Thursday, May 04, 2006

MILOSEVIC MURDER: AN IATROGENIC JUDICIAL ASSASSINATION--Open Letter to Madame Del Ponte, ICTY Prosecutor, and the Doctors assigned by ICTY

[Here is the English language version of the open letter to Carla Del Ponte and the iatrogenocidaires on staff at the ICTY/Scheveningen UN death camp. Jacques Vergès is right up there with my all-time favorite shysters: Sam Liebowitz, KO Hallinan, Clarence Darrow--I was going to say he's my own personal Johnny Cochran, but the Junk Yard Dog ain't what he used to be--and not just because he's dead, either. Maitre Vergès and his croaker sidekick (whom I don't know) lay out a murder mystery worthy of Hercule Poirot, the original Holmes-boy, or Jimbo Rockford. In fact, doing this translation made me feel like I was working on a Quincy rewrite--or, for the young 'uns out there, a CSI-Miami script. Only problem here is, it's obvious from the jump who done it. They've been doing it and will probably keep doing it until a lot of coats get pulled as to just how deadly shitty it is to live in a false world, with a consciousness founded almost entirely on lies and house music. But I'll shuddup here. Dig it. --mc]


Open Letter to Madame Del Ponte, ICTY prosecutor, and to the Doctors assigned by The Hague Tribunal

Maître Jacques Vergès and Docteur Patrick Barriot

Doctors possess the art of treating and relieving the suffering of their patients by the use of medicines, and their effectiveness never stops growing. Unfortunately, this power is sometimes used to silence those prisoners who won’t be broken.

The Case of Prisoner IT.02.54.T

Slobodan Milosevic suffered from severe and unstable high blood pressure (malignant hyper-tension with systolic readings frequently at 220 and 230), aggravated by the conditions of his detention. This high blood pressure had grave repercussions, both with his heart and his brain: left ventricular hypertrophy, troubles with repolarization of the precordial flow evident on EKGs suggest obstruction, arterial sclerosis of vessels in the neck (particularly the right carotid) and of intracranial blood vessels. This malignant hypertension required a heavy treatment consisting of: a beta-blocker (metoprolo: 200 mg), a calcic inhibitor (amlodipine: 20 mg), a conversion enzyme inhibitor (enalapril: 40 mg) and a diuretic (hydrochlorothiazide: 50 mg).

Throughout the last half of 2005 Slobodan Milosevic also experienced symptoms of an inner ear disorder (located in the cochlear vestibule, the membranous labyrinth of the inner ear), specifically an impairment of his hearing that became progressively disabling: a buzzing or ringing in his ears, diminished acuity approaching deafness especially in his right ear, pain in his right ear that was aggravated by having to wear headphones, dizziness. All these signs point to an attack on the inner ear originating from the intracranial blood vessels.


A vascular pathology aggravated by stress

The conditions of Slobodan Milosevic’s imprisonment played an important role in the aggravation of his vascular illness, particularly the stress connected with his isolation from his family. Since his abduction and imprisonment at The Hague nearly five year ago, Slobodan Milosevic was not authorized to receive visits from members of his family. A few months ago, Slobodan Milosevic wrote (in French) to Javier Solana, Secretary General of the Council of the European Union (EU) and High Representative to the EU for Foreign Affairs and Security. He wrote the following:

“Mr. Solana, You know very well that I was the leader of Yugoslavia
and its armed forces at the moment you launched air strikes against
my country, and you also know that at present I find myself in your
prison at Scheveningen. The fundamental difference between myself
and the other detainees around me is not just that I am the only head
of state imprisoned here, but also that I am the sole person here who
is deprived of any possibility of seeing his family. I describe my
situation to you because I am not sure you have been informed of
the conditions of my detention, and I cannot imagine that a respectable
man would be responsible for allowing such villainy. Reprisals against
an enemy’s wife and children are not the gestures of an honorable man.
In light of the high office you held and continue to hold today, I have
no doubt that you will take all necessary measures to enable my family
to travel freely to the Netherlands in order to visit me.
Slobodan Milosevic.”

Obviously, these necessary measures were never taken.

The stress of organizing his defense was another factor deleterious to Slobodan Milosevic’s health in the opinion of the Dutch cardiologist appointed by the ICTY, a doctor who, as we will see, was not susceptible to the slightest compassion for his patient, ‘The Accused’. In a letter dated 23 November 2005, Dr. P. Van Dijkman (staff cardiologist at Bronovo Hospital) wrote to Dr. P. Falke (the doctor at the detention centre):

“In light of his work schedule, it is normal that the patient should
feel fatigued. He takes part in three session per week and spends the
rest of his time in preparation, in interrogating, among others, his
witnesses. That does not leave much time for him to rest. It is most
likely that his blood pressure will continue to elevate in the course
of these stressful court sessions.”(1).


