For a number of years, Dr Jim MacKeith had known that he would die of the cancer that finally took his life at the age of 68. He would make no mention of that prospect, but during the last year, obliquely and often, telephone calls would include suggestions: “Just in case,” he would say, “I’m not quite up to it, I have introduced B to Dr A”, or Dr X “would be a good person to have on board as backup.”
Each suggestion would relate to the care, advice or the benefit of the experience of a profoundly moral life that MacKeith gave day by day to an extraordinary range of recipients: returnees from Guantánamo Bay, innocent individuals facing trial or locked up indefinitely without trial, wrongly convicted men and women, ministers of state, professional colleagues whom he was constantly encouraging to think outside narrow disciplinary parameters, and lawyers fortunate in their friendship with this extraordinary man.
Two decades of knowing him well helped with interpretation, since he disconcertingly combined reserve and self-deprecation with the innate sureness of a person rooted in an absolute sense of what was right and wrong. Born in Leamington Spa, with a long line of paternal medical forebears, he shared a commitment to social justice with a mother now in her 90s and most recently arrested in the best traditions of Quaker protest at an Oxfordshire airbase from which RAF planes were flying to Iraq. Saved from the straitjacket of an undiluted English education by studying for a degree in literature and politics in Dublin at Trinity College, he could always see the more conventional world he thereafter re-entered as a doctor with an independent eye.
What he did, in a way that no one else has matched, was as a fine doctor, to understand the importance of the responsibility that medicine should carry towards other areas of life. Interested as a pioneer of forensic psychiatry in the plight of vulnerable individuals before the courts, he had the insight to understand that the traditional method of ensuring convictions, via confessions, could be analysed scientifically and shown to be unsafe.
He and his colleague Gisli Gudjonnson, whom he met in 1980, honed a methodology for the reassessing of a succession of ostensibly strong convictions. They provided to the courts a means of understanding why, in particular, measurably vulnerable individuals might confess under pressure, physical or mental, to crimes of which they were innocent.
The remarkable history of this, MacKeith’s best known work, began tentatively, case by case, until it exposed a litany of wrongful convictions, all finally and belatedly quashed. One case pioneered the legal and medical framework for the next: Engin Raghip, wrongly imprisoned from 1987 to 1991 for the murder of PC Keith Blakelock at Broadwater Farm, north London; Judith Ward, who spent 18 years in prison on the basis of a false confession to three IRA bombings in 1973-74; George Long, released after 16 years in prison, convicted after confessing (completely falsely) to the murder of a 14-year-old boy; and Vincent Hickey, whose conviction for the murder of the 13-year-old Carl Bridgewater in 1978 was finally overturned in 1997.
Sometimes the forensic analysis, meticulously conducted in prison visit after prison visit, was never put to the test in any court. For the Guildford Four and the Birmingham Six, intervening proof of the fabrication of evidence by the police preempted and avoided any need for further analysis.
Nevertheless the methodology and its results in those cases is there for all to see. Of the Birmingham Six, the most vulnerable of the six defendants, Hugh Callaghan (an innocent man who nevertheless confessed within hours to the bombing of pubs carried out by the IRA in 1975), scored as high as it was possible to score in terms of measurable traits of suggestibility and compliance; Paddy Hill, however, who, of the six, never signed a confession, measured sky high off the top of the Gudjonsonn scale as a resistant personality.
Appreciating those rigorously professional assessments though, and the integrity and importance of the results they produced, takes one not even half way towards comprehending MacKeith’s true worth. The rest flowed from the extra integrity and responsibility he demonstrated beyond his chosen profession. When Paddy Hill was enduring the pain of his 16th year in prison before his conviction was quashed, it was MacKeith who advised him how to get through his torment. In 2007, more than 15 years on from his release, it was MacKeith who was helping and advising Hill’s Miscarriages of Justice Organisation, Mojo, on setting up a retreat for the aftercare of the wrongly convicted upon release. When Gerry Conlon, of the Guildford Four, hit problems that were too hard to handle on his second night out of prison, it was MacKeith who drove in the night from Dulwich to north London to reassure him.
In a world where ambition and competitiveness sometimes intrude, MacKeith taught by his example the lessons of selflessness and generosity. The adversarial context of our courts and bruising encounters between the individual and the state breed mistrust. MacKeith would counsel defence lawyers and their clients not automatically to mistrust doctors instructed by their opponents; he would look always for common ground. Equally, he would quietly advise civil servants and ministers to abandon their preconceptions of those who challenged their decisions, and he would find endless, innovative ways of arguing the merits of the cases of the voiceless.
In the as yet unwritten histories of many corrected injustices, there will be a record of MacKeith’s wise presence. Just before his death, in a form of recognition that must have triggered from him a wry response, Jack Straw commended him for an OBE for having “changed the landscape in criminal justice and human rights”.
He agonised long and hard before putting forward his name as a founding commissioner in 1997 of the Criminal Cases Review Commission. He wondered how he would fare in a new and large organisation once he had left the familiar and far smaller psychiatric unit he had established at the Bethlem Royal and Maudsley hospitals, south-east London, over the previous 20 years, but as in every aspect of his life he felt a personal responsibility to make a difference - in the case of the commission, to try to influence its understanding of the painful lessons to be learned from past injustices.
Long before its creation, MacKeith had advocated to the Home Office the necessity of a properly resourced and truly independent organisation; when it was set up, he made a commitment to try to make it work, to which he stuck despite his own competing personal nightmares. His signature as commissioner for the CCRC’s final and successful reference to the court of appeal of the tragic and disgraceful case of David Cooper and Michael McMahon - cleared only posthumously of the murder of a Luton sub-postmaster in 1969 - is much prized. Successive Home Secretaries had referred the case to senior judges five times in the 1970s, only to see it rejected on each occasion; MacKeith combated exhaustion and illness to complete the task.
In the same spirit, he continued to carry out almost to the bitter end inspections, at great personal cost, as a medical adviser for the European Committee for the Prevention of Torture (1991-2006) in order to persuade member states of the Council of Europe to honour their paper commitments to the abolition of torture, and it was he who identified the need for a comprehensive psychiatric overview of disturbing evidence emerging from Belmarsh Prison, where from December 2001 a number of foreign nationals were interned without trial under the infamous Anti-Terrorism, Crime and Security Act of that year.
The legislation was repealed, but not until 2005 and only after half of those detained had been driven into serious mental illness. Indefinite detention, as the conscientious joint analysis of 48 separate psychiatric reports demonstrated, was largely responsible for having endangered the mental health of those detainees.
Horrified by Guantánamo Bay, even though ill and in pain, when Mac- Keith was asked, he agreed without hesitation to travel there if allowed, to carry out psychiatric assessments of the British nationals and residents held there. But neither he nor the lessons of his enduring work on the dangers of coercive interrogation, which by now constitute a worldwide legal lifeline even for US prisoners on death row, were allowed to penetrate Guantánamo, and he was cheated, by one day, of the relief of learning of the British government’s announcement that it would, after five years of refusal, change its stance and finally ask the US for the return of five of the camp’s UK residents.
For this remarkable and courageous life, innumerable recipients of his work give thanks to his family who sustained him: his wife Keesje and their children, Gwen, the poet, and Sam and Piet, the doctors, the telling of whose accomplishments constituted the only occasions on which their father could ever be heard quietly to blow an otherwise totally silent trumpet of pride.
Richard Taylor writes: Having gained his medical qualification in Dublin (1965) and trained in psychiatry at the Bethlem Royal and Maudsley hospitals, Jim MacKeith became a pioneer in the new speciality of forensic psychiatry. There were limited opportunities in the early 1970s, and he took the radical step of working for the prison medical service.
Brixton Prison (1972-74) must have been a difficult place to be a psychiatrist. Jim made great efforts to improve the lot of mentally disordered offenders there, on one occasion working behind the scenes to encourage the introduction of concert parties for inmates. Famously a charabanc containing visiting thespians became wedged inside the prison gate, creating a potential security hazard.
Jim went on to work at Broadmoor hospital, Berkshire (1974-77), and then moved back to the Bethlem Royal and Maudsley to set up the new medium-secure forensic psychiatry service. With the benefit of Jim’s experience at Broadmoor, the Denis Hill unit at the Bethlem Royal Hospital was the prototype medium-secure psychiatric service in the south-east. A generation of forensic psychiatrists who passed through the Denis Hill unit will always remember Jim’s humane approach to the difficult task of looking after mentally disordered offenders.
He was always willing to share with junior colleagues his insights as a skilled clinician, medico-legal writer and expert witness, which had been honed by his experience in high-profile cases. Those who worked with him will remember his attention to detail and his meticulous approach to teasing apart the complex ethical dilemmas relating to the psychiatric evaluation of defendants. He will be very much missed.
· James Alexander Culpin MacKeith, psychiatrist, born October 29 1938; died August 4 2007