanks to horse racing: odds of 3 to 7 means you win 7 if you are right and lose 3 if you are wrong. Chances and odds are two ways to describe the same thing. Another example: odds of 2 to 10 correspond to probabilities of 2/12 and 10/12.

You need two elements for a simple Bayesian calculation. The prior odds and the likelihood ratio. In the example, the prior odds are mathematician vs. lawyer 1 to 100. The likelihood ratio is the probability that a mathematician does calculations (100%) divided by the probability that a lawyer does (10%). So 10 to 1. Bayes’ theorem now says that you must multiply the prior odds (1 : 100) and the likelihood ratio (10 : 1) to get the posterior odds, so they are (1 x 10 : 100 x 1) = (10 : 100) = (1 : 10), corresponding to a probability of 1 / 11 that it is a mathematician and 10/11 that it is a lawyer. Precisely what we found before. The posterior odds are what you can say after the data are known, the prior odds are what you could say before. And the likelihood ratio is the way you learn from data.

Back to the Lucy Clog case. If the chance of 11 deaths is 1 in 100 million when Lucy Clog is innocent, and 1/2 when she is guilty – more about that “1/2” much later – then the likelihood ratio for innocent against guilty is 1 : 50 million. But to calculate the posterior probability of being guilty, you need the prior odds. They follow from the chance that a random nurse will commit murders. I estimate that at 1 to 400,000. There are forty thousand nurses in hospitals in the Netherlands, so that would mean nursing killings once every 10 years. I hope that is an overestimate.

Bayes’ theorem now says that the posterior odds of “innocent” in the event of 11 deaths would be 400,000 to 50 million. That’s 8 : 1000, so a small chance of 8/1008, maybe enough to convict someone. Yet large enough to want to know more. And there is much more worth knowing.

For instance, it is remarkable that nobody saw Lucy doing anything wrong. It is even stranger when further investigation yields no evidence of murder. If you think that there would still be an 80% chance of finding clues in the event of many murders, against of course 0% if it is a coincidence, then the likelihood ratio of the fact “no evidence was found” is 100 : 20 in favour of innocence. Application of the rule shows that we now have odds of 40 : 1000, so a small 4% chance of innocence. Conviction now becomes really questionable. And if the suspect continues to deny, which is more plausible when she is innocent than when she is guilty, say twice as plausible, the odds turn into 80 : 1000, almost 8% chance of innocence.

As an explanation, a way of looking at this that requires less calculation work (but says exactly the same thing) is as follows: It follows from the assumptions that in 20,000 years it occurs 1008 times that 11 deaths occur in a nurse’s shifts: 1,000 of the nurses are guilty and 8 are innocent. Evidence for murder is found for 800 of the guilty nurses, moreover, 100 of the remaining 200 confess. That leaves 100 guilty and 8 innocent among the nurses who did not confess and for whom no evidence for murder was found.

So Lucy Clog must be acquitted. And all the while, I haven’t even talked about doubts about the exact probability of 1 in 100 million that “by chance” 11 people die in so many nurses’ shifts, when on average it would only be 1. This probability would be many times higher in every Bayesian analysis. I estimate, based on experience, that 1 in 2 million would come out. A Bayesian analysis can include uncertainties. Uncertainties about the similarity of circumstances and qualities of nurses, for example. And uncertainties increase the chance of extreme events enormously, the literature contains many interesting examples. As I said, I think that if I had access to the data that Elffers uses, I would not get a chance of 1 in 100 million, but a chance of 1 in 2 million. At least I assume that for the time being; it would not surprise me if it were much higher still!

