The Strange Death of Slobodan Milošević and Its Cover-Up by the ICTY

Part V The End

MILOŠEVIĆ VOLUNTEERS TO UNDERGO BLOOD TEST

Tired of the accusations that he either wasn’t taking his medication or was taking non-prescribed medication, Milošević volunteered to undergo blood tests under controlled conditions. This test took place on Jan. 12, 2006. The goal was to ensure that the levels of prescribed medication could be accurately recorded both before and after ingestion. Falke and the detention unit staff carried out the tests. Afterwards, Falke informed Milošević that the level of prescribed medication was “lower than expected.” This finding was consistent with previous low findings. The test results were sent to Daan Touw, chief of the Clinical Pharmaceutical and Toxicology Laboratory of the Pharmacy of The Hague Hospital.

Touw, according to Parker, reported on Jan. 20, that

the persistently high blood pressure being experienced by Mr. Milošević might be explained by the failure to achieve adequate concentrations of amlodipine and metoprolol, in spite of the prescribed adequate or even high dosages. One theoretical explanation considered in Dr Touw’s report was interaction with another medication. Dr Touw identified rifampicin as such a medication.

(Amlodipine is a calcium-channel blocker used to treat high blood pressure; Metroprolol is a beta-blocker that is also used to treat high blood pressure.)

Once again Parker engaged in serious deception. Touw had in fact advanced five possibilities, only one of which was “interaction with another medication,” of which Rifampicin was an example. He listed a number of possibilities:

1. poor absorption from the gastrointestinal tract, 2. insufficient compliance with the therapy, 3. interaction with for example a substance binding with drugs such as activated carbon, 4. decreased absorption by induction of enzymes, for example, rifampicine, and 5. a fast metabolism for CYP2D6. [CYP2D6 is an enzyme that catalyzes the metabolism of ingested drugs.]

Touw said that there was no way of knowing what was causing Milošević’s low ingestion of metoprolol readings. Nonetheless, the ICTY’s Falke (himself nothing more than a general practitioner) took it upon himself to write to Milošević on Jan. 31, saying he had “strong doubts” about his “ingestion of medication.” According to Falke, “lab reports indicated that the levels of prescribed medication were far too low…and that non-prescribed drugs were found as well.”

Falke told Milošević that his concerns were “not conclusive. Therefore, it was decided that a second toxicologist should look at all the lab results…to see whether my findings and those of the initial toxicologist could support or allay those concerns.” Falke did not explain who “decided” to consult a “second toxicologist.”

This second toxicologist turned out to be none other than Uges of the Laboratory for Clinical and Forensic Toxicology in Groningen. Uges was instructed to examine all of the Milošević’s medical and pharmacological results and to produce a report “analysing the data and expressing an expert opinion on its significance.”

Uges duly provided a report on Jan. 24, in which he said, “The diazepam and nordazepam levels are too low for any pharmacodynamic effect…In conclusion, there are very strong indications for no, or a not regularly intake of the prescribed medication.” This of course was extremely baffling, since the issue hitherto had been the presence of Nordazepam in Milošević’s blood, even though he had not been prescribed Nordazepam. Recall that the presence of Nordazepam had been touted as proof that Milošević was taking non-prescribed medication. So now Uges was arguing the exact opposite: The issue was insufficient amounts of Diazepam and Nordazepam!

Incidentally, contrary to Uges’s insistence to the media that he had no idea whose blood he was examining, it is clear that he knew perfectly well that the medical information in his hands pertained to Milošević. In his Jan. 24, 2006, letter, Uges stated “The information we received in Groningen by fax on 23 January 2006 was said to refer Mr. S. Milošević, born 20 August 1941, mentioned in this report as ‘the accused’. ” Also, contrary to his claims, he made no mention in his Jan. 24 report of his suspicions about Rifampicin. In fact, he made no mention of Milošević’s supposed ingestion of non-prescribed medication. He only said, “The patient compliance for taking medication regularly is very doubtful.” The only further tests Uges suggested was to confirm the presence of Diazepam and Nordazepam.