The medical expertise of 4 November 2005

Three independent specialists examined Slobodan Milosevic, on his request, the 4th of November, 2005: Dr. M. Shumilina, angiologist, a specialist in cerebral (venous) circulation at the Institute for cardio-vascular surgery at the Bakulev clinic in Moscow; Professor V. Andric, ear/nose/throat specialist (ENT staff at the VMA hospital in Belgrade); and Professor F. Leclercq, chief of the cardiology staff at the Arnaud de Villeneuve hospital (CHU de Montpellier).

Professor F. Leclercq confirmed suspicious signs on the EKG and prescribed further examinations (coronary CAT scan, myocardial scintigraphy) to better evaluate the coronary circulation (2). Soon after the announcement of the death of Slobodan Milosevic, Professor Leclercq sent us a message specifying:

“I am sad that the examinations we asked for were not done.”

Beyond that, the Professor had insisted on the necessity for an effective period of rest:

“It is inarguable that stress is playing a great part in the
irregularities in blood pressure and that a period of rest must
be ordered.”

Dr. M. Shumilina and Professor V. Andric concurred on the vascular origins of the disabling inner-ear condition (3, 4). In view of the examinations conducted, especially the magnetic resonance imaging (MRI), Dr. Shumilina submitted as evidence vascular anomalies on several levels: the brachiocephalic trunk (innominate artery), the inside right carotid artery, the right vertebral artery, the coronary arteries. According to Dr. Shumilina, there also existed certain anomalies in the cerebral venous circulation linked to an inadequate treatment of the vascular illness from which Slobodan Milosevic suffered. Dr Shumilina and Professor Andric also prescribed additional examinations (ultra sound imaging of the blood vessels in the neck, cerebral arteriography).

The critical point of this independent expertise is that the three specialists established a connection between the symptoms of the inner-ear disorder (especially the dulled auditory perception) and the extremely high blood pressure. But this connection was vigorously denied by the Dutch doctors assigned by the ICTY, with the singular exception of Dr. J. De Laat (Leiden University Medical Centre) who wrote on 28 November 2005 to Dr. P. Falke:

“It is probable that his cardiovascular condition plays a role in
the patient’s auditory difficulties” (5).

But his opinion was ignored.

The conclusion of the independent doctors’ report was without ambiguity:

“After considering the results of the medical examinations
indicated in the patient’s file and carried out at the time of our
visit on 4 November 2005, we can conclude that the state of the
patient’s health is not stable and that complications are possible.
His condition demands follow-up examinations in order to find the
precise origins of his current problems. It is necessary that the patient
be given a period of rest, that is to say, a cessation of all his physical
activities and all of his intellectual effort for at least 6 weeks.”(6).

The report of the experts group thus brought up certain unresolved problems, at once diagnostic and therapeutic. It also emphasized the gravity and urgency of the situation. The report also cited that the patient should be given a provisional release toward a period of hospitalization at the Bakulev Institute in Moscow, the Russian government having offered all guarantees of security for the return of Slobodan Milosevic to The Hague after treatment had been carried out. The Bakulev Institute has the technical capability to offer both the diagnostics (coronography, cerebral arteriography) and therapeutics (coronary dilation, arterial by-pass) necessary, as well as top specialist under the direction of Professor L. Bockeria. Professor Bockeria determined that Slobodan Milosevic was in ‘critical condition’ and predicted a ‘cardio-vascular catastrophe’. (7).


Disagreement and controversy

The conclusions of the independent experts group were contested by the Dutch doctors assigned by the prison authority and became the object of a double controversy. The first controversy pitted Professor F. Leclercq against Dr. P. Van Dijkman. In a report addressed to Hans Holthuis, registrar of the ICTY, dated 14 November 2005, Dr. P. Falke stated:

“Contrary to the conclusion of the examining doctors (V. Andric,
F. Leclercq and M. Shumilina), the treating physician (P. Van
Dijkman) concluded that there was little probability that the
vascular anomalies had a connection with the symptoms presented.
The treating physician determined that a period of rest would not
have any positive effect on these symptoms.” (8, 9).

This opinion is confirmed a few days later in a letter from Dr. Van Dijkman, dated 18 November 2005 and addressed to Dr. Falke. Here is what Dr. Van Dijkman thought of the prescriptions of Professor Leclercq (additional examinations and rest):

“This last point seems to me a little excessive in view of the
examinations already carried out (. . .). As of now, I don’t
see any argument for changing the procedure and, from my
point of view, there is no justification on a cardiological basis
for changing the way the trial is being conducted.” (10).

This position is reaffirmed several days later in another letter, dated 1 December 2005, and again addressed by Dr. Van Dijkman to Dr. Falke:

“In my letter of 18 November 2005, I indicated that I did not
see any reason to change treatment and, from the point of
view of cardiology, there was also no reason to change the way
the trial was being conducted (. . .). The three foreign doctors
who examined Mr. Milosevic recommend a 6 week period of
rest be granted him immediately. This seems to me to be
a totally arbitrary period of time for which, in my opinion, no
justification has been presented.”(11).

