John Bodkin Adams

On 24 August, the British Medical Association (BMA) sent a letter to all doctors in Eastbourne reminding them of "Professional Secrecy" (i.e., patient confidentiality) if interviewed by the police.[41] The police were frustrated by this move, although some local doctors ignored it and gave statements relating either to deceased patients or, in one instance, one that was alive.[42] The action of the BMA was part of a concerted attempt by it to secure better terms for its members, whose pay had remained virtually static since the National Health Service had been set up in 1948:[43] this action later led to talk of an all-out strike.[44]

The Attorney-General, Sir Reginald Manningham-Buller (who customarily prosecuted cases of poisoning or delegated them to the Solicitor General),[45][46] wrote to the BMA secretary, Angus Macrae, "to try to get him to remove the ban".[41] The impasse continued until on 8 November Manningham-Buller met Macrae to convince him of the importance of the case. During this meeting, in a highly unusual move, he passed Hannam's confidential 187-page report on Adams to Macrae. His intention was to convince the BMA of the seriousness of the accusations and for the need to obtain cooperation from local doctors.[47] Macrae took the report to the President of the BMA and returned it the next day. Convinced of the seriousness of the accusations, Macrae dropped his opposition to doctors talking to the police.[48]

It has been speculated that Macrae also copied the report and passed it on to the defence,[49] and conspiracy theorists have claimed that Manningham-Buller did so with the intention of assisting the defence case, but there is no evidence of this.[50] However, the incident does call Manningham-Buller's competence into question, and he was strongly criticised at the time.[lower-roman 2]

On 28 November 1956, opposition Labour Party MPs Stephen Swingler and Hugh Delargy gave notice of two questions to be asked in the House of Commons regarding the affair, one asking what "reports [the Attorney-General] has sent" to the General Medical Council (GMC) in the "past six months".[52] Manningham-Buller replied that he had "had no communications" with the GMC, but only with an officer of it. He did not mention the report.[52] Instead, he instigated an investigation into a leak,[52] later concluding that Hannam himself[49] had passed information regarding the meeting with Macrae to a journalist, probably Rodney Hallworth of the Daily Mail.[53]

On 1 October 1956, Hannam met Adams,[lower-roman 3] who asked, "You are finding all these rumours untrue, aren't you?"[55] Hannam mentioned a prescription Adams had forged: "That was very wrong [...] I have had God's forgiveness for it", Adams replied.[55] Hannam brought up the deaths of Adams's patients and his receipt of legacies from them. Adams answered: "A lot of those were instead of fees, I don't want money. What use is it? I paid £1,100 super tax last year"[55] Hannam later mentioned, "Mr. Hullett left you £500". Adams replied, "Now, now, he was a life-long friend [...] I even thought it would be more than it was."[55] Finally, when asked why he had stated untruthfully on cremation forms that he was not to inherit from the deceased, Adams said:

Oh, that wasn't done wickedly, God knows it wasn't. We always want cremations to go off smoothly for the dear relatives. If I said I knew I was getting money under the Will they might get suspicious and I like cremations and burials to go smoothly. There was nothing suspicious really. It was not deceitful.[56]

On 24 November, Hannam, Hewett and the head of Eastbourne CID, Detective Inspector Pugh, searched Adams's house with a warrant issued (in Pugh's name) under the Dangerous Drugs Act 1951. When told they were looking for, "Morphine, Heroin, Pethidine and the like", Adams was surprised: "Oh, that group. You will find none here. I haven't any. I very seldom ever use them", he said.[57] When Hannam asked for Adams's Dangerous Drugs Register, which was at that time the record of those controlled drugs ordered, but not how they were used,[58] Adams responded: "I don't know what you mean. I keep no register."[59] He had not kept one since 1949,[60] although such failures were not uncommon at that period.[61] When shown a list of dangerous drugs he had prescribed Morrell, and asked who administered them, Adams said, "I did nearly all. Perhaps the nurses gave some but mostly me". This was later contradicted by the contents of the nurses' notebooks produced during his trial. Hannam then observed, "Doctor, you prescribed for her 75 [heroin tablets of 1⁄6-grain (≈ 10.8 mg) each] the day before she died." Adams replied, "Poor soul, she was in terrible agony. It was all used. I used them myself [...] Do you think it is too much?"[59]