Preliminary calculations show that it might even be as high as 1 in 100,000. But 1 in 2 million already saves a factor of 50 compared to 1 in 100 million, and my odds would not be 80 to 1000 but 4000 to 1000, so 4 to 1. A chance of 80% to wrongly convict. This is the 80% chance of innocence that I mentioned in the beginning. Unfortunately, it is not possible to explain the factor 50 (or a factor 1000 if the 1 in 100,000 turns out to be correct) from the last step within the framework of this article without resorting to mathematics. [Aart de Vos is probably thinking of Poisson distributions, but adding a hyperprior over the Poisson mean of 1, in order to take account of uncertainty in the true rate of deaths, as well as heterogeneity between nurses, causing some to have shifts with higher death rates than others – RDG]

What I hope has become clear is that you can always add information. “Not being able to find concrete evidence of murder” and “has not confessed” are new pieces of evidence that change the odds. And perhaps there are countless facts to add. In the case of Lucia de Berk, those kinds of facts are there. In the hypothetical case of Lucy Clog, not.

The fact that you can always add information in a Bayesian analysis is the most beautiful aspect of it. From prior odds, you come through data (11 deaths) to posterior odds, and these are again prior odds for the next steps: no concrete evidence for murder, and no confession by our suspect. Virtually all further facts that emerge in a court case can be dealt with in this way in the analysis. Any fact that has a different probability under the hypothesis of guilt than under the hypothesis of innocence contributes. Perhaps the reader has noticed that we only talked about the chances of what actually happened under various hypotheses, never about what could have happened but didn’t. A classic statistical test always talks about the probability of 11 or more deaths. That “or more” is irrelevant and misleading according to Bayesians. Incidentally, it is not necessarily easier to just talk about what happened. What is the probability of exactly 11 deaths if Lucy de Clog is guilty? The number of murders, something with a lot of uncertainty about it, determines how many deaths there are, but even though you are fired after 11 deaths, the classical statistician talks about the chance of you committing even more if you are kept on. And that last fact matters for the odds. That’s why I put in a probability of 50%, not 100%, for a murderous nurse killing exactly 11 patients. But that only makes a factor 2 difference.

It should be clear that it is not easy to come to firm statements if there is no convincing evidence. The most famous example, for which many Bayesians have performed calculations, is a murder in California in 1956, committed by a black man with a white woman in a yellow Cadillac. A couple who met this description was taken to court, and many statistical analyses followed. I have done a lot of calculations on this example myself, and have experienced how difficult, but also surprising and satisfying, it is to constantly add new elements.

A whole book is devoted to a similar famous case: “a Probabilistic Analysis of the Sacco and Vanzetti Evidence,” published in 1996 by Jay Kadane, professor of Carnegie Mellon and one of the most prominent Bayesians. If you want to know more, just consult his c.v. on his website http://lib.stat.cmu.edu/~kadane. In the “Statistics and the Law” field alone, he has more than thirty publications to his name, along with hundreds of other articles. This is now a well-developed field in America.


I have thought for a long time about what the conclusion of this story is, and I have had to revise my opinion several times. And the perhaps surprising conclusion is: the actions of all parties are not that bad, only their rationalization is, to put it mildly, a bit strange. Elffers makes strange calculations but formulates the conclusions in court in such a way that it becomes intuitively clear that he is not giving the answer that the court is looking for. The judge makes judgments that sound as though they are in terms of probabilities but I cannot figure out what the judge’s probabilities are. But when I see what is going on I do get the feeling that it is much more like what is optimal than I would have thought possible, given the absurd rationalisations. The explanation is simple: judges’ actions are based on a process learnt by evolution, judges’ justifications are stuck on afterwards, and learnt through training. In my opinion, the Bayesian method is the only way to balance decisions under uncertainty about actions and rationalization. And that can be very fruitful. But the profit is initially much smaller than people think. What the court does in the case of Lucia de B is surprisingly rational. The 11 deaths are not convincing in themselves, but enough to change the prior odds from 1 in 40,000 to odds from 16 to 5, in short, an order of magnitude in which it is necessary to gather additional information before judging. Exactly what the court does. [de Vos has an optimistic view. He does not realise that the court is being fed false facts by the hospital managers – they tell the truth but not the whole truth; he does not realise that Elffers’ calculation was wrong because de Vos, as a Bayesian, doesn’t know what good classical statisticians do; neither he nor Elffers checks the data and finds out how exactly it was collected; he does not know that the medical experts’ diagnoses are influenced by Elffers’ statistics. Unfortunately, the defence hired a pure probabilist, and a kind of philosopher of probability, neither of whom knew anything about any kind of statistics, whether classical or Bayesian – RDG]