As we can see, Dr. Van Dijkman peremptorily contradicts the opinion of a professor of cardiology. At the same time he contests the prescription of additional examinations for the purpose of a more precise diagnosis and the granting of a period of rest during which to effect therapy. Nonetheless he declares himself incompetent to judge the pathologies of the inner-ear and has nothing to say about Dr. Shumilina’s opinions on the cardio-vascular problems. He would have had to have taken into account the opinions of his colleagues or have asked the opinion of an internist. Too sure of himself, he seems more comfortable with diminishing the convalescence of a sick man than with achieving an accurate diagnosis. It is important to note here that even in the opinion of Professor J.H. Kingma (former Inspector General of the Dutch Ministry of Health), Dr. Van Dijkman would have had to consider the opinion of another specialist:

“Professor Kingma believes that the opinion of an additional
specialist must have been required to advise Dr. Dijkman in the
treatment of The Accused. A specialist in internal medicine
would probably have been good counsel at this stage because
The Accused suffered from arterial hypertension, a condition that
effects all the organs of the body and not just the heart. Professor
Kingma offered to speak to Dr. Van Dijkman about the possibility
of seeking an additional opinion.” (12, 13).

The second controversy set Dr. Shumilina against Dr. N. Aarts (a Dutch neurologist) over the link between the observed symptoms of the inner-ear disorder and the patient’s mis-treated high blood pressure. For Dr. Shumilina and Professor Andric, the vascular origins of the ear problems were beyond any doubt and that contradicted the interpretations of the Dutch doctors. (14). A document from the ICTY dated 14 December 2005 specifies most unambiguously:

“Dr. N. Aarts, specialist appointed by The Tribunal, believes that
Mr. Milosevic demonstrates no pathology necessitating treatment.” (15)

Only Dr. J. De Laat, as we said, confirmed the connection between the vascular illness and the signs of an inner-ear disorder, but his opinion was not considered.

The assurance, let’s call it arrogance, with which Dr Van Dijkman contested the opinion of Professor Leclercq and the arrogance with which Dr. Aarts contested the opinion of Dr. Shumilina and Professor Andric are suspicious. These ‘experts appointed by the ICTY’ did not allow for the slightest doubt in their diagnoses, nor did they adhere to any professional code of ethics, be it with regard to a sick man, whose health they had been charged to preserve, protect and defend, or with regard to their fellow medical professionals, whose opinions should have been considered in light of their great experience and competence. In fact, these doctors were much more influenced by the arguments of the Prosecution than by those of their colleagues. Let’s take note again that when the one doctor appointed by The Tribunal declared himself incompetent and handed off the patient’s file to another physician, that second doctor’s opinion went along with that of the independent experts. The opinion of Dr. J. De Laat was solicited by Dr H. Spoelstra (ENL service of Bronovo Hospital) in a letter dated 21 November 2005 because the latter, appointed by the ICTY, believed that certain problems afflicting Slobodan Milosevic were outside his area of competence and he wanted the opinion of a third person. (16)


Unfounded accusations concerning the non-observation of treatment

In July and August 2004, Dr. Van Dijkman and Professor R. Tavernier addressed reports to the ICTY expressing their doubts that The Accused was actually taking his medicine.(17) It is important to note that immediately after this medical accusation was made, several confidential memoranda were issued by the authorities at the detention center: memorandum of 31 August 2004, signed T. McFadden, director of the Detention Center; memorandum of 14 October 2004, signed T. McFadden; memorandum of 26 October 2004, signed J. Hocking, vice-registrar of the ICTY (18, 19, 20). These memoranda supported the doctors’ theses and suggested certain retaliatory measures that would keep Slobodan Milosevic from mounting his own defense (21) and eliminate certain facilities that had been accorded him in order to prepare his witnesses.
At the end of 2005 and the beginning of 2006, a new series of memoranda was forthcoming from the authorities at the detention center aimed once again at curtailing the rights of the defense: memorandum of 7 March 2005, signed J. Hocking; memorandum of 6 December and 19 December 2005, signed T. McFadden; memorandum of 20 December 2005, signed H. Holthuis; memorandum of 6 January 2006, signed P. Falke; memorandum of 1 February 2006, signed F. Gilmour, assistant director of the detention center; memorandum of 13 February 2006, signed F. Gilmour (22, 23, 24, 25, 26, 27). All these memoranda again accused Slobodan Milosevic of willfully trying to aggravate his health by refusing to take the medicines prescribed by Dr. P. Van Dijkman and by taking other, non-prescribed medications. These memoranda cite as support certain medical reports stating that the levels of prescribed medications in the patient’s blood are abnormally low. As a gesture of good faith, Slobodan Milosevic offered to submit to additional blood tests, under strict medical supervision, in order to better administer the prescribed medication and to search out the non-prescribed medication. The most important blood tests were conducted on 12 January 2006 (28, 29, 30). The report issued 24 January 2006 by Dr. D. Uges and Dr. D. Touw (pharmo-toxicologists, experts in forensic medicine) concluded that

“there is solid data in the results of these pharmacological tests to support that
‘The Accused’ is not taking, or is irregularly taking, his prescribed medication, and
that it seems evident that this could be the cause of his persistent arterial hypertension.”