As Parker told his tale, the vigilant ICTY detention unit staff, suspecting Milošević of subterfuge, had sent some of the remaining blood samples taken on Jan. 12 and forwarded them—for some strange reason—to Uges. “His laboratory at Groningen was equipped to conduct the specialised testing necessary to detect rifampicin. Rifampicin had never been prescribed for Mr. Milošević.”

In other words, it was the ICTY that had come up with the Rifampicin story—following Touw’s mention of it as a possible enzyme inducer that might be affecting Milošević’s ingestion of anti-hypertensive medication. And it was the ICTY that had provided the blood sample that—serendipitously—had Rifampicin in it. “Uges detected rifampicin and its metabolite desacetylrifampicin in concentrations of 0.8 mg/l and 1.1 mg/l, respectively, in the blood sample taken from Mr. Milošević on 12 January 2006.”

So, this was it. The ICTY supposedly had the proof it wanted. “The presence of rifampicin offers an explanation for the failure to achieve adequate levels of the prescribed antihypertensive drugs in Mr. Milošević’s blood, despite adequate, even high prescribed dosages,” Parker explained. The blood pressure medication wasn’t working because Milošević was taking another medication that undermined it.

Parker delivered his conclusion:

[T]he circumstances point to the conclusion that throughout his detention Mr. Milošević failed to act on advice to adjust his lifestyle to lessen the cardiovascular risk which he presented, and that on occasions he refused to accept advice to take medications, or varied the prescribed dosage, refused to undergo recommended tests, and administered to himself medications which had not been prescribed by his treating doctors. The conclusion may also be drawn from the known circumstances, despite denial by Mr. Milošević, that he administered rifampicin to himself, this being a medication that could significantly countervail the effectiveness of medications prescribed to lower his blood pressure. If this were the case the circumstances would also support a conclusion that he was manipulating the effectiveness of his prescribed treatment for other purposes, at obvious risk to himself.

However, Parker’s Rifampicin tale was full of loose ends. First, why had it taken the ICTY such a long time to disclose the Rifampicin finding? Let’s recall: it was Milošević himself who disclosed the alleged Rifampicin discovery, not the ICTY. Parker suggested that this was merely a pre-emptive strike on Milošević’s part once he had realized that his ruse was about to be exposed. “It is apparent that events before the Trial Chamber concerning Mr. Milošević’s health were approaching something of a watershed. The presence of rifampicin in Mr. Milošević’s blood had just been reported to the Trial Chamber….The death of Mr. Milošević…intervened so that none of these issues were able to be resolved by the Trial Chamber.”

The ICTY was on the brink of exposing Milošević’s plot, but his death intervened and got him off the hook. Or so the ICTY would have us believe.

Parker’s account of Milošević’s would-be sinister manipulations still didn’t explain the ICTY’s leisurely pace in disclosing—or rather not disclosing—Uges’s Rifampicin finding. Uges had supposedly sent the test results to Touw on Feb. 17. On Feb. 23, Touw sent the results to Falke. Upon receiving the results, “Dr Falke consulted with medical colleagues and then with a lawyer,” Parker wrote.

His concern was whether under Dutch law he could disclose these results to the Trial Chamber without Mr. Milošević’s consent. He also discussed the problem he faced informally with the Commanding Officer of UNDU and his deputy, and then with the Registrar and the Deputy Registrar. He then confronted Mr. Milošević with the test results on Friday, 3 March 2006 and told him he would disclose these results. On 3 March 2006 he sent a letter to the Registrar informing him of the results and of the effect of this drug. The President was informed on Monday, 6 March 2006 and at his direction the Trial Chamber was informed on Tuesday, 7 March.