When I made my calculations, I thought at times: I have to go to court. I finally sent the article but I heard nothing more about it. It turned out that the defence had called for a witness who seriously criticized Elffers’ calculations. However, without presenting the solution. [The judge found the defence witness’s criticism incomprehensible, and useless to boot. It contained no constructive elements. But without doing statistics, anybody could see that the coincidence couldn’t be pure chance. It wasn’t: one could say that the data was faked. On the other hand, the judge did understand Elffers perfectly well – RDG].

Maybe I will once again have the opportunity to fully calculate probabilities in the Lucia de Berk case. That could provide new insights. But it is quite a job. In this case, there is much more information than is used here, such as poisonous traces in patients. Here too, it is likely that a Bayesian analysis that takes into account all the uncertainties shows that statements by experts who say something like “it is impossible that there is another explanation than the administration of poison by Lucia de Berk” should be taken with a grain of salt. Experts are usually people who overestimate their certainty. On the other hand, incriminating information can also build up. Ten independent facts that are twice as likely under the hypothesis of guilt change the odds by a factor of 1000. And if it turns out that the toxic traces found in the bodies of five deceased patients are each nine times more likely if Lucia is a murderer than if she isn’t, it saves a factor of nine to the fifth, a small 60,000. Etc, etc

But I think the court is more or less like that. It uses an incomprehensible language, that is, incomprehensible to probabilists, but a language sanctioned by evolution. We have few cases of convictions that were found to be wrong in the Netherlands. [Well! That was a Dutch layperson, writing in 2004. According to Ton Derksen, in the Netherlands about 10% of very long term prisoners (very serious cases) are innocent. It is probably something similar in other jurisdictions – RDG].

If you did the entire process in terms of probability calculations, the resulting debates between prosecutors and lawyers would become endless. And given their poor knowledge of probability, it is also undesirable for the time being. They have their secret language that usually led to reasonable conclusions. Even the chance that Lucia de Berk is guilty cannot be expressed in their language. There is also no law in the Netherlands that defines “legal and convincing evidence” in terms of the chance that a decision is correct. Is that 95%? Or 99%? Judges will maintain that it is 99.99%. But judges are experts.

So I don’t think it’s wise to try to cast the process in terms of probability right now. But perhaps this discussion will produce something in the longer term. Judges who are well informed about the statistical significance of the starting situation and then write down a number for each piece of evidence of prosecutor and defender. The likelihood ratio of each fact must be motivated. At the end, multiply all these numbers together, and have the calculations checked again by a Bayesian statistician. However, I consider this a long-term perspective. I fear (I am not really young anymore) it won’t come in my lifetime.

BOLC (Bureau Verloren Zaken) “reloaded”

Het BOLC is weer terug.

10 jaar geleden (in 2010) werd de Nederlandse verpleegster Lucia de Berk bij een nieuw proces vrijgesproken van een aanklacht van 7 moorden en 3 pogingen tot moord in ziekenhuizen in Den Haag in een aantal jaren in de aanloop naar slechts een paar dagen voor de gedenkwaardige datum van “9-11”. De laatste moord zou in de nacht van 4 september 2001 zijn gepleegd. De volgende middag meldden de ziekenhuisautoriteiten een reeks onverklaarbare sterfgevallen aan de gezondheidsinspectie en de politie. Ook plaatsten ze Lucia de B., zoals ze bekend werd in de Nederlandse media, op ‘non-active’. De media meldden dat er ongeveer 30 verdachte sterfgevallen en reanimaties werden onderzocht. De ziekenhuisautoriteiten meldden niet alleen wat volgens hen vreselijke misdaden waren, ze geloofden ook dat ze wisten wie de dader was.