This report, once again, cites the abnormally low levels of the prescribed medicines in the patient’s blood, even though this medication had been administered under strict medical control and within the framework of widely recognized blood tests, and even at the demand of Slobodan Milosevic. It should be noted as well that the toxicologists limited their investigation to two medications, metoprolol and amlodipine, and that they didn’t think it useful to measure the levels of enelapril (especially essential to the treatment) or hydrochlorothiazide. The reports clearly stipulates:

“We decided not to check for enalapril or hydrochlorothiazide.”

Furthermore, the sensitivity of the test-methods used is subject of some concern, and the separate laboratories of Drs. Uges and Touw do not use the same procedures. Dr. Touw seems to have used a less sensitive method of detection by UV chromatography rather than the more sensitive chromatographic separation in a liquid phase. But the interpretation of the results differs as a function of the sensitivity of the methods of measurement, a hemodynamic activity being observable from upward of 6 micrograms per liter for amlodipine and from 20 micrograms per liter for metoprolol.

A major point must be highlighted about the blood tested on 12 January 2006: at no time was there any mention made by the laboratory in its results of the discovery of rifampicine. On the contrary, this antibiotic, known for a tendency to trigger enzymatic induction, is mentioned in the discussion of just how to explain the abnormally low levels of metoprolol and amlodipine. A reduced blood level of certain medications can result from, among other causes, poor digestive absorption, various medicinal interactions, an enzymatic induction mechanism, or a rapid metabolism due to genetic duplication (CYP2D6, CYP3A4). The report states:

“In measurements where amlodipine is a substratum of
the enzyme CYP3A4, the concentration of amlodipine could
be reduced by an enzymatic induction caused by the taking
of rifampicine,”

and further on:

“At this stage, we can not furnish a satisfactory explanation for
the low levels of metoprolol and amlodipine.”

In other words, at the time the results of the January 2006 blood tests were issued, the expert toxicologists knew nothing for certain, but only had some suppositions. They suggest the possibility of an enzymatic induction, and they cite as an example of a good enzymatic inductor: rifampicine. But at no time do they indicate the presence of rifampicine in any of the blood samples. Curiously, two month later, they announced having discovered an elevated level of rifampicine in the samples from 12 January, specifically 0.8 mg/liter of rifampicine and 1.1 mg/liter of desacetyl-rifampicine, which, according to them, corresponds to the absorption of a therapeutic dosage (about 10mg/kg/day or about 2 capsules of 300 mg in a single dose for an adult). But this result, which appeared in a letter from Dr. Touw to Dr. Falke, dated 23 February 2006 (31), then in a letter from Dr. Falke to ICTY registrar Holthuis, dated 3 March 2006 (32), was not communicated to Slobodan Milosevic until 7 March 2006.

Slobodan Milosevic never took rifampicine in an attempt to aggravate his health, and he hadn’t taken any other kind of antibiotic during his nearly five years of imprisonment. We should remember that the cardio-vascular illness from which Slobodan Milosevic suffered was neither an absolute nor even a relative counter-indication to the taking of this antibiotic, effective against numerous bacterial infections, and not only against tuberculosis or leprosy. Rifampicine, in cases of repeated use, is only capable of diminishing (and not nullifying) the efficacy of certain medicines by means of enzymatic induction. Many questions naturally spring to mind about the methods of these ‘expert toxicologists’: How was it that the presence of rifampicine was not detected in the other different blood samples? How could we verify that the occasional use of rifampicine would cancel the effects of a powerful therapeutic regime (diuretic, anti-oxidant, beta-blocker, enzyme conversion inhibitor)? Why wasn’t a liver scan ordered to determine if there had been an increase in hepatic enzymes? Why were levels of enalapril and hydrochlorothiazide not measured? Why was the presence of the metabolites of the medications not looked for? Why were these tests not run with a more sensitive method like liquid phase chromatography? Why wait till 7 March to inform the patient of the results of his blood test conducted on 12 January? Why was the computer printout indicating the discovery of rifampicine never produced by Dr. D. Uges? One is struck dumb by such thoughlessness, such inconsistency and such incompetence.

If Slobodan Milosevic had wanted to counteract the effects of his medication, it would have been easier just not to take the medicines than to take the drugs he’d been prescribed while at the same time taking a non-prescribed drug (rifampicine), which is difficult to get, would be readily discovered during shake downs of his cell (it comes as an easily recognizable red pill), colors the urine and can be easily detected in blood tests. Let’s also remember, contrary to what has appeared in the media, Slobodan Milosevic could receive neither medicines nor alcohol from the outside. Medication was taken with a glass of water in the presence of a nurse. His cell was regularly searched when he was not there, which is illegal. As to the presence of nordiazepam, a metabolic agent used in many benzodiazepines and detected in some of the blood samples, it was too low to have had any pharmacodynamic effects. These effects would have been, in any case, rather ameliorative to the hypertension. And these traces of nordiazepam correspond to the old prescription for diazepam written by Dr. Falke.