Devlin suggested that Hannam generally considered what a suspect said in interrogation was the best form of evidence, and that the police and prosecution case was based to a significant degree on admissions that Hannam had recorded Adams making.[62] He considered that Hannam's records were reasonably accurate, although putting emphasis on matters that might assist a prosecution, as was the practice at the time.[63] However, Devlin considered that proof of guilt should be based as far as possible on facts, rather than pre-trial statements to the police,[63] and that an admission had to be taken as a whole, so that Adams's statement that he had used all 121⁄2 grains or 75 tablets of heroin could not be divorced from his claim that Mrs Morrell was in terrible agony.[64]

Adams opened a cupboard for the police: amongst medicine bottles were "chocolates – slabs stuck – butter, margarine, sugar".[65] While the officers inspected it, Adams walked to another cupboard and slipped two objects into his jacket pocket. Hannam and Pugh challenged him and Adams showed them two bottles of morphine; one he said was for Annie Sharpe,[65] a patient and major witness who had died nine days earlier under his care; the other said "Mr. Soden".[65] Soden had died on 17 September 1956, but pharmacy records later showed he had never been prescribed morphine.[66] Adams was later (after his main trial in 1957) convicted of obstructing the search, concealing the bottles and for failing to keep a Dangerous Drugs register. Later at the police station, Adams told Hannam:

Easing the passing of a dying person isn't all that wicked. She [Morrell] wanted to die. That can't be murder. It is impossible to accuse a doctor.[67][60]

In the basement of Adams's house, the police found, "a lot of unused china and silverware. In one room there were 20 new motor car tyres still in their wrappings and several new motor car leaf springs. Wines and spirits were stored in quantity."[68] Hallworth reports that Adams was stockpiling in case of another World War.[69] On the second floor, "one room was given over to an armoury [:] six guns in a glass-fronted display case, several automatic pistols".[68] He had permits for these. Another room was used "wholly for photographic equipment. A dozen very expensive cameras in leather cases" lay around.[68]

Adams became engaged around 1933 to Norah O'Hara[lower-roman 4] but called it off in 1935 after her father had bought them a house and furnished it. Various explanations have been suggested: Surtees suggests that it was because Adams's mother did not want him to marry "trade"[70] though he also quotes a rumour that Adams wanted O'Hara's father to change his will to favour his daughters.[70] Adams remained friends with O'Hara his whole life and remembered her in his will.[lower-roman 5]

In December, the police acquired a memorandum belonging to a Daily Mail journalist,[lower-roman 6] concerning rumours of homosexuality between "a police officer, a magistrate and a doctor".[73] The "doctor" directly implied Adams. This information had come, according to the reporter, directly from Hannam.[73] The 'magistrate' was Sir Roland Gwynne, Mayor of Eastbourne (1929–31) and brother of Rupert Gwynne, MP for Eastbourne (1910–24).[74] Gwynne was Adams's patient and known to visit every day at 9:00 a.m. They went on frequent holidays together and had spent three weeks in Scotland that September.[75] The 'police officer' was the Deputy Chief Constable of Eastbourne, Alexander Seekings.[76] Hannam interviewed Gwynne on 4 February 1957, following which Gwynne severed all connection with Adams. Hannam's record of the interview makes no reference to any homosexual acts (which were a criminal offence in 1956),[77] and the police instead gave the journalist a dressing-down.[72]

Adams was first arrested on 24 November 1956 on 13 charges including false representation on cremation certificates and granted bail.[78] He was arrested on 19 December 1956 and charged with the murder of Mrs. Morrell.[79][80] When told of the charges, he said:

Murder... murder... Can you prove it was murder? [...] I didn't think you could prove it was murder. She was dying in any event.[81][60]

Then, while he was being taken away from Kent Lodge, he reportedly gripped his receptionist's hand and told her: "I will see you in heaven."[81][60]

Hannam considered he had collected enough evidence in at least four of the cases for prosecution to be warranted: regarding Clara Neil Miller,[82] Julia Bradnum,[82] Edith Alice Morrell and Gertrude Hullett.[83] Of these, Adams was charged on one count: the murder of Morrell, but with the death of Mr. and Mrs. Hullett being used to prove 'system'.[84] Although it was usual in 1956 for only one count of murder to be indicted, evidence of other suspected murders not being tried could be given, provided each such instance would, on its own facts, be capable of proof beyond reasonable doubt and strikingly similar to the case tried.[85]

On 22 February 1957, the police were notified of a libellous and potentially prejudicial poem about the case titled Adams and Eves. It had been read at the Cavendish Hotel on the 13th by the manager in front of 150 guests. An officer spent ten days investigating and discovered a chain of hands through which the poem had passed and been recopied to be redistributed. The original author was not discovered; an unnamed Fleet Street journalist was suspected.

Morrell was a wealthy widow who suffered a stroke on 24 June 1948 while visiting her son in Cheshire. She was partially paralysed and was admitted to a hospital near Chester, where she received morphine injections for nine days from 27 June, prescribed by a Dr. Turner.[86] Cullen suggests that Adams, supposedly her usual doctor, arrived there on 26 June, the day before she was first prescribed morphine for the pain.[87] However, the Attorney-General's opening speech states that Mrs. Morrell was transferred to Eastbourne on 5 July 1948, only then becoming one of Adams's patients, and that he first prescribed morphine on 9 July, adding heroin on 21 July.[88] Mrs. Morrell was not expected to live more than six months or so, but survived her stroke for over two years, suffering also from arthritis. Between July 1948 and August 1950, she received routine evening injections of morphine and heroin and her condition was stable,[89] but from then, as her condition deteriorated, the dosages increased. An expert witness for the prosecution claimed that Mrs. Morrell would have become addicted, but the only apparent symptoms of this were attributed by the defence's expert to a second stroke.[90]

Mrs. Morrell left an estate of £157,000 and made eight cash bequests of between £300 and £1,000. Cullen claims that in some of the several wills she made Adams was bequeathed large sums of money and her Rolls-Royce Silver Ghost (valued at £1,500).[91] This appears incorrect and, in her will of 5 August 1950, the only outright bequest Mrs. Morrell made to Adams was a chest of silver cutlery worth £276. This will also awarded him a contingent right to the car and a Jacobean court cupboard, but only if Mrs. Morrell's son predeceased her, which Devlin noted was unlikely.[92] A codicil of 13 September 1950 cut Adams out of her will completely.[93] and she died on 13 November 1950 aged 81[91] without any further changes to her will.[92] Adams certified the cause of death as "stroke"[91] and on inspecting the body, slit her wrist to ensure she was dead.[94] Despite the last codicil, Mrs. Morrell's son gave Adams the Rolls-Royce which was 19 years old, and the chest of silver cutlery.[95] After Mrs. Morrell's death, he also took away an infrared lamp she had bought herself, worth £60.[96] Adams billed Morrell's estate for 1,100 visits,[97] costing £1,674 in total.[98] The police estimated that Adams had visited Morrell a total of 321 times during her treatment. On her cremation form, Adams stated that "as far as I am aware" he had no pecuniary interest in the death, thereby avoiding the necessity of a post-mortem.[91]

On 23 July 1956, Gertrude Hullett, another of Adams's patients, died aged 50.[99] She had been depressed since the death of her husband four months earlier and had been prescribed sodium barbitone and sodium phenobarbitone.[lower-roman 7] She had told Adams on frequent occasions of her wish to commit suicide.[99] When questioned by the coroner, Adams said that he personally gave Mrs. Hullett two barbiturate tablets each morning, initially of 71⁄2 grains each, a normal dose, later reduced to two tablets of 6 grains each, then 5 grains. However, he did not ensure that she took both tablets daily and no attempt had been made to retrieve any that had been prescribed to the late Mr. Hullett but unused when he died.[101]

