DUTCH PROSECUTORS SERVE AS ICTY ENABLERS
After the spate of stories about Rifampicin, the Dutch autopsy results, delivered on March 17, were a bit of a disappointment. The Dutch Public Prosecutor’s Office announced that provisional autopsy results indicated that Milošević had not been poisoned, that a number of medicines prescribed for Milošević were found in the body material, but not in toxic concentrations, and that no traces of Rifampicin had been detected in his body. But, the Dutch prosecutor’s office rushed to add, “The NFI /Dutch Forensic Institute/ has informed us that rifampicine disappears from the body quickly, and the fact that no traces were found implies only that it is not likely that rifampicine had been ingested or administered in the last few days before death.”[i]
So Milošević had not been poisoned; yet the absence of Rifampicin in his blood was no proof that he had not taken Rifampicin. There was a certain lack of logic here. If the absence of Rifampicin was no proof that Milošević hadn’t taken Rifampicin, then why was the absence of toxins taken as proof that he wasn’t poisoned? Wasn’t it at least possible that a lethal toxin had been administered to Milošević, one that, like Rifampicin, disappears from the body rapidly, leaving no traces? Moreover, if the Dutch prosecutors refused to rule out the possibility that Rifampicin had been ingested, how could they be sure that someone had not administered the Rifampicin to Milošević with a view to inducing a heart attack? The Dutch prosecutors’ claims made no sense, but they demonstrated their eagerness to serve as handmaidens or enablers of the ICTY. Their illogical findings accorded neatly with ICTY needs. Milošević was not poisoned, but may still have taken the Rifampicin.
Interestingly, Uges stuck by his claims. According to the New York Times, Uges
suggested that even if the drug was absent at the time of his death, it might still have played a role. He said Mr. Milošević could have precipitated a heart attack by stopping rifampicin a few days before his death, for fear that court officials suspected his illicit use of the drug. If he had abruptly stopped taking rifampicin after using it to keep his blood pressure high, it could have caused his blood pressure to plummet abruptly and brought on a heart attack.[ii]
But this argument cut both ways. If somebody else was administering the Rifampicin to Milošević and then stopped a few days before his death—it was Milošević himself, after all, who disclosed the Rifampicin finding in his March 7 letter—that too could have “precipitated” the heart attack. That person or persons would then have been responsible for his death.
Not too much reliance should be placed on any Dutch investigation of death at the ICTY. According to the 1994 headquarters agreement between the United Nations and the Netherlands, “The competent authorities shall not enter the premises of the Tribunal to perform any official duty, except with the express consent, or at the request of, the Registrar or an official designated by him. Judicial actions and the service or execution of legal process, including the seizure of private property, cannot be enforced on the premises of the Tribunal except with the consent of and in accordance with conditions approved by the Registrar.” In addition,
The Tribunal, its funds, assets and other property, wherever located and by whomsoever held, shall enjoy immunity from every form of legal process, except insofar as in any particular case the Tribunal has expressly waived its immunity….The Judges, the Prosecutor and the Registrar shall, together with members of their families…shall enjoy: a) personal inviolability, including immunity from arrest or detention; b) immunity from criminal, civil and administrative jurisdiction in conformity with the Vienna Convention; c) inviolability for all papers and documents
In other words, the Dutch authorities had no jurisdiction over anything that went on at the ICTY. The ICTY could cooperate with any outside investigation or not cooperate, and there was nothing that anyone could do about it. The ICTY enjoyed total immunity for any possible criminal acts committed within its portals—a privilege that police, prosecutors and prison officials around the world could only wonder at with envy.
In 2001, when Milošević sought to challenge in a Hague district court the legality of his abduction from Belgrade and his subsequent imprisonment in The Hague, the Dutch court said it had no jurisdiction to hear his claim. The 1994 agreement, it said, had “transferred the jurisdiction to hear an application for release from detention from the Dutch courts to the ICTY.” The court cited the ICTY’s 1995 decision, Prosecutor v. Tadić, which dismissed the challenge to the ICTY’s legality. (Since the ICTY was not accountable to anyone, it could act as a judge in its own case and hear and dismiss challenges to its legality.) Finally, the court cited the European Court of Human Rights’ 2000 decision, Naletilić v. Croatia, which held that courts have no business second-guessing the ICTY because it is an “international court which, in view of the content of its Statute and Rules of Procedure, offers all the necessary guarantees including those of impartiality and independence.” When Milošević subsequently made the same application to the European Court of Human Rights, the court dismissed it, ruling that Milošević “had failed to exhaust the available domestic remedies” in the Netherlands.