The ICTY Order of 26 January 2006, which refers to the memorandum from H. Holthuis of 20 December 2005, restates the accusations of 2004:

“The Accused willfully manipulated the course of the trial
and willfully manipulated the condition of his own health by
not taking the medications that had been prescribed to him
and taking other medications that had not been prescribed to
him by doctors appointed by The Tribunal. The Accused was
found in possession of potentially lethal quantities of non-prescribed
drugs on two occasions in 2004 (during an inspection of his office
in August and again in the inspection of his cell during the week of
29 November). The medical reports issued after the August discovery
made mention of traces of non-prescribed medicines in the blood of
The Accused.” (33)

The regular treatment of Slobodan Milosevic included the anti-hypertension medicines we have cited, a medicine treating heightened cholesterol levels (simvastatine: 40 mg), small quantities of aspirin (ascal: 300 mg), an antihistamine (cinnarazine: 25 mg), and occasionally diazepam and diclofenac. What then were these ‘potentially lethal’ medications found in Slobodan Milosevic’s office and cell? In the Summer of 2004, guards from the detention center found in his office an envelope marked ‘Misha’ containing some benzodiazepines (midazolam and prazepam). This was an envelope belonging to one of his lawyers, Dragoslav Ogjanovic, which had been forgotten in Slobodan Milosevic’s office. Whatever the circumstances, these medications were inoffensive unto beneficial to his condition. On 1 February 2006, 21 pills of an anti-hypertension medicine, Prilazid Plus (a compound of cilazapril and hydrochlorothiazide), were discovered in Slobodan Milosevic’s cell. This discovery became the object of a new memorandum dated 2 February 2006 and signed by J. Hocking (34). In fact, these pills, found with a note written in Cyrillic, had been expired since March 2003. These were the pills that Slobodan Milosevic had in his pocket when he was abducted from Belgrade in June 2001, and that had been confiscated at the time of his processing into the detention center. Curiously these pills reappeared during the 1 February 2006 search just in time to support the thesis that Slobodan Milosevic was trying to manipulate his own health. Once again, these were drugs the effects of which could only have been beneficial to a patient suffering from arterial hypertension.

The forensic report of Dr. W. Zwart Voorspuij, dated 11 March 2006, concerns the discovery of the body of Slobodan Milosevic in cell E04 of the detention center. Before even describing the discovery of the body, Dr. Voorspuij declares in his report:

There were indications of failure to adhere to treatment and the
taking of non-prescribed medications. The results of a blood
test administered in January 2006 revealed the presence of rifampicine
(at therapeutic levels) and diazepam. What’s more, he was taking
a medication which is not available in The Netherlands (Vascase
Plus, similar to Co-Renitic). The rifampicine could have triggered
an enzymatic induction leading to an increased metabolism of the
other medicines. Certain prescribed medications were not found
in the blood or were found at abnormally low levels.” (35).

It is astonishing that a doctor charged with noting the death of a prisoner he knew not at all should lead off his report with unfounded accusations suggested by the ICTY. At this stage of the investigation, his role is limited to noting the facts and only the facts. Dr. Voorspuij indicates that Slobodan Milosevic was taking a medication, Vascase Plus, not available in The Netherlands. But Vascase Plus (a compound of a conversion enzyme inhibitor, cilazapril, and a diuretic, hydrochlorothiazide) appears on the prescription sheets, particularly those from July and August 2002 (36). How could a drug, supposedly not available in The Netherlands, have been prescribed in the detention center? Did Dr. Voorspuij commit an error in mentioning Vascase Plus? Did he mean to say Prilazid Plus, mentioned earlier, which is also a compound of cilazapril and hydrochlorothiazide? This kind of confusion is serious in a coroner’s report. In any case, this was a medication that was being prescribed to Slobodan Milosevic before his abduction in Belgrade as well as in the detention center at Scheveningen. Finally, it should be noted that no trace of any conversion enzyme inhibitor (be it Vascase, Prilazid or Renitec) was found by these ‘expert toxicologists’.


Journalists and Doctors ‘embedded’ by the ICTY

The unfounded accusations made against Slobodan Milosevic by these doctors allowed the Prosecutor’s office to curtail his rights to defend himself. As usual, the positions of the Prosecutor were repeated and broadcast far and wide in the media, especially the French media. Here are a few examples:

The 16 March 2006 issue of the weekly Le Point speaks
of “the medicinal mélanges in which the prisoner indulged,
hoping to reduce the effectiveness of the treatment being
administer to him,” and goes so far as to say that “it was the
ingestion of these chemicals that snared the Serbian dictator
in his own trap.”