De wielen van gerechtigheid draaien langzaam, dus er was een proces en een veroordeling; een beroep en een nieuw proces en een veroordeling; eindelijk een beroep op het hooggerechtshof. Het duurde tot 2006 voordat de veroordeling (levenslange gevangenisstraf, die in Nederland pas wordt beëindigd als de veroordeelde de gevangenis verlaat in een kist) onherroepelijk wordt. Alleen nieuw bewijs kan het omverwerpen. Nieuwe wetenschappelijke interpretaties van oud bewijs worden niet als nieuw bewijs beschouwd. Er was geen nieuw bewijs.

Maar al, in 2003-2004, maakten sommige mensen met een interne band met het Juliana Kinderziekenhuis zich al zorgen over de zaak. Nadat ze in vertrouwen met de hoogste autoriteiten over hun zorgen hadden gesproken, maar toen ze te horen kregen dat er niets aan te doen was, begonnen ze journalisten te benaderen. Langzaam maar zeker raakten de media weer geïnteresseerd in de zaak – het verhaal was niet meer het verhaal van de vreselijke heks die baby’s en oude mensen zonder duidelijke reden had vermoord, behalve voor het plezier in het doden, maar van een onschuldige persoon die was verminkt door pech, incompetente statistieken en een monsterlijk bureaucratisch systeem dat eens in beweging, niet kon worden gestopt.

Onder de supporters van Metta de Noo en Ton Derksen waren enkele professionele statistici, omdat Lucia’s aanvankelijke veroordeling was gebaseerd op een foutieve statistische analyse van door het ziekenhuis verstrekte onjuiste gegevens en geanalyseerd door amateurs en verkeerd begrepen door advocaten. Anderen waren informatici, sommigen waren ambtenaren op hoog niveau van verschillende overheidsorganen die ontsteld waren over wat ze zagen gebeuren; er waren onafhankelijke wetenschappers, een paar medisch specialisten, een paar mensen met een persoonlijke band met Lucia (maar geen directe familie); en vrienden van zulke mensen. Sommigen van ons werkten vrij intensief samen en werkten met name aan de internetsite voor Lucia, bouwden er een Engelstalige versie van en brachten deze onder de aandacht van wetenschappers over de hele wereld. Toen kranten als de New York Times en The Guardian begonnen te schrijven over een vermeende gerechtelijke dwaling met verkeerd geïnterpreteerde statistieken, ondersteund door opmerkingen van Britse topstatistici, hadden de Nederlandse journalisten nieuws voor de Nederlandse kranten, en dat soort nieuws werd zeker opgemerkt in de gangen van de macht in Den Haag.

Snel vooruit naar 2010, toen rechters niet alleen Lucia onschuldig verklaarden, maar voor de rechtszaal hard-op verklaarden dat Lucia samen met haar collega-verpleegkundigen uiterst professioneel had gevochten om het leven van baby’s te redden die onnodig in gevaar werden gebracht door medische fouten van de medisch specialisten die waren belast met hun zorg. Ze vermeldden ook dat alleen omdat het tijdstip van overlijden van een terminaal zieke persoon niet van tevoren kon worden voorspeld, dit niet betekende dat het noodzakelijkerwijs onverklaarbaar en dus verdacht was.