It is hard to understand why Falke needed to get yet more legal advice. Since there had already been a number of court orders requiring the disclosure of all medical information about Milošević, with or without Milošević’s consent, and since detention unit officials had happily shared medical information with ICTY prosecutors (not to mention U.S. embassy officials), and since ICTY rules permitted the disclosure of medical information about detainees without their consent, Parker’s explanation for the Feb. 17 to March 6 delay in disclosing this extraordinarily significant information was laughably implausible.

Parker had already admitted that “On 3 January 2006 the Chamber directed the Registrar to provide immediately to the Trial Chamber, copies of all of the medical and pharmacological data that formed the basis for these memoranda, and to identify an appropriate expert to produce a report for the Trial Chamber analysing the data and expressing an expert opinion on its significance.”

Indeed, Rule 34 of the ICTY’s rules governing detention, to which the Milošević court had resorted with some frequency, is unambiguous on the matter: “Information contained in the detainee’s medical records may be consulted or disclosed for medical reasons…in the interest of justice and the good administration of trial, by order of a Judge or Chamber of the Tribunal, after consultation with the medical officer.”

Be that as it may, why was Milošević himself not told of the test results until March 3 (according to Parker) or March 7 (according to Milošević)? Parker would have us believe that there was a vexing legal problem at issue:

Mr. Milošević was not told of the results until 3 March 2006 because of the difficult legal position in which Dr Falke found himself by virtue of the Dutch legal provisions concerning medical confidentiality.

Tellingly, Parker didn’t offer a citation for this unusual legal provision. It is hard to understand how any doctor anywhere could be prohibited from revealing to his patient the results of blood tests the patient himself had volunteered to undergo. It is even more absurd given that the ICTY, as it had often reminded us, was not bound by Dutch law, or by any national law.

Moreover—and again, damagingly for the ICTY—if Falke’s concerns were so serious that he felt he needed to consult a lawyer before he released the toxicological results, then it is more than likely that it was his own—and the ICTY’s—legal liability that he was most concerned with. The Rifampicin discovery, and particularly Milošević’s overt accusation that the ICTY was poisoning him, would have made the opening of a Dutch police investigation of the ICTY, and especially of its treating staff such as Falke, all but unavoidable.

There may also however been something else worrying Falke. Amidst all of its numerous accusations, Parker’s report made a very interesting disclosure. Parker mentioned in passing that the Dutch autopsy results had been sent to the Institut für Rechtsmedizin, Universitätsklinikum in Bonn, Germany, for further toxicological investigation. According to the institute’s findings, there was “indication of a possible but unconfirmed presence of a conversion product of droperidol, an antipsychotic, in the urine.”[i] But, Parker hastily added, “the result could not be definitely demonstrated by that laboratory.”

Droperidol, needless to say, had never been prescribed to Milošević, and it is unavailable in the Netherlands. Bizarrely, Parker attached little significance to the finding. While Parker went on at inordinate length about Rifampicin, even though the Dutch autopsy had found no trace of it Milošević’s body, he dismissed the Droperidol finding in a couple of sentences. “Even if there had been a trace of droperidol in Mr. Milošević’s urine, which the Inquiry is advised is extremely unlikely given these circumstances,” he wrote, “the toxicological report confirms that this could have no relevance to his death.”

“No relevance to his death”? That would seem to be a strangely complacent conclusion for Parker to draw. Droperidol is a powerful drug that provides tranquilization and sedation. It is used to treat psychotic disorders such as extreme agitation; it is also used to treat post-surgery nausea. The drug has serious side-effects: It is known to cause serious arrhythmias and other cardiac problems. Indeed, Droperidol used to carry a warning from the U.S. Food and Drug Administration regarding the potential for sudden cardiac death at high doses.[ii] So, if there was Droperidol in Milošević’s body, how had it got there?