Jacques Amalric writes in the 16 March 2006 Libération:
“Milosevic was able to obtain counter-indicated medications
with an eye toward so altering the condition of his health
as to give greater merit to his request for provisional release
to seek care in Moscow.”

The same thesis is developed by Stephanie Maupas who, in the
pages of the 19-20 March 2006 Le Monde, suggests that
Slobodan Milosevic took non-prescribed medications in order
to make his ‘escape’ to Russia. Stephanie Maupas cites
“traces of rifampicine, a drug against tuberculosis, which
nullifies the effects of the treatment prescribed for his
cardiovascular problems.”


Suspicions of poisoning.

Slobodan Milosevic, whose health was in steady and unrelenting deterioration from the beginning of 2006, seemed convinced that the Tribunal was poisoning him. 11 November 2005, Dr. P. Falke noted that Slobodan Milosevic was in a state of exhaustion and declared that he was incapable of attending his trial (37). 21 November 2005, this same Dr. Falke alerted H. Holthius that Slobodan Milosevic had suffered a spike in his blood pressure, that his “arterial pressure was beyond acceptable parameters” and that he could not attend his trial (38). The effects on his hearing had become incapacitating. Slobodan Milosevic’s suspicions that he was being poisoned were based largely on the fact that he was not informed of the discovery of rifampicine in his 12 January blood test until two months later on 7 March 2006. And he knew very well that he had never knowingly or willingly taken any of this drug.

It seems improbable that the ICTY would want to aggravate his health by administering rifampicine to curb the effectiveness of his treatment for hypertension. In effect, the rifampicine would have had to have been administered regularly and with the patient’s knowledge. There are other enzymatic inductors which are easier to handle, and there are certainly drugs more effective and harder to detect that could be used to aggravate the cardiovascular health of a patient. Finally it is difficult to understand why the ICTY would order blood tests to search for non-prescribed drugs (particularly the test of 12 January 2006), knowing that the rifampicine would certainly be discovered. On the other hand, the Tribunal had a strong interest in the ‘discovery’ of rifampicine to support its theory that Slobodan Milosevic was not adhering to, but, in fact, manipulating his treatment. To the ICTY, since Slobodan Milosevic was willfully aggravating his own health, he did not deserve the slightest considerations of leniency, and it became more legally reasonable to curtail his rights to defend himself.

Thus on 24 February 2006, the Tribunal rejected the demand for hospitalization that would have allowed Slobodan Milosevic to be properly treated in Moscow. Slobodan Milosevic addressed a final appeal, in the form of a hand-written letter dated 8 March to the Russian Foreign Minister, for an emergency hospitalization in the Bakulev Institute of Cardio-Vascular Surgery in Moscow. He died three days later, Saturday 11 March 2006, in cell E04. His death at the Scheveningen prison followed those of Slavko Dokmanovic, Milan Kovacevic and Milan Babic. The autopsy performed by the Dutch Institute of Forensics determined that Slobodan Milosevic died from a myocardial infarction (a heart attack) and that he had no traces of toxic medicines in his blood. Clearly the death of Slobodan Milosevic could never have been assigned to the normal and predictable evolution of his cardio-vascular pathology if this condition had been properly treated. It was therefore a case of ‘judicial assassination’ brought about by the inhuman conditions of his detention and the artless and inappropriate medical care ‘agreed to’ by doctors carrying out the orders of the prison authorities.


Suicide eliminated as reasonable possibility

Contrary to some impetuously advanced theories, Slobodan Milosevic did not commit suicide. In the first place, those who knew him well understood his total commitment to fighting for the dissolution of the ICTY, which had failed abjectly to produce any material evidence of his guilt. Mr. J. Bissett, the former Canadian ambassador to Yugoslavia, who testified before the ICTY at the end of February 2006, described Slobodan Milosevic working as relentlessly as ever with his sense of humor undiminished. The day before his death, Slobodan Milosevic had a phone conversation with Milorad Vucelic of the Socialist Party of Serbia. He said to Vucelic with great energy:

“Don’t worry. They will not destroy me. They will not break me.
It is I who will win!”

In fact, prosecutor G. Nice had acknowledged some months before that the project for a ‘Greater Serbia’, the lynch pin to the prosecution’s case, did not rest on any established facts. It is therefore stupid to pretend that the taking of rifampicine or some other non-prescribed medication could have been responsible for a sudden death comparable to a form of suicide. The suicide theory can easily be struck from the list without leaving a shadow of doubt, especially since the autopsie did not reveal the slightest presence of a suspicious substance.


