West pleaded guilty to third-degree murder and other charges, admitting that on Nov. 19, 2009, she administered some of the Demerol overdose that killed Karnamaya Mongar, 41, during an abortion at Gosnell's Women's Medical Society clinic.
West also admitted that after accompanying the comatose Mongar and her family to a hospital emergency room, she lied about what happened and destroyed or altered Mongar's medical records.
On Thursday, however, West maintained she "treated patients like family" during her 18 months at the clinic and "didn't mean to do anything wrong."
Lerner told West she was in denial: "I think at some point you'll come to be more honest in terms of what your role was here. And I think that you're not there yet."
After pleading guilty and agreeing to testify against Gosnell, West did an about-face. Under questioning by defense lawyer Jack McMahon at trial last April, West said she did not want to plead guilty and did not believe she did anything wrong.
West's attorney, Michael Wallace, told Lerner her involvement with Gosnell stemmed from her "special relationship" with the 72-year-old physician. Gosnell was her personal doctor for more than 20 years and hired her under the table after she lost her job as a surgical technician at the VA hospital in West Philadelphia.
"It was an extremely bad time for her," said Wallace, who said West's personal problems made her vulnerable to Gosnell's "Svengali influence."
Gosnell is serving three consecutive life terms after being convicted of murder for killing babies born alive and viable during illegal late-term abortions.
West was one of nine Gosnell workers charged in connection with the operation of his Women's Medical Society Clinic at 3801 Lancaster Ave. All pleaded guilty and two await sentencing.
Assistant District Attorney Joanne Pescatore asked for the five- to 10-year prison term, citing West's testimony at Gosnell's trial and her role in the death of Mongar, a Bhutanese refugee and mother of three who had just immigrated to the United States four months earlier and was living in Virginia.
Lerner, however, cited West's 22 years as a surgical technician.
"You had experience in a real hospital. You had reason to understand that this was not a medical facility," Lerner said of Gosnell's clinic.
"As evil as Kermit Gosnell is, as charismatic as he may have been . . . he could not have accomplished all he accomplished alone," Lerner added. "He needed the help of other people."
West will get credit for three years she has been in prison since Gosnell's clinic was raided in a federal-state drug sting. Her sentence will be concurrent with a four-year federal prison term on her guilty plea to helping Gosnell operate a "pill mill" out of the clinic.