Enkelen van ons, opgetogen door onze overwinning, besloten om samen te werken en een soort collectief te vormen dat zou kijken naar andere ‘verloren zaken’ met mogelijke justitiele dwalingen waar de wetenschap misbruikt was. Ik had al had mijn eigen onderzoeksactiviteiten omgebogen en gericht op het snelgroeiende veld van forensische statistiek, en ik was al diep betrokken bij de zaak Kevin Sweeney en de zaak van José Booij. Al snel hadden we een website en waren we hard aan het werk, maar kort daarna gebeurde er een opeenvolging van ongelukken. Ten eerste betaalde het ziekenhuis van Lucia een dure advocaat om me onder druk te zetten namens de hoofdkinderarts van het Juliana Children’s Hospital. Ik had namelijk wat persoonlijke informatie over deze persoon (die toevallig de schoonzus was van Metta de Noo en Ton Derksen) geschreven op mijn homepage aan de Universiteit van Leiden. Ik voelde dat het van cruciaal belang was om te begrijpen hoe de zaak tegen Lucia was begonnen en dit had zeker veel te maken met de persoonlijkheden van enkele sleutelfiguren in dat ziekenhuis. Ik schreef ook naar het ziekenhuis en vroeg om meer gegevens over de sterfgevallen en andere incidenten op de afdelingen waar Lucia had gewerkt, om het professionele onafhankelijke statistische onderzoek te voltooien dat had moeten plaatsvinden toen de zaak begon. Ik werd bedreigd en geïntimideerd. Ik vond enige bescherming van mijn eigen universiteit die namens mij dure advocatenkosten betaalde. Mijn advocaat adviseerde me echter al snel om toe te geven door aanstootgevend materiaal van internet te verwijderen, want als dit naar de rechtbank zou gaan, zou het ziekenhuis waarschijnlijk winnen. Ik zou de reputatie van rijke mensen en van een machtige organisatie schaden en ik zou moeten boeten voor de schade die ik had aangericht. Ik moest beloven om deze dingen nooit weer te zeggen en ik zou beboet worden als ze ooit herhaald zou worden door anderen. Ik heb nooit toegegeven aan deze eisen. Later heb ik wel wat gepubliceerd en naar het ziekenhuis opgestuurd. Ze bleven stil. Het was een interessante spel bluf poker.

Ten tweede schreef ik op gewone internetfora enkele zinnen waarin ik José Booij verdedigde, maar die de persoon die haar bij de kinderbescherming had aangegeven ook van schuld verweet. Dat was geen rijk persoon, maar zeker een slim persoon, en ze meldden mij bij de politie. Ik werd verdachte in een geval van vermeende laster. Geïnterviewd door een aardige lokale politieagent. En een paar maanden later kreeg ik een brief van de lokale strafrechter waarin stond dat als ik 200 euro administratiekosten zou betalen, de zaak administratief zou worden afgesloten. Ik hoefde geen schuld te bekennen maar kon ook niet aantekenen dat ik me onschuldig vond.

Dit leidde ertoe dat het Bureau Verloren Zaken zijn activiteiten een tijdje stopzette. Maar het is nu tijd voor een come-back, een “re-boot”. Ondertussen deed ik niet niets, maar raakte ik betrokken bij een half dozijn andere zaken, en leerde ik steeds meer over recht, over forensische statistiek, over wetenschappelijke integriteit, over organisaties, psychologie en sociale media. De BOLC is terug.


Het BOLC is al een paar jaar inactief, maar nu de oprichter de officiële pensioenleeftijd heeft bereikt, “herstart” hij de organisatie. Richard Gill richtte de BOLC op aan de vooravond van de vrijspraak van verpleegster Lucia de Berk in 2006. Een groep vrienden die nauw betrokken waren geweest bij de beweging om Lucia een eerlijk proces te bezorgen, besloten dat ze zo genoten van elkaars gezelschap en zoveel hadden geleerd van de ervaring van de afgelopen jaren, dat ze hun vaardigheden wilden uitproberen op enkele nieuwe cases. We kwamen snel een aantal ernstige problemen tegen en stopten onze website tijdelijk, hoewel de activiteiten in verschillende gevallen werden voortgezet, meer ervaring werd opgedaan, veel werd geleerd.

We vinden dat het tijd is om het opnieuw te proberen, nadat we enkele nuttige lessen hebben geleerd van onze mislukkingen van de afgelopen jaren. Hier is een globaal overzicht van onze plannen.

  1. Zet een robuuste formele structuur op met een bestuur (voorzitter, secretaris, penningmeester) en een adviesraad. In plaats van het de wetenschappelijke adviesraad te noemen, zoals gebruikelijk in academische organisaties, zou het een morele en / of wijsheidsadviesraad moeten zijn om op de hoogte te worden gehouden van onze activiteiten en ons te laten weten als ze denken dat we van de rails gaan.
  2. Eventueel een aanvraag indienen om een Stichting te worden. Dit betekent dat we ook zoiets zijn als een vereniging of een club, met een jaarlijkse algemene vergadering. We zouden leden hebben, die misschien ook donaties willen doen, aangezien het runnen van een website en het af en toe in de problemen komen geld kost.
  3. Schrijf over de zaken waar we de afgelopen jaren bij betrokken zijn geweest, met name: vermeende seriemoordenaars Ben Geen (VK), Daniela Poggiali (Italië); beschuldigingen van wetenschappelijk wangedrag in het geval van het proefschrift van een student van Peter Nijkamp; het geval van de AD Haring-test en de kwaliteit van Dutch New Herring; het geval van Kevin Sweeney.

Re-launch of the Bureau of Lost Causes

The BOLC is back. 10 years ago (in 2010) the Dutch nurse Lucia de Berk was acquitted, at a retrial, of a charge of 7 murders and 3 attempted murders at hospitals in the Hague in a number of years leading up to just a few days before the memorable date of “9-11”. The last murder was supposed to have been committed in the night of September 4, 2001. The next afternoon, hospital authorities reported a series of unexplained deaths to the health inspectorate and to the police. They also put Lucia de B., as she became known in the Dutch media, onto “non-active”. The media reported that about 30 suspicious deaths and resuscitations were being investigated. The hospital authorities not only reported what they believed to be terrible crimes, they also believed that they knew who was the perpetrator.

The wheels of justice turn slowly, so there was a trial and a conviction; an appeal and a retrial and a conviction; finally an appeal to the supreme court. It took till 2006 for the conviction (a life sentence, which in the Netherlands is only terminated when the convict leaves prison in a coffin) to become irrevocable. Only new evidence could overturn it. New scientific interpretations of old evidence is not considered new evidence. There was no new evidence.

Yet already, in 2003-2004, some people with an inside connection to the Juliana Children’s Hospital were already getting very concerned about the case. Having spoken of their concerns, in confidence, with the highest authorities, but being informed that nothing could be done, they started to approach journalists. Slowly but surely the media started getting interested in the case again – the story was not anymore the story of the terrible witch who had murdered babies and old people for no apparent reason whatsoever except for the pleasure in killing, but of an innocent person who was mangled by bad luck, incompetent statistics, and a monstrous bureaucratic system which once in motion could not be stopped.

Among the supporters of Metta de Noo and Ton Derksen were a few professional statisticians, because Lucia’s initial conviction had been based on a faulty statistical analysis of faulty data supplied by the hospital and analysed by amateurs and misunderstood by lawyers. Others were computer scientists, some were civil servants at high levels of several government organs appalled at what they saw going on; there were independent scientists, a few medical specialists, a few persons with some personal connection with Lucia; and friends of such people. Some of us worked quite intensively together and in particular worked on the internet site for Lucia, building an English language version of it, and bringing it to the attention of scientists world-wide. When newspapers like the New York Times and The Guardian started writing about an alleged miscarriage of justice in the Netherlands involving wrongly interpreted statistics, supported by comments from top UK statisticians, the Dutch journalists had news for the Dutch newspapers, and that kind of news certainly got noticed in the corridors of power in the Hague.

Fast forward to 2010, when judges not only pronounced Lucia innocent, but actually stated in court that Lucia together with her colleague nurses had fought with utmost professionality to save the lives of babies which were unnecessarily endangered by medical errors of the medical specialists entrusted with their care. They also mentioned that just because the time of a death of a terminally ill person could not be predicted in advance, it did not mean that it was necessarily unexplainable and hence suspicious.

A few of us, exhilarated by our victory, decided to band together and form some sort of collective which would look at other “lost causes” involving possible miscarriages of justice where science had been misused. Aready, I had turned my own research activities to the burgeoning field of forensic statistics, and already I was deeply involved in the Kevin Sweeney case, and the case of José Booij. Soon we had a web-site and were hard at work, but soon after this, a succession of mishaps occurred. Firstly, Lucia’s hospital paid for an expensive lawyer to put pressure on me on behalf of the chief paediatrician of the Juliana Children’s Hospital. I had namely written some information of some personal nature about this person (who coincidentally was the sister-in-law of Metta de Noo and Ton Derksen) on my home page at the University of Leiden. I felt it was crucially in the public interest to understand how the case against Lucia had started and this certainly had a lot to do with personalities of a few key persons at that hospital. I also wrote to the hospital asking for further data on the deaths and other incidents in the wards where Lucia had worked, in order to complete the professional independent statistical investigation which should have taken place when the case started. I was threatened and intimidated. I found some protection from my own university who actually paid expensive lawyer fees on my behalf. However, my lawyer soon advised me to give way by removing offensive material from internet, since if this went to court, the hospital would most likely win. I would be harming the reputation of rich persons and of a powerful organisation, and I would have to pay for the harm I did. Secondly, on some ordinary internet fora I wrote some sentences defending José Booij, but which pointed a finger of blame at the person who had reported her to the police. That was not a rich person, but certainly a clever person, and they reported me to the police. I became a suspect in a case of alleged slander. Got interviewed by a nice local policeman. And a few months later I got a letter from the local criminal courts saying that if I paid 200 Euro administrative fees, the case would be administratively closed.

This led to the Bureau of Lost Causes shutting down its activities for a while. But it is now time for a come-back, a “re-boot”. In the meantime I did not do nothing, but got involved in half a dozen further cases, learning more and more about law, about forensic statistics, about scientific integrity, about organisations, psychology and social media. The BOLC is back.


The BOLC has been dormant for a few years, but now that the founder has reached official retirement age, he is “rebooting” the organisation. Richard Gill founded the BOLC on the eve of nurse Lucia de Berk’s acquittal in 2006. A group of friends who had been closely associated with the movement to get Lucia a fair retrial decided that they so enjoyed one another’s company, and had learnt so much from the experience of the past few years, that they wanted to try out their skills on some new cases. We rapidly ran into some serious problems and temporarily closed down our website, though activities continued on several cases, more experience was gained, a lot was learnt.

We feel it is time to try again, having learnt some useful lessons from our failures of the last few years. Here is a rough outline of our plans.

1. Set up a robust formal structure with an executive board (chairman, secretary, treasurer) and an advisory board. Rather than calling it the scientific advisory board as is common in academic organisations, it should be a moral and/or wisdom advisory board, to be kept informed of our activities and to let us know if they think we are going off the rails. 

2. Possibly, make an application to become a foundation (“Stichting”). This means we will also be something like a society or a club, with an annual general meeting. We would have members, who might also like to make donations, since running a web site and occasionally getting into legal trouble costs money.

3. Write about the cases we have been involved in during recent years, in particular: alleged serial killer nurses Ben Geen (UK), Daniela Poggiali (Italy); allegations of scientific misconduct in the case of the PhD thesis of a student of Peter Nijkamp; the case of the AD Herring test and the quality of Dutch New Herring; the case of Kevin Sweeney.