A medically assisted judicial assassination

The doctors had no obligation to achieve results, but they did have an obligation to employ certain means and they had to dispense their care in conformity with the facts of current science. However, the doctors of the ICTY demonstrated such great incompetence in both their diagnostics and their therapeutics that they could reasonably be compared to those who fail to offer assistance to someone in danger. The only diagnosis they presented, that of Slobodan Milosevic manipulating his treatment for his own ends, served as a strong justification for the prosecution to argue for the curtailment of their patient’s rights to defend himself in person in court. They never acted as medical professionals responsible for the health of a ‘Patient’, but rather as penal functionaries charged with the surveillance of an ‘Accused’. The internal documents of the ICTY show a perfect collaboration between the Dutch doctors, the prosecutors and the authorities at the detention center, with the common goal of reducing the rights of the defense. These doctors must be brought in to court to answer for their failure to aid someone in danger, in as much as independent specialists whose competence and experience is beyond question had indicated the gravity of the situation and the risk of serious complications.

The baseless accusations made against Slobodan Milosevic were meant to achieve (and in many instances did achieve) the following:

1. To keep him from defending himself and assigning counsel,
against his will, to represent him (Steven Kay et Gillian Higgins).

2. To eliminate the facilities that had been accorded him for the preparation of his defense by the ‘Order concerning the Preparation and Presentation of the Defence Case’ of 17 September 2003.

3. To reduce the time allotted for the organization of his defense and increase the number of court sessions from three to four or five per week, so that Slobodan Milosevic would have neither the physical nor material means to prepare his witnesses, and would eventually find the fatigue and stress unbearable.

4. To reject his request for emergency hospitalization at the Bakulev Institute. The doctors assigned by the ICTY accused Slobodan Milosevic of not taking his prescribed medication so as to make him solely responsible for the steady decline in his health. This done, they were relieved of having to search out the real causes of the alarming symptoms presented by Slobodan Milosevic, and they justified the refusal of emergency hospitalization in Moscow by asserting that all that was needed, according to them, to return him to good health was for Slobodan Milosevic to take his medicine properly. They thereby deprived Slobodan Milosevic of a measure of leniency afforded to other prisoners (V. Kovacevic, P. Strugar).

From August 2004, Dr. P. Van Dijkman and Professor R. Tavernier indicated to the court that Slobodan Milosevic was probably not taking his medicine. But there was no evidence to support such an accusation, which did serious damage to Slobodan Milosevic in the judgement of the court, and which reflected to a much greater extent the derelictions rather than the obligations of care giving. And then these doctors assigned by the ICTY reiterated this accusation and exalted their lone ‘diagnosis’ as the explanation for the degradation of Slobodan Milosevic’s health. Dr. P. Falke stated that

“The Accused put his health and his life in jeopardy by not
correctly adhering to his treatment.”

Several times this general practitioner rendered peremptory opinions on subjects outside his area of competence (pharmacokinetics of diazepam, the validity of UV chromatography, etc.). Furthermore, the reliability of his prescriptions is far from being established: occasional prescriptions or prescriptions ‘on demand’ were not noted on the prescription charts. We have also highlighted the blank spots in the diagnoses of other doctors assigned by the ICTY, be they ENT (Dr. H. Spoelstra), neurologists (Dr. N. Aarts) or toxicologists (Dr. D. Uges, Dr. D. Touw). An analysis of internal documents of the ICTY shows that the reports of the doctors (1, 8, 9, 10, 11, 17, 25, 28, 29, 30, 31, 32) preceded and even perhaps generated the memoranda of the prison authorities (18, 19, 20, 22, 23, 24, 26, 27, 34) and the charges of the prosection (39). These doctors bear a heavy responsibility in the death of Slobodan Milosevic by myocardial infarction. It is undeniable that this was a case of judicial assassination with the complicity of doctors, or said another way, a medically assisted judicial assassination. We must say that the assigned counsel, Steven Kay and Gillian Higgins, during the first three months of 2006, defended the rights of Slobodan Milosevic by denouncing certain of the actions previously discussed here (40, 41).

These are the facts, Madame Prosecutor and Doctors of the ICTY, and we challenge you to deny them and to bring us before the Tribunal.

The confidential documents cited here as references were communicated to us by certain members of the Prosecutor’s Office who are indignant over the behavior of their chief.


Références.