If Falke had got wind of a possible Droperidol finding, on top of a Rifampicin finding, during the January 2006 blood test his concerns about possible legal liability would have been amply justified. It bears repeating: It was the ICTY that oversaw Milošević’s medication intake; and it was the ICTY, unlike Milošević, that had access to unusual and exotic drugs.

However, let us return to Parker’s Rifampicin tale: Even if every one of Parker’s assertions about the Uges-Touw-Falke Rifampicin mutual messaging were true, Parker would still have failed to address the one obvious problem with the entire “Milošević administered the Rifampicin himself” thesis. The Rifampicin was allegedly found during a blood test carried out at the suggestion of Milošević himself. Why would Milošević be foolish enough to submit to a blood test while he’s taking a powerful antibiotic? Why would he do so given that discovery would lead to draconian consequences for him such as re-imposition of counsel or enforced absence from the trial? Why would Milošević, who during his nearly five years in custody had proved to be more than a match for the ICTY judges and prosecutors, now risk humiliation and exposure to the world as a liar and a manipulator?

Parker explained this away by arguing that Milošević hadn’t counted on ICTY resourcefulness. “This was the first time that a blood test of Mr. Milošević had undergone the additional specific testing for rifampicin. Normal testing would not have disclosed the presence of rifampicin. Mr. Milošević was not aware that the sample he gave would be tested for rifampicin.”

This of course was ludicrous. Why would Milošević, a layman in medical matters, assume that his blood would not be tested for Rifampicin? Moreover, if he were taking Rifampicin in order to “manipulate” his health, would it not have been much easier simply not to volunteer to undergo the blood tests? And, if Milošević were taking Rifampicin, and since Rifampicin apparently disappears from the blood within a few days, and since Milošević was supposedly so well informed about medical matters, would it not have made sense for him to stop taking this drug a few days before his blood test?

Parker’s argument, incidentally, casts more suspicion on the ICTY than it does on Milošević. If Milošević’s blood had never before been tested for Rifampicin, then it is quite possible that someone in the ICTY detention unit had been secretly plying Milošević with Rifampicin for a long time, counting on it not to be ever detected. It was only now discovered because the blood-work specialists were specifically looking for Rifampicin. Milošević’s volunteering to undergo the blood test would surely suggest that he had no idea about the Rifampicin.

In the end, however, the Dutch autopsy found no Rifampicin in Milošević’s body. Parker attempted to explain that away by suggesting that Milošević must have stopped taking the Rifampicin a few days before his death. But why would he have done that, yet not stopped taking the Rifampicin a few days before his blood test? In particular, why would he have stopped taking the Rifampicin, given that he had just written to the Russian foreign ministry accusing the ICTY of poisoning him with Rifampicin? Perhaps he was so fiendish that he had figured out that he would be dead within a few days and wanted to stick it to the ICTY one last time by making sure that no Rifampicin would show up in the autopsy? Doubtless, it was all part of his plan to throw “down the final gauntlet in our faces,” to quote del Ponte’s stirring words. As with all conspiracy theories of this type, the master manipulator is at one and the same time devilishly clever and staggeringly stupid.

To prove that it was Milošević who administered the Rifampicin to himself, Parker exercised considerable ingenuity. Milošević must have done it, Parker reasoned, because Uges had claimed

that an effect of taking rifampicin is a marked reddish discolouration of the urine. Such discolouration would have been obvious to Mr. Milošević on 12 January 2006, yet he made no mention of this to Dr Falke or the nurse at UNDU. Were rifampicin being administered without his knowledge it is highly likely he would have reported such abnormal discolouration of his urine.

Let’s see. There exists no evidence that Milošević’s urine had ever been discolored; no sample had been taken and he had never mentioned it to anyone on the detention unit’s medical staff. However, Parker concluded on the basis of claims made by Uges—the same Uges who claimed to have suspected Milošević was taking Rifampicin before he had conducted any tests, the same Uges who miraculously discovered Rifampicin in Milošević’s blood—that Milošević’s urine must have been discolored because he must have been taking Rifampicin! Moreover, because it’s “highly likely”—the ICTY used this expression a lot long before it came into vogue—that Milošević would have mentioned the discoloration, and because he didn’t do so he must have wanted to keep quiet about this. And that was Parker’s definitive proof that Milošević must have administered the Rifampicin himself.