Let us return to the Rifampicin: It was striking that, despite the Dutch authorities’ failure to find any Rifampicin in Milošević’s blood, the media chose to believe the ICTY story: Milošević had administered Rifampicin to himself. According to the AP story that reported the Dutch autopsy results, Hans Holthuis, the ICTY registrar had “ordered an external investigation to find out how Milošević obtained drugs he was not supposed to have. Tribunal officials earlier said he also had regular access to alcohol.”[iii]
According to AFP, Holthuis had discovered non-prescribed medication in Milošević’s cell in late 2005 and early 2006. Holthuis was quoted as saying, “We did take the necessary action when this contraband was found in a regular search. (Warden Timothy McFadden) took action immediately, but I do not want to go into details.” Holthuis added that Milošević had been “under constant and very effective scrutiny.” As for the Rifampicin discovery, “Holthuis insisted the information was passed to the trial chamber ‘immediately.’ ” Ah, so the ICTY had now corrected the one last bit of bad news. The ICTY was not lackadaisical about security in its prison. To the contrary: It engaged in “constant and very effective scrutiny.”
This was apparently too much even for the AFP reporter to swallow. Didn’t the blood test supposedly take place in January? So how come no one knew about the result until March? Holthuis, according to the AFP reporter, “added that it ‘took some time’ for it to be brought to the attention of the chamber overseeing the Milošević trial.” Holthuis, the AFP reporter noted, was “apparently contradicting his earlier statement that action was taken immediately.”[iv]
THE ICTY’S REPORT ON MILOŠEVIĆ’S DEATH
In due course, on May 31, the ICTY released the report of its internal inquiry, written by its vice president, Judge Kevin Parker. As expected, the tribunal absolved itself—its judges, prison staff, administrators and doctors—of any blame for Milošević’s death. About as much credibility should attach to this report as to the internal report of any police department, which, following the sudden death of a high-profile prisoner in its custody, tells the world that not one police officer, not one corrections officer, not one medical attendant, had done anything for which he or she should be ashamed. However, given the uncritical adulation that the willfully gullible media bestowed on the ICTY and the phalanx of so-called non-governmental organizations such as Human Rights Watch and Institute for War & Peace Reporting that lobbied fiercely on its behalf, the ICTY had every reason to be confident that its self-serving explanations would soon be accepted as unquestioned fact.
Nonetheless, the ICTY’s account of Milošević’s death was a self-serving work of deception, in which almost every assertion was untrue.
At the outset, Parker realized that the Milošević judges’ refusal to allow Milošević to receive treatment in Moscow and, above all, their justification for that decision, namely, that Milošević had failed to show that he couldn’t get the same treatment in the Netherlands wouldn’t suffice. It sounded too lawyerly and heartless. So Parker set out to show that the judges had acted on the best medical advice. To do that, Parker had to address head-on the November 2005 independent specialists’ report on Milošević’s health. Parker juxtaposed the views of the Western doctors against those of their Russian and Serbian counterparts. On one side, we had van Dijkman and Tavernier. On the other side, the Russians, Margaret Shumilina and Leo Bokeria, and the Serb, Vukasin Andrić. Working on the assumption that the Western public would deem Western doctors more credible than Russian and Serb doctors, Parker proceeded to denigrate and belittle the expertise of the latter.
Shumilina barely got a mention. Andrić was dismissed because a Dutch specialist had rejected his diagnosis. According to Parker,
Dr J. de Laat, a physicist-audiologist expressed quite different opinions from those of Professor Andrić as to the cause and nature of the concerns raised by Mr. Milošević. He agreed there was a perceptive hearing loss, more so in the right ear, but considered that with different technical arrangements Mr. Milošević could continue with the trial.
Typically, what Parker said here was untrue. Back in November 2005, the trial chamber had turned to an outside expert for a diagnosis on Milošević’s hearing problems. That expert, De Laat said that, based on tests of Milošević’s hearing, “observed perceptive hearing loss on both sides” had taken place. In his view, “it was probable that the two current medical conditions of the Accused were ‘connected,’ but he could not be sure.” De Laat said that it was “probable that the cardiovascular situation is…connected to the hearing loss. We cannot be sure of this.” This was a bit of a problem for the tribunal, since its man, N.J.M. Aarts—a Dutch ear, nose and throat specialist who had been treating Milošević for two months—had dismissed Milošević’s hearing problems as merely something to be expected for a man of his age.
Parker made no mention of what de Laat actually said—for obvious reasons. As for Bokeria’s diagnosis, Parker solemnly declared, “Nor can it be concluded that surgery as identified by Professor Bockeria in his letter of 5 April 2006 would have prevented the death of Mr. Milošević.” The passive voice, the use of the subjunctive and the double negative serve to obscure the arrogance and dishonesty of Parker’s claim. There is no medical procedure in the world that is guaranteed to save the life of a very ill person. But that has nothing whatever to do with whether it should be attempted or not. Significantly, both doctor and patient wanted to undertake the procedure, and the ICTY could cite no doctor who advised against it.