1. Lettre du Dr. P. Van Dijkman datée du 23 novembre 2005 et adressée au Dr. P. Falke, IT-02-54-T, pages 45804-45805.
2. Rapport du Pr. F. Leclercq daté du 4 novembre 2005, IT-02-54-T, pages 45840-45842.
3. Rapport du Dr. M. Shumilina daté du 4 novembre 2005, IT-02-54-T, pages 45845-45846.
4. Rapport du Pr. V. Andric daté du 4 novembre 2005, IT-02-54-T, pages 45843-45844.
5. Lettre du Dr. J. De Laat datée du 28 novembre 2005 et adressée au Dr. P. Falke, IT-02-54-T, pages 45800-45801.
6. Conclusion collective (Pr. F. Leclercq, Dr. M. Shumilina, Pr. V. Andric) datée du 4 novembre 2005, IT-02-54-T, page 45839.
7 Lettre du Pr. L. Bockeria datée du 14 décembre 2005 et adressée à Fausto Pocar, président du TPIY, IT-02-54-T, pages 45765-45766.
8. Rapport du Dr. P. Falke daté du 14 novembre 2005 et adressé au greffier H. Holthuis, IT-02-54-T, pages 45822- 45823.
9. Rapport du Dr. P. Falke daté du 14 novembre 2005 et adressé au greffier H. Holthuis, IT-02-54-T, page 45820.
10. Lettre du Dr. P. Van Dijkman datée du 18 novembre 2005 et adressée au Dr. P. Falke, IT-02-54-T, pages 45813-45814.
11. Lettre du Dr. P. Van Dijkman datée du 1er décembre 2005 et adressée au Dr. P. Falke, IT-02-54-T, page 45667 et page 45791.
12. Avis du Pr. J.H. Kingma, ancien Inspecteur-général de la Santé des Pays-Bas, IT-02-54-T, page 45515.
13. Geoffrey Nice, The Prosecutor v. Slobodan Milosevic, 28 février 2006, pages 45514-45517.
14. Rapport du Dr. M. Shumilina daté du 14 décembre 2005, IT-02-54-T, page 45787.
15. The Prosecutor v. Slobodan Milosevic, 2 mars 2006, IT-02-54-T, page 45667.
16. Lettre du Dr. H. Spoelstra datée du 21 novembre 2005 et adressée au Dr. P. Falke, IT-02-54-T, page 45807.
17. Rapport du Dr. P. Van Dijkman daté du 18 août 2004, IT-02-54-T, pages 37641-37643.
18. Mémorandum interne du 31 août 2004 signé T. McFadden, IT-02-54-T, pages 45642- 45644.
19. Mémorandum interne du 14 octobre 2004 signé T. McFadden, IT-02-54-T, pages 45645- 45647.
20. Mémorandum interne daté du 26 octobre 2004 signé J. Hocking, IT-02-54-T, page 45648.
21.Ordre du 22 septembre 2004 « Reasons for Decision on Assignment of Defence Councel.» assignant Steven Kay et Gillian Higgins.
22. Mémorandum interne du 7 mars 2005 signé J. Hocking, IT-02-54-T, page 45508.
23. Mémorandum interne du 19 décembre 2005 signé T. McFadden, IT-02-54-T, page 45640.
24. Mémorandum interne du 20 décembre 2005 signé H. Holthuis, IT-02-54-T, page 45641.
25. Rapport du 6 janvier 2006, adressé par le Dr. P. Falke au greffier H. Holthuis, IT-02-54-T, page 45634.
26. Mémorandum interne du 1er février 2006 signé F. Gilmour, IT-02-54-T, page 45613.
27. Mémorandum interne du 13 février 2006 signé F. Gilmour, IT-02-54-T, pages 45542-45546.
28. Rapports du Dr. D. Touw datés du 16 et du 20 janvier 2006 et adressés au greffier H. Holthuis, IT-02-54-T, pages 45583-45588.
29. Rapport du Dr. D. Uges daté du 24 janvier 2006 et adressé au greffier H. Holthuis, IT-02-54-T, pages 45623-45627.
30. Résultats des analyses toxicologiques adressés le 20 janvier 2006 au TPIY par le Dr. D. Touw, IT-02-54-T, pages 45558-45566.
31. Lettre du Dr. D. Touw datée du 23 février 2006 et adressée au Dr. P. Falke, IT-02-54-T, page 45506.
32. Lettre du Dr. P. Falke datée du 3 mars 2006 et adressée au greffier H. Holthuis, IT-02-54-T, page 45507.
33. Ordre du 26 janvier 2006, « Submissions following trial chamber’s order du 26 janvier 2006 », IT-02-54-T, page 45619, paragraphe 6.
34. Mémorandum interne du 2 février 2006 signé J. Hocking, IT-02-54-T, page 45611.
35. Rapport médico-légal du Dr. W.A. Zwart Voorspuij daté du 11 mars 2006, IT-02-54-T, page 45470.
36. Fiches de prescriptions médicales faisant apparaître le médicament anti-hypertenseur « Vascase Plus », IT-02-54-T, pages 45522- 45525.
37. Rapport du Dr. P. Falke daté du 11 novembre 2005 et adressé au greffier H. Holthuis, IT-02-54-T, page 45827.
38. Rapport du Dr. P. Falke daté du 21 novembre 2005 et adressé au greffier H. Holthuis, IT-02-54-T, pages 45811.
39. Geoffrey Nice, The Prosecutor v. Slobodan Milosevic, le 6 février 2006, IT-02-54-T, pages 45576-45578.
40. Arguments de Steven Kay et Gillian Higgins pour la défense de Slobodan Milosevic, 20 février 2006, IT-02-54-T, pages 45527-45539.
41. Arguments de Steven Kay et Gillian Higgins pour la défense de Slobodan Milosevic, 6 mars 2006, IT-02-54-T, pages 45509-45512.

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