It was alarming enough that a man described as a judge assigned culpability based entirely on speculation piling up on speculation, but his reasoning was transparently fallacious. Parker had constructed the perfectly circular argument. He had assumed as as true that which he then sets out to prove as true. He had assumed that Milošević had administered the Rifampicin to himself, and had then taken his silence about its possible consequences—for which there was no evidence—as proof that, yes, he had administered the Rifampicin to himself.

The truth is somebody else could easily have administered the Rifampicin surreptitiously to Milošević, and there may have been any number of reasons why Milošević would have kept quiet about the sudden appearance of discolored urine. Milošević, like many people, might have felt uncomfortable discussing such things; he might have thought the matter not terribly significant, a side effect of the medication he was taking; he might have lost all faith in Falke, given his churlish response to previous complaints; he might have thought, with good reason, that the judges would be very unsympathetic to yet another health complaint; he might have had more urgent health issues to worry about. Alternatively, he might well have mentioned it to a nurse or to Falke and they either forgot or lied about it to cover themselves. In typical ICTY fashion, out of a large number of possible explanations, Parker plumped for the one that most conveniently confirmed the official ICTY narrative.

Alternatively still—and this is where it got very tricky for the ICTY—Milošević’s urine may never have been discolored at all because there may never have been any Rifampicin in Milošević’s blood to begin with. Uges’s uncorroborated claim on that score was all the ICTY was going with. Uges had made no mention of Rifampicin in his Jan. 24 report. The ICTY detention unit authorities found no Rifampicin in Milošević’s cell; the autopsy showed no Rifampicin. Indeed, according to the autopsy, “a number of medicines prescribed for Mr. Milošević were found in the body material, but not in toxic concentrations.” The only person who claimed to have found Rifampicin was…Uges. Yet, amid all of the documents the ICTY released, notably absent are any reports of lab work that Uges had supposedly preformed. To be sure, his Jan. 24 report is there. But there he was simply reviewing Touw’s findings and reports. He made no claim of having undertaken any tests himself.

The first mention of discovery of Rifampicin came in Touw’s Feb. 23 letter to Falke. The subject was “Addition to the report of Mr. Zomer, dob 20 August 1941.” Touw began,

At your request materials of Mr. Zomer (dob 20 August 1941) have been further examined and in addition to my report of 20 January 2006 I can provide you with the following additional findings. In the blood sample which was taken on 12 January 2006 in order to examine the presence of metoprolol we found rifampicine and desacetyl rifampicine in concentrations of 0.8 mg/l and 1.1 mg/l respectively. The lowest common concentrations when taking 600 mg/day are 0.5-1 mg/l for the sum of both components.…The combination of rifampicine and metoprolol has been known to considerably decrease the bio-availability of metoprolol, resulting in ineffective concentrations.

But there is no report or letter from Uges, the man who supposedly found the Rifampcicin. Touw made no mention of Uges in his letter to Falke.

From his letter, it was quite clear that Touw was referring to Milošević and knew that he was referring to Milošević. In much the same way, Uges also knew about whom he was writing in his Jan. 24 report. Yet for some reason the pair of them insisted on pretending that they did not know whose blood they were discussing. It was also strange that Touw in his letter made no mention of his having already speculated about the possible presence of Rifampicin in his Jan. 20 report. Above all, it was very strange that Touw didn’t find it bewildering that the alleged concentrations of Rifampicin were so high.

THE ICTY’S DRUG-SMUGGLING CLAIMS

Having concluded that Milošević was self-medicating—and thereby undermining the ICTY doctors’ treatment—and that his heart condition was untreatable, all that remained for Parker and the ICTY to do was to assert—without presenting any evidence, needless to say—that Milošević together with his legal associates were breaching detention unit rules in order to smuggle in medication and alcohol. “The unique arrangements established at UNDU to enable Mr. Milošević to conduct his own defence compromised the security at UNDU,” Parker declared. “Because of these arrangements Mr. Milošević was able to obtain medications not prescribed for him by treating doctors at UNDU.” Parker’s evidence for this was as well founded and as convincing as his evidence for the self-medication.

To be fair, Parker cheerfully admitted that he had as little evidence to back up his drug-smuggling claims as he had to back up his self-medication claims. He announced

that without knowledge of the content of conversations, which was precluded because the telephone was “privileged”, it could not be established that frequent telephone calls to members of his family, to former political colleagues, to journalists, and to friends, were not for the purposes of his defence. While the presence of unauthorised medication was clear, there was no clear proof of how this medication came to be in the privileged room.

Leave aside the wildly unwarranted “the presence of unauthorized medication was clear” claim, as well as the double-, if not triple-, negatives, an obvious question arose: How did Parker know Milošević was making frequent calls to family and associates, unless the ICTY was listening in on the “privileged” calls? In one of his memoranda, Hocking, the acting ICTY deputy registrar, claimed that Milošević had to have been making those calls because Milošević had stopped using the public payphone for that purpose. For Parker this was all the proof he needed: Milošević was obviously making calls to family and friends from his “privileged” office, outrageously seeking to evade the ICTY snoops who were trying to listen in on payphone calls. As for the “clear proof of how this medication came to be in the privileged room,” Parker deliberately ignored the most obvious explanation, namely, the one that Milošević had offered: The medication belonged to one of his associates. Lack of “clear proof” didn’t stop Parker from asserting that Milošević was able to “persuade visitors to smuggle [medication] into UNDU.”

To reassure his NATO paymasters that the ICTY was on to Milošević’s trickery and that it had taken appropriate action, Parker disclosed that,

[O]n 15 December 2004, in a memorandum to the Commanding Officer of UNDU, the Deputy Registrar set out measures to be taken to curb further abuse of the privileged setting by Mr. Milošević. The measures in question included…increasing security measures to ensure that legal associates are searched (while respecting privileged material) as thoroughly and frequently as possible, installing a one way viewing window and posting security to observe Mr. Milošević at all times whilst he is in the privileged office.

That was Dec. 15, 2004. Yet, even with all this added security, searching, observing and spying, the ICTY still came up with nothing, not one instance of any act of abuse. Not to worry: as usual, absence of proof isn’t proof of absence. Parker explained,

While the UNDU procedures accord with best current practices standards, it would be naïve to consider that even these measures will always ensure that no unauthorised objects can be smuggled into UNDU. In the case of Mr. Milošević, however, this matter was more complicated. First, in addition to personal visitors, Mr. Milošević had a large number of visitors in connection with the preparation and conduct of his defence. These have typically included persons presently or previously involved in political, governmental and military activities, journalists and potential witnesses, as well as a number of legal associates. Secondly, because of his trial schedule visits were often beyond normal visiting hours and for long periods. Thirdly, it was quite usual for these visitors to have with them a variety of documents, books and other papers, which were carried in brief cases, bags, folders, bundles or boxes, and variety of other materials such as videos, films, tapes, maps, etc. Fourthly, as such visitors were for the purpose of his defence, it was necessary that UNDU guards respect the confidentiality or “privilege” attached to such working materials. This was so not only for his legal associates but also for others whom Mr. Milošević said were visiting in connection with his defence preparation. Fifthly, having entered UNDU, these visitors then met with Mr. Milošević in his privileged office so that the visits could not be conducted in the physical presence or hearing of a guard.

In other words, the fact that things went on not within the eyeshot or earshot of the ICTY was proof that something untoward had to have been going on. No proof that Milošević wasn’t taking his medication? It would be naïve to think he didn’t know some trick to fool the guards. No proof that Milošević was taking non-prescribed medication? It would be naïve to think that he and his associates didn’t figure out a way to smuggle in contraband. No Rifampicin in Milošević’s blood? It only meant that he had stopped taking it a few days before he died. Not using the public payphone to call his family? It only meant he was using his privileged phone to organize his drug-smuggling operation. (“The availability of a privileged telephone in the office may well have facilitated arrangements to obtain medications.”)

CONCLUSION

So that was it. Milošević was dead, and the ICTY, through Parker’s report, had rendered its verdict: the cause of death was a heart attack. The ICTY had provided the best care imaginable, and nothing could have been done to avert Milošević’s death, not even the proposed treatment in Moscow. 

That might have been it: The ICTY could have gone with the myocardial infarction story, and could have determined that Milošević had a serious heart condition that no amount of treatment could ameliorate. Of course, that would still have left unanswered such questions as why the ICTY had done so little over five years to address this heart condition, why it had refused the proposed the treatment in Moscow, why it had focused instead almost obsessively on Milošević’s blood pressure, and why it had accused him—without much in the way of evidence—of manipulating it.

Predictably, most of the world accepted Parker’s report, though the Russian Federation, to its credit, did not. Vitaly Churkin, Russia’s permanent representative to the United Nations, made his country’s feelings clear both about the treatment the ICTY had accorded to Milošević during his years of detention and about the quality of Parker’s report. At a meeting of the U.N. Security Council on June 7, 2006, Churkin, after expressing astonishment that the ICTY had not sought to provide Milošević with proper cardiac treatment in the Netherlands when the dramatic deterioration in his health had become apparent, declared that the ICTY had “committed a grave error in not releasing him for treatment in Moscow, where routine medical procedures would have been carried out.” Churkin went further:

The upshot here is that medical assistance was denied to a man who needed it. Does the ICTY not recall the presumption of innocence? Having proven nothing, the Tribunal is left without its primary indictee, whose case had consumed some three years and vast amounts of money. What lessons has the Tribunal drawn from all of this? “We did everything correctly.”[iii]

“We did everything correctly”—that has indeed been the familiar ICTY mantra.

However, there was one issue that the ICTY could not dismiss, and that was the strange Rifampicin story that the world had learned about in the immediate aftermath of Milošević’s death. Troublingly for the ICTY, the world had learned about the Rifampicin only because of the letter Milošević had sent to the Russian foreign ministry a few days before his death more or less accusing the tribunal of poisoning him.

The ICTY was forced to address the issue, and did so by resuscitating its old self-medication accusations. For years, as we have seen, the ICTY had alleged that Milošević was manipulating his health in order to evade justice. However, as we have also seen, the ICTY’s claims that Milošević was sabotaging his blood-pressure treatment by taking non-prescribed medication were so patently absurd that even its own prosecutors were eventually forced to drop them. The presence of Nordazepam in his blood was easily explained as the natural product of the breakdown of diazepams that he had been prescribed. And, as the prosecutors finally acknowledged, even if Milošević were taking the non-prescribed medication that he was alleged to have been taking, it would have had no negative effects on his health.

Thus the bizarre Rifampicin story: A highly unusual, very powerful antibiotic is allegedly discovered during a blood test that Milošević had volunteered to undergo. The ICTY pounces, and proclaims that, finally, it had found something in Milošević’s blood that would affect his blood pressure adversely. It wasn’t the ICTY that had surreptitiously slipped Rifampicin in among Milošević’s medication, as he had alleged in his letter. No, Parker asserts, it was Milošević himself who had surreptitiously obtained the Rifampicin from somewhere and was secretly ingesting it. His playing around with the drug, the ICTY’s report alleged, was of a piece with his habitual refusal to follow the ICTY doctors’ directives and his habitual practice of self-medication. His goal, as always, was to thwart the ICTY’s noble project of dispensing justice.

However, as we have seen, the Rifampicin story that the ICTY put out in the days following Milošević’s death and then in its final report was full of holes. The ICTY was unable to answer any of the obvious questions. How could an imprisoned Milošević get hold of this drug? Why would he start experimenting with a drug that might have all manner of side-effects and long- and short-term health consequences? Why would he volunteer to undergo a blood test at the very time he was taking this drug? Why would he risk damage to his reputation, not to mention loss of all of his prison privileges and his right to represent himself? What possible objective would be worth such a risk? Above all, why did the ICTY keep the news of the alleged Rifampicin discovery to itself for such a long time? And what about the Bonn toxicologists’ Droperidol finding? Why did the ICTY take such a dismissive attitude toward it?

The truth is that it was the ICTY, and the ICTY alone, that concocted the self-medication/Rifampicin story. The ICTY based its Rifampicin allegations solely on the claims of toxicologist Donald Uges, who had supposedly found it in an anonymous blood sample that he had been given. However, it was the ICTY that was ultimately responsible for whatever Milošević ingested while he was in its custody. The ICTY, and particularly toxicologist Uges, would have far easier access to such an unusual drug than Milośević would.

Moreover, it is hard to see what possible motive Milošević would have to take such a powerful drug. He would be jeopardizing his already failing health without any serious prospect of gaining any benefits. Uges’s claims to the media that Milošević was trying to book a passage to Moscow by making himself ill were ludicrous. There was no way in the world the ICTY would have agreed to allow Milošević to go to Moscow even if he were on death’s door. It had already ruled definitively on the matter. To its credit, the ICTY, unlike the willfully gullible media, made no attempt to subscribe to Uges’s nonsense.

The ICTY, however, had every incentive either to administer the Rifampicin (or indeed the Droperidol) in secret to Milošević, or to fake a sudden Rifampicin discovery in the laboratory.

Rifampicin was at the heart of the story the ICTY wanted to relay to the world in its final report—despite the fact that the Dutch autopsy had found no trace of Rifampicin in his body. The ICTY was very insistent on this point: The former Yugoslav president had ingested Rifampicin himself, and had put his life in danger. The ICTY had laid the groundwork for its claim by detailing its largely unsubstantiated claims that Milošević was self-medicating throughout his stay in its prison.

However, if the ICTY were right, and Rifampicin played a crucial role in Milošević’s death, then it is vital to find the culprit. Who administered the Rifampicin? The ICTY had accused Milošević, but failed to produce any evidence. It failed also to come up with means, motive or opportunity. When it comes to a possible culprit, the ICTY is much the likelier suspect.

Thus, we have a sudden death; a rushed and inadequate autopsy report that outside specialists brought into question; a cause of death that cardiologists disputed; a sloppy, poorly-argued, incoherent ICTY report, filled with absurdities, contradictions, wild accusations and patent falsehoods; a long record of perfunctory, negligent treatment at the ICTY; and Dutch physicians and legal authorities more interested in saving the ICTY from embarrassment than in ensuring that the rights of its detainees are protected.

The U.N. Security Council should long ago have ordered a full audit of the ICTY: its obvious political biases; its jurisprudence that was not based on any common understanding of international criminal law; its unfair and selective prosecutions; its outrageous sentencing practices; and its prison, in which so many defendants have died. Above all, the U.N. Security Council should never have accepted so blithely the strange death within the ICTY’s portals of Serbia and Yugoslavia’s former long-time head of state.

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[i] “Report to the President: Death of Slobodan Milošević,” paragraph 35.

[ii] https://pubs.asahq.org/anesthesiology/article/97/1/287/40047/FDA-Black-Box-Warning-Regarding-Use-of-Droperidol

[iii] U.N. Security Council, 5453rd Meeting, June 7, 2006, S/PV. 5453.