On 17 July, Hullett wrote out a cheque to Adams for £1,000 – to pay for an MG car her husband had promised to buy him.[102] Adams paid the cheque into his account the next day, and on being told that it would clear by the 21st, asked for it to be specially cleared – to arrive in his account the next day.[103] On 19 July, Hullett is thought to have taken an overdose and was found the next morning in a coma.[99] Adams was unavailable and a colleague, Dr. Harris, attended to her until Adams arrived later in the day.[99] Not once during their discussion did Adams mention her depression or her barbiturate medication.[102] They decided a cerebral haemorrhage was most likely. On 21 July, Dr. Shera, a pathologist, was called in to take a spinal fluid sample and immediately asked if her stomach contents should be examined in case of narcotic poisoning. Adams and Harris both opposed this.[99] After Shera left, Adams visited a colleague at the Princess Alice Hospital in Eastbourne and asked about the treatment for barbiturate poisoning. He was told to give doses of 10 cc of Megimide every five minutes, and was given 100 cc to use. The recommended dose in the instructions was 100 cc to 200 cc.[104] Dr. Cook also told him to put Hullett on an intravenous drip. Adams did not.[105]

The next morning, at 8.30, Adams called the coroner to make an appointment for a private post-mortem. The coroner asked when the patient had died and Adams said she had not yet.[105] Harris visited again that day and Adams still made no mention of potential barbiturate poisoning. When Harris had left, Adams gave a single injection of 10 cc of the Megimide.[105] Hullett developed broncho-pneumonia and on the 23rd at 6.00 a.m. Adams gave Hullett oxygen.[106] She died at 7.23 a.m. on 23 July.[106] The results of a urine sample taken on 21 July were received after Hullett's death, on the 24th. It showed she had 115 grains of sodium barbitone in her body – twice the fatal dose.[107]

An inquest was held into Hullett's death on 21 August. The coroner questioned Adams's treatment and in his summing up said that it was "extraordinary that the doctor, knowing the past history of the patient" did not "at once suspect barbiturate poisoning".[108] He described Adams's 10 cc dose of Megimide as another "mere gesture".[108] The inquest concluded that Hullett committed suicide: it was described as a "travesty" as, in the opinion of Cullen; with an ongoing police investigation, the inquest should have been adjourned until the investigation had concluded.[109] However, the coroner asked Superintendent Hannam whether the police wished him to adjourn the inquest, to which Hannam replied that he had no application to make.[110] After the inquest, the cheque for £1,000 disappeared.[111]

Hullett left Adams her Rolls-Royce Silver Dawn (worth at least £2,900)[111] in a will written five days before her overdose.[102] Adams sold it six days before he was arrested.[111]

Charles Hewett, Hannam's assistant, was quoted as saying that both officers were astounded at Manningham-Buller's decision to charge Adams with the murder of Morrell, since her body had been cremated and therefore there was no evidence to present before a jury. This assertion was published after the deaths of both Hannam and Manningham-Buller.[69] This shows a misunderstanding of the principle of corpus delicti, and his assertion that traces of drugs found in exhumed remains were more compelling as proof against Adams[69] was disputed by Devlin, as the exhumations and subsequent post-mortems yielded nothing of interest.[80] and as the pathologist concerned did not consider that the levels found were significant.[112] Cullen also describes Morrell as "the weakest" case of the four the police deemed most suspicious.[83] Devlin, who regarded none of the cases mentioned by Hallworth as being as strong as the Morrell case, despite it being six years old, suggested that, in an investigation covering a ten-year period, the police were unable to find a better case than the Morrell one.[113]

In 1957, it was the job of the police to investigate reported crimes, to determine if one had been committed and arrest a suspect. It was then the job of the Director of Public Prosecutions (DPP), or in very serious cases of the Attorney-General or Solicitor-General, to review the police case and decide whether to prosecute and, in more serious cases, what offences to prosecute. What to prosecute depends on legal issues and Devlin states that, to succeed in the murder case against Adams, the prosecution had to show, firstly, there had been an unnatural death, secondly, an act by Adams was capable of being murderous (such as an injection so large as to cause death) and finally Adams's intent to kill.[114] The Attorney-General thought he had evidence that Adams had prescribed large quantities of opiates to Mrs. Morrell, Adams's own admissions that he had used them all on Mrs. Morrell and injected all or almost all of them himself, and a medical expert's testimony that the only possible reason to inject so much over a short time was to kill her.[115]

Cullen mentions Mrs. Morrell, Mr. and Mrs. Hullett, Clara Neil Miller and Julia Bradnum as cases that Hannam regarded as warranting prosecution.[116] However, in the cases of Mr. Hullett, Clara Neil Miller and Julia Bradnum there was no certainty of an unnatural death, as there was evidence in the committal hearing that Mr. Hullett died of a heart attack[117] and, at their exhumations, the pathologist concluded Miller had died from pneumonia,[118] and the condition of Bradnum's body did not allow a cause of death to be stated, so none of these were good cases.[80] Mrs. Hullett had died an unnatural death, of a barbiturate overdose, but there was no evidence or admission that Adams had persuaded her to take that overdose[119] and, had Mrs. Hullett's case been brought to trial after Adams's first acquittal, Devlin believed that a second acquittal was virtually certain.[120] In these five cases, Adams may have contributed to the deaths in some way, but this would not have been sufficient for a capital murder conviction.[118][121]

The committal hearing opened in Lewes on 14 January 1957.[122] In accordance with the legal rule applying in 1957, Adams was charged on the single count of murdering Mrs. Morrell, but the prosecution also alleged he had killed Mr. and Mrs. Hullett in a similar fashion, and introduced evidence relating to them as evidence of system, which the prosecution also wished to refer to in the Morrell trial.[85] Despite the objections of the defence that this evidence was inadmissible, the magistrates allowed it but, in cross examination, the defence forced an admission from the Crown's expert witness that Mr Hullett died of a coronary thrombosis.[117] The hearing concluded on 24 January when, after a five-minute deliberation, Adams was committed for trial on the Morrell charge.[123]

Melford Stevenson, who led the Crown's case at this hearing, made an explicit claim that Adams's instructions to specially clear Mrs. Hullett's cheque two days before her death showed that he knew she was to die very soon, using her wealth and foreseen death as evidence of critical similarities to the deaths of Mr. Morrell and Mrs. Hullett.[124] He also made an implication, unsupported by evidence, that Adams had been involved in the administration of the drugs that caused her death.[125] Devlin considered the police case that there were similarities in deaths of Mrs. Morrell and Mrs. Hullett was not well founded, as the claimed similarities were not distinctive. Had the police found two recent cases similar to Mrs. Hullett's, where a patient had died of an overdose of pills prescribed by Adams, that might have shown system, but the police found no such cases.[126]

The Chairman of the magistrates was Sir Roland Gwynne, but he stepped down because of his close friendship with Adams.[122] An exhibit that supported Melford Stevenson's evidence, the cheque written out for £1,000, went missing after the hearing, instigating a further police investigation. While the culprit was not found, Scotland Yard suspected the local Deputy Chief Constable of Eastbourne, Seekings, of having misplaced it to help Adams. Seekings was known to have taken holidays with Adams and Gwynne, and looked after Gwynne's finances while he was in hospital in January 1957.[76]

Following the committal hearing, the Attorney-General advised Devlin that he would not be using the evidence regarding the Hullets in the Morrell trial, but seeking a second indictment relating to Mrs. Hullett, which he did on 5 March 1957. Had this been proceeded with, a second committal hearing would have been required.[127] The trial on the indictment relating to Mrs. Morrell started on 18 March 1957 at the Old Bailey, with that relating to Mrs. Hullett held back for a possible second separate trial. Three days later, a new Homicide Act came into effect; a single murder by poison became a non-capital offence. Adams, having been indicted on both charges before this date, would still face the death penalty if convicted. The Home Secretary would be less likely to grant clemency in the case of a second murder conviction in the Hullett case, as this would make it far more difficult politically to sentence Adams to life imprisonment, particularly as a double murder could still be capital under the 1957 Homicide Act, and Devlin considered that the Attorney-General's aim in bringing forward a second indictment was to make it more likely that Adams would hang.[128]

After the not guilty verdict on the count of murdering Morrell, the normal process would have been to bring the indictment regarding Mrs. Hullett to trial—either a full trial or, in view of the acquittal in Mrs. Morrell's case, a speedy one—so that Adams would plead not guilty. After such a plea, the Attorney-General would offer no evidence and the judge would direct the jury to bring in a not guilty verdict, which was the course Devlin expected.[148] However the Attorney-General, as a minister of the Crown, had the power to suspend an indictment through a nolle prosequi, something which Devlin said had never been used to prevent an accused from an acquittal, suggesting this was done because Manningham-Buller did not want a second acquittal and adverse verdicts in both the cases he had indicted.[149] Nolle prosequi could legitimately be used in cases to protect a guilty person granted immunity to turn Queen's evidence or to save the lives of the innocent, or sometimes on compassionate grounds.[150]

Devlin later referred to Manningham-Buller action as "an abuse of process", saying: "The use of nolle prosequi to conceal the deficiencies of the prosecution was an abuse of process, which left an innocent man under the suspicion that there might have been something in the talk of mass murder after all".[35]

Manningham-Buller later told Parliament after the Morrell trial that the publicity which attended the Morrell trial would make it difficult to secure a fair trial on the indictment relating to Mrs. Hullett, and that the second case depended very greatly on inference, which was not supported by admissions, as in Mrs. Morrell's case. This was a reference to Adams's admission that he had himself administered most of Mrs. Morrell's opiate injections, whereas he had only said in his statements to the police that he had handed two barbiturate tablets to Mrs. Hullett each day, and said nothing to link the total of barbiturates supplied to prescriptions he had issued.[35]

Cullen mentions Mrs. Morrell, Mr. and Mrs. Hullett, Clara Neil Miller and Julia Bradnum as cases that Hannam regarded as warranting prosecution.[83] Details about Mrs. Morrell and Mrs. Hullett are given above: the case of Mr. Hullett and the two cases where police suspicions led to exhumations indicate that there was insufficient evidence of the cause of death to warrant a prosecution.[181]

• 11 May 1952 – Julia Bradnum died aged 85. The previous year Adams asked her if her will was in order and offered to accompany her to the bank to check it. On examining it, he pointed out that she had not stated her beneficiaries' addresses and that it should be rewritten. She had wanted to leave her house to her adopted daughter but Adams suggested it would be better to sell the house and then give money to whomever she wanted. This she did. Adams eventually received £661. While Adams attended to this patient, he was often seen holding her hand and chatting to her on one knee.[182]
  • The day before Bradnum died, she had been doing housework and going for walks. The next morning she woke up feeling unwell. Adams was called and saw her. He gave her an injection and stated "It will be over in three minutes". It was. Adams then confirmed "I'm afraid she's gone" and left the room.[182]
  • Bradnum was exhumed on 21 December 1956. Adams had said on the death certificate that Bradnum died of a cerebral haemorrhage, but Francis Camps examined her remains and was unable to find evidence either to prove or disprove this, stating that, because of the advanced degree of decomposition of the corpse, the brain was not in a condition to be assessed. Had the final injection given to Mrs. Bradnum been morphine, heroin or barbiturates, this might have been apparent from the liver, but Camps did not order toxicology tests, considering he could not be sure of the state of the internal organs what comprised the remains of the liver.[183]
• 22 February 1954 – Clara Neil Miller, died aged 87. Adams often locked the door when he saw her – for up to twenty minutes at a time. A witness, Dolly Wallis, asked Clara about this, and she said he was assisting her in "personal matters": pinning on brooches, adjusting her dress. His fat hands were "comforting" to her. Wallis also claimed that Clara appeared to be under the influence of drugs.[184]
  • Early that February, the coldest for many years, Adams had sat with her in her room for forty minutes. A nurse entered, unnoticed, and saw Clara's "bed clothes all off... and over the foot rail of the bed, her night gown up around her chest and the window in the room open top and bottom",[185] while Adams read to her from the Bible. When later confronted by Hannam regarding this, Adams said "The person who told you that doesn't know why I did it".[186]
  • Clara left Adams £1,275, and he charged her estate a further £700 after her death[187] in addition to a £500 cheque he got from her earlier. He was the sole executor.[187] Her funeral was arranged by Adams and only he and Annie Sharpe, the owner of the guest house, were present.[188] Annie Sharpe received £200 in Clara's will.[189] Adams tipped the vicar a guinea after the ceremony.[188] Clara Neil Miller was one of the two bodies exhumed during the police investigation on 21 December 1956. Despite the poor condition of the corpse, Francis Camps found evidence of coronary thrombosis and bronchopneumonia. Small amounts of morphine and barbiturates were also found, but not in sufficient quantities to draw any conclusions.[190] According to prescription records, Adams had not prescribed anything to treat the bronchopneumonia.[118]
• 14 March 1956 – Alfred John Hullett died, aged 71. He was the husband of Gertrude Hullett. Sometime in the 1940s, Adams falsely told Alfred Hullett that he (Hullett) needed an urgent operation; Hullett consulted another doctor and Adams's claim was revealed to be absolutely wrong.[191] Still, Adams remained Hullett's friend. In November 1955, Adams diagnosed Hullett with cancer in his abdomen (the same diagnosis as Annie Sharpe). A doctor called in from London attempted an operation during which "something went wrong". Ten days later, Alfred's "whole abdomen burst"; Adams, and his partner in practice, operated immediately and "repaired the burst" (in Adams's words). Since then, Adams was giving Hullett large doses of morphine. "I am too full of dope to say anything sensible", Hullett said to one of his friends. Hullett started exhibiting heart problems, and in March 1956, a heart specialist opined that Hullett had been suffering from "some type of heart trouble" since childhood, and that the condition was now worsening. The specialist expected that Hullett would die within a few months and might die at any time; on 13 March, he had severe chest pains consistent with a heart attack. He died the next morning of what Adams described as cerebral hemorrhage.[192]
  • Shortly after his death, Adams went to a chemists to get a 10 cc hypodermic morphine solution containing 5 grains in Mr. Hullett's name, and for the prescription to be back-dated to the previous day. The police presumed this was to cover morphine Adams had given him from his own private supplies. Mr. Hullett left Adams £500 in his will.[193] In cross examination during Adams's committal hearing, the defence forced an admission from the Crown's expert witness that Mr. Hullett died of a coronary thrombosis.[117]

Mrs. Annie Sharpe was the proprietor of 'Barton', a boarding house where at least two of Adams's victims, the Neil Miller sisters (Hilda, died 1953; and Clara, died 1954) had lived;[194] Adams had cut both of them off from their relatives and prevented them from receiving their mail.[195] Sharpe herself tried to get the Neil Miller sisters to "invest £5,000 in her business";[194] she admitted only to receiving a £200 cheque from Clara Neil Miller.[196] She and Adams were the only people present during Clara Neil Miller's burial.

After interviewing Sharpe, Hannam considered her a key witness and thought she was the key to the whole matter,[194] suspecting she was money-grabbing and in collusion with Adams.[196]

While the investigation was underway, Sharpe was suddenly "diagnosed" by Adams with cancer in her abdominal cavity and died a few days after this diagnosis, on 13 or 15 November 1956. Her body was cremated.

Opinion regarding Adams has been divided, though in recent years has tended to the view that he was a murderer. The writer Sybille Bedford, present at Adams's trial, was adamant that he was not guilty.[lower-roman 9] Many publications were sued for libel during Adams's lifetime, showing the prevalence of the rumours that surrounded him.

After Adams's death, writers were more free to speculate. In 1983, Rodney Hallworth and Mark Williams concluded Adams was a serial killer and probably schizophrenic:[206] "In the opinion of many experts Adams died an unconvicted mass-murderer".[207] Percy Hoskins, writing in 1984, was of the opposite opinion, adamant that Adams was not guilty but merely "naive" and "avaricious".[67] In 1985, Sir Patrick Devlin, the judge, stated that Adams may have been a "mercenary mercy killer"[208] but, though compassionate, he was at the same time greedy and "prepared to sell death":[202] "He did not think of himself as a murderer but a dispenser of death [...] According to his lights, he had done nothing wrong. There was nothing wrong in a doctor getting a legacy, nor in his bestowing in return [...] a death as happy as heroin could make it."[202] He also "could be convinced that Dr. Adams had helped to end Mrs. Hullett's life".[209] In 2000, Surtees, a former colleague of Adams, wrote a more sympathetic account of him as being the victim of a police vendetta.

In 1986, The Good Doctor Bodkin Adams, a television docudrama based on his trial, was produced with Timothy West in the lead.

