The whole case raises questions about the nature and definition of sanity and what dictates this or otherwise. Plenty of children have suffocating childhoods to one degree or another but do not go on to become dangerous criminals.
The case of Letby is particularly strange as her apparent normality was commented on by everyone. Often such people do display some slightly strange behaviours that people notice. Or they have a strange look in the eyes - I now that is not a scientific observation, but I do remember when my OH was so ill for his last few years his eyes took on a very strange and rather creepy empty look, and I have observed this when working with people with dementia and mental illnesses - it is hard to define as it is almost an "absence."
So much of our behaviour is dictated by brain structure and function, which can be determined in utero or by life experiences. I know that a close relative of mine who has engaged in criminal behaviour (and had suffered damage in utero) has a strange and slightly vacant look about her - it is as if she is "not wired up right".
But this outwardly normal young woman, who was socially active and intelligent has undertaken these dreadful acts.
Or if not mentally ill is she just evil as some would have us believe? - and if that is the case then what is this, where does it come from?
Being in love, especially in the first flush, fulfils all the definitions of psychosis - maybe her infatuation with the doctor who would be called to these sick babies is at the root of this.
So sad all round. Those poor babies and their families - and her parents.
No doubt she will be sentenced to life imprisonment; but there is always the possibility of parole at some point. Would a parole board be fooled by her apparent normality I wonder?
In the absence of an identifiable mental illness there is no possibility of treatment or rehabilitation, so it is likely that incarceration is the only way forward in this sad situation.