"[1] The trial also established the legal doctrine of double effect, where a doctor giving treatment with the aim of relieving pain may, as an unintentional result, shorten life.
The Eastbourne police had received an anonymous call, later discovered to be from the music hall performer Leslie Henson who had been working in Dublin at the time,[8] about the unexpected death of his friend Gertrude Hullett on 23 July 1956, while being treated by Adams.
The inquest concluded that Mrs Hullett had committed suicide, but the coroner questioned Adams' treatment and said in his summing up that it was "extraordinary that the doctor, knowing the past history of the patient" did not "at once suspect barbiturate poisoning".
[15] Two features of Adams' way of practicing medicine had attracted attention among doctors, nurses and others in Eastbourne: his lavish use of the opiate drugs, heroin and morphia, and his asking wealthy patients for legacies.
[18] Hannam's team investigated the wills of 132 of Adams' former patients dating between 1946 and 1956 where he had benefited from a legacy, and prepared a short list with around a dozen names for submission to the prosecuting authorities.
Adams' first statement, that he had administered almost all the dangerous opiate drugs he prescribed for Mrs Morrell himself and that virtually none were left unused at her death, was critical to the prosecution's case on method, but was later contradicted by other evidence.
Cullen, whose account is based on the Scotland Yard case files, stated that Adams was already her doctor, that he arrived in Cheshire on 26 June, and on the following day prescribed morphia for the pain.
[32] Adams, she claimed, also made special arrangements to take Mrs Morrell back to Eastbourne and gradually increased the dose of morphia and added heroin until she was addicted.
[50] The prosecution's opening statement claimed that, at some time not more than two weeks before her death, the amount of opiates given to Mrs Morrell dramatically increased with the intent of ending her life.
[54] However, on the second day of the trial, the defence produced nurses' notebooks, which showed that smaller quantities of drugs were given to the patient than the prosecution, basing its calculations on Adams' prescriptions, had thought.
[55] The notebooks also stated that Mrs Morrell was conscious until shortly before her death, and the two injections made the night of 12 to 13 November 1950 were recorded as being of paraldehyde, described as a safe soporific.
[56] The leading Defence counsel Sir Frederick Geoffrey Lawrence, QC asked for a list of all prescriptions for the whole period in which Adams had cared for Mrs Morrell, not just of the dangerous drugs for ten and a half months in 1950 presented by the prosecution.
[63] Dr Douthwaite also admitted in cross-examination that his evidence at the committal hearing was given without knowledge of her treatment in Neston, was based on the medication Mrs Morrell had received from January 1950 only, and on the incorrect assumption that she had been in a coma for the last three or four days of her life.
[50] The Attorney-General continued to focus on 8 November 1950 as the critical date and on Adams' unguarded admissions that he had used almost all the drugs he had prescribed as showing the nurses' records were incomplete.
[68] The prosecution claimed that Adams killed Mrs Morrell because he feared she would alter her will to his disadvantage, although the only firm, non-contingent legacy he was ever awarded was a chest of silver cutlery worth £276.
[69] Adams believed that he had been promised Mrs Morrell's Rolls-Royce and possibly other items, and the prosecution continued to claim that this belief, rather than the actual contents of the wills, was proof of his motive.
[70] Mrs Morrell left a gross estate of £157,000 and made eight cash bequests of between £300 and £1,000 to her household, all greater in value than the silver cutlery that Adams eventually received, and six charitable donations of £100 to £1,000.
[73] Devlin's summing up involved one legal direction which established the double effect principle, that where restoring a patient to health is no longer possible, a doctor may lawfully give treatment with the aim of relieving pain and suffering which, as an unintentional result, shortens life.
[77] Lawrence and Dr Harman had stated that Mrs Morrell had died as natural a death as was possible, eased by necessary drugs,[78] although Adams' instruction to the nurses to give sufficient medication to "keep her under" might suggest some hastening of that event.
[79] The court did not ignore the suggestion that Adams had hastened Mrs Morrell's death, and Devlin clarified for the jury and medical profession how far the law allowed the orthodox doctor to go in easing the passing of the dying.
[81] Although Adams' use of opiates was extreme, other doctors also used them to ease the passing of the dying, and Dr. Douthwaite for the prosecution accepted that a physician might knowingly give fatal doses of pain-relieving drugs to a terminally ill patient, adding it was not his business to say whether it was murder.
[97] At an early stage in the investigation, Hannam believed he had found Adams' modus operandi: that he first made his victims drug addicts, then influenced them to change their wills in his favour and finally gave them a lethal dose of opiates.
After Drs Camps and Douthwaite had assured the Attorney General and the two other lawyers present that the amounts of opiates prescribed for Mrs Morrell were fatal beyond doubt, Manningham-Buller instructed the police to arrest Adams.
[110] Dr Douthwaite apparently accepted Hannam's theory, as he stated in evidence-in-chief, that morphia and heroine would have turned Mrs Morrell into an addict and given Adams complete ascendancy over her, and any anger she had shown was a withdrawal symptom, not a sign of independence.
[21] Robins, who consulted the same police files in the National Archives as Cullen did, as well as material not seen by Cullen, reports that the decision was made when all the prosecution team and police were present, and only after Dr Camps, a pathologist, and Dr Douthwaite, a recognised authority on opiates,[114] had assured the Attorney General and two other lawyers present that the amounts of opiates prescribed for Mrs Morrell would undoubtedly have been fatal.
[115] Dr Douthwaite also initially endorsed Hannam's theory that morphia and heroin would have turned Mrs Morrell into an addict and given Adams complete ascendancy over her.
[119] This caused the prosecution embarrassment when the nurses' notebooks were produced, over the destruction of the case based on prescriptions[120] and when Dr Douthwaite's change of opinion while in the witness box.
Manningham-Buller complained in a parliamentary debate soon after the verdict that Devlin had wrongly rejected his submission that Adams' admission that he had used virtually all the prescriptions supplied should have been accepted, believing that the acquittal was due to judicial misdirection.
[132] Melford Stevenson was reported by Hallworth to have criticised the right to silence in the 1980s as having enabled Adams to escape punishment, saying "I firmly believe justice is not served by the present law.
[147] In line with Devlin's legal direction on the double effect principle, as Mrs Morrell was dying, restoring her to health was no longer possible, so Adams could lawfully give her treatment to relieve pain and suffering even if that shortened her life.