These writers, other than Devlin, who read and based his account on the papers from the committal proceedings and the case papers for the Hullett case before it was discontinued, based their opinions almost entirely on the evidence given in court regarding Morrell.[lower-roman 10] The police archives were opened in 2003 at the request of Pamela Cullen,[8] who speculates that Adams was acquitted more due to the way the case "was presented than [to] Doctor Adams' lack of guilt".[210] She also highlights the fact that Hannam's investigation was "blinkered" from the perspective of motive: Hannam assumed monetary gain was the driving force because during the 1950s, little was known of what really motivated serial killers, i.e. "physical needs, emotions and often bizarre interpretations of reality".[211]

The apparently incompatible accounts of Adams as a barely competent doctor lavish in his use of heroin and morphia[212] with his successful and lucrative medical practice may be explained by the medical profession's attitude to end-of-life care in the period. Between the 1930s and 1960s, the medical profession in general regarded a death as a failure and subjected dying patients to treatments aimed at prolonging life rather than relieving suffering, an attitude prevalent in the post-war National Health Service, which failed to make adequate provision for the dying.[213] Increasingly, patients feared suffering before death and, although a few doctors were prepared to advocate the use of opiates in palliative care openly, published medical commentary on care of the dying was rare before the 1960s. However, a 1948 article observed that "purely medical treatment" for the dying could "almost be written in one word—morphine", and a 1957 British Medical Association meeting heard the use of heroin to induce euphoria, oblivion, and relieve pain.[214] Although doctors were aware that hastening a patient's death was illegal, one suggested in 1944 it was something "the law forbids in theory but ignores in practice": he added it was something only the doctor could judge, and it should not be discussed with patients, their families, or medical colleagues.[215]

In Adams's case, the court did not ignore the suggestion that he had hastened death. As Devlin makes clear, he needed to clarify for the jury, and incidentally the medical profession, the extent to which the law allowed the orthodox doctor to go in easing the passing of the dying.[45] Mahar regards Adam's statements to Hannam on Mrs. Morrell as less about his guilt or innocence than a disconnection between the medical and legal views on assisted dying: Adams never denied giving his patients large doses of opiates, but denied it was murder.[216] This was not simply Adams's idiosyncratic view, as appears from the evidence of Dr. Douthwaite for the prosecution, who accepted that a physician might knowingly give fatal doses of pain relieving drugs to terminally ill patients, adding it was not his business to say whether it was murder.[217] Devlin's directions to the jury confirmed that it was a medical issue, not a legal or moral one, whether Adams' treatment was designed to promote comfort.[218] Devlin's view was that Adams may have been guilty of mercy killing or even perhaps finishing off a troublesome patient, but was one who cared for his patients to the best of his ability.[208] Adams eased the passing of Mrs. Morrell, but his greed brought his motives into question.[219] Mahar notes that an editorial in a medical journal following the case suggested that the publicity it caused might hamper medical discretion, but claimed the use of opiates in terminal cases was essential. Adams may be seen as an extreme case in their use, but other doctors also used them to ease the passing.[220]

It was 25 years before another doctor in Britain, Leonard Arthur, stood trial for murder arising from treatment. Arthur was tried in November 1981 at Leicester Crown Court for the attempted murder of John Pearson, a newborn child with Down syndrome. Like Adams, on the advice of his legal team he did not give evidence in his defence, relying instead on expert witnesses. He was acquitted.[225]

More recently, the double effect principle figured in two British murder trials. In 1990, Dr. Nigel Leigh Cox, a rheumatologist, was convicted of the attempted murder of a terminally ill patient who had begged him to kill her. Once pain killers had proved ineffective, he injected her with twice the lethal dose of potassium chloride and she died within minutes. Cox's claim that his intention was to relieve suffering was not accepted, as potassium chloride had no analgesic properties.[226] In the same year, Dr. Thomas Lodwig gave a terminal cancer patient an injection of lignocaine and potassium chloride which proved rapidly fatal. However, as lignocaine is a pain-killer, his claim that potassium chloride could accelerate the analgesic effect of recognised pain killers was not disputed by the prosecution. Although Dr. Lodwig was charged with murder, the prosecution offered no evidence at his trial.[227]

In 2000, Harold Shipman became the only British doctor to be successfully prosecuted for the murder of his patients.[27] He was found guilty on 15 counts and the Shipman Inquiry concluded in 2002 that he had probably murdered a further 200.