The French cardiologist, Florence Leclercq, the third of the three experts who examined Milošević in November, was clearly the swing vote. Unlike the other two experts, Leclercq, a Westerner, received respectful treatment from Parker who, understandably, was anxious to prove that her diagnosis was in full accord with those of van Dijkman, Tavernier and the ICTY doctors. According to Parker,
There is a difference of expert opinion whether surgical intervention was appropriate and would have prevented Mr. Milošević’s death. Professor Bockeria of Moscow has indicated this view to the Inquiry since the death of Mr. Milošević. This was not advised by Dr van Dijkman. Other cardiologists, Professor Leclercq from France and Professor Tavernier from Belgium, who are independent of the treating doctors, agree with the treatment provided to Mr. Milošević at UNDU. They do not agree that surgery was necessary or that it would have prevented the death of Mr. Milošević. In these circumstances it cannot be concluded that there was a failure to provide proper care by those treating Mr. Milošević at UNDU.
However, Tavernier and van Dijkman were severely compromised. Van Dijkman had treated Milošević for a number of years to no great effect. Tavernier had all too easily fallen in with ICTY political desiderata over the attorney-imposition issue. They had every incentive to insist that the ICTY-provided treatment was first-class. Rather than attend to an increasingly ailing patient, they had chosen to make a variety of unfounded and damaging accusations against him.
Parker applied all of his ingenuity to suggest—dishonestly—that Leclercq had endorsed the treatment the ICTY had provided Milošević. Both Tavernier and Leclercq, according to Parker, “were of the opinion that the treatment regime prescribed for Mr. Milošević at UNDU was appropriate.” According to Tavernier, Parker reported, “there is no test that if carried out would have helped detect or prevent the cause of death. When you have a heart hypertrophy and a high blood pressure you have to change your life-style and take your medications. Having taken additional tests would not have resulted in new recommendations or changing the prescribed medications.” And, according to Leclercq, Parker reported, “unfortunately, the possibilities of preventive treatment are almost nil.”
But Parker was seriously mischaracterizing what Leclercq had actually said. In fact, she had said nothing of the sort. In her Nov. 4 report, Leclercq said that Milošević
is a patient with a cardiovascular risk and the left ventricular hypertrophy increases this risk. The disorders the patient is now complaining of could have developed from an atherosclerosis of the neck or intracranial vessels as a consequence of the risk factors which have developed over several years.
She recommended additional tests. In subsequent newspaper interviews, she said, “His medical condition was not good, so we asked for additional tests to evaluate his cardiac situation. But these investigations were never performed, and now that’s a problem.”[v] She added, “Prison officials assured her that some cardiac tests, like an ultrasound, had been done and were ‘normal,’ but they could not show her the actual test results, leaving her to conclude that more was needed.”[vi]
To be sure, Leclercq recommend no change in the anti-hypertension treatment and other cardiovascular therapy. However, this was a far cry from her claiming that the “treatment regime prescribed for Mr. Milošević at UNDU was appropriate.”
Interestingly, while Parker swore by Tavernier and Leclercq when it came to their supposedly recommending no change to Milošević’s treatment, Parker admitted, without comment, that neither cardiologist seemed to agree with the pathologist’s report as to the cause of death.
Both Professor Leclercq and Professor Tavernier noted the wording of the pathological report in its use of the term “hartinfarct,” which they understood as “myocardial infarction.” In Professor’s Leclercq’s opinion, “I do not think that that the description in the pathology report suggests a myocardial infarction in the sense in which I would use that term as a cardiologist.” Professor Tavernier did not consider that the report was demonstrating what he, as a cardiologist, would describe as an acute myocardial infarction.
Parker seemed to attach little significance to this. However, it undermined his entire thesis. Myocardial infarction is the medical term for heart attack. The two cardiologists, with whose diagnoses Parker purported to associate himself, were telling him that they didn’t think Milošević had died of a heart attack. The two cardiologists’ doubts raised serious questions about the rushed Dutch autopsy. The pathologists’ report was inconsistent with heart attack being the cause of death. That’s not an insignificant issue!
REPORT OFFERS DEARTH OF NEW INFORMATION
Parker’s report added few new details to the story the ICTY had put out to the media through its not-for-attribution quotes in the immediate aftermath of Milošević’s death: Milošević was not murdered; he did not commit suicide; he had been self-medicating for years; he had administered the Rifampicin to himself; he received first-rate medical care in the ICTY prison, which he chose to sabotage; nothing could have been done to prevent his death; he sought to conceal his medical records from the ICTY; the decision not to allow him to go to Moscow was based on sound medical advice and solid legal reasoning and, in any case, had no bearing on his sudden death; and he obtained the non-prescribed medication by exploiting the “privileges” the ICTY had been forced to grant him because of his insistence on acting as his own counsel.
The cause of death, Parker concluded, was neither murder nor suicide. Milošević died from a heart attack and there was “no poison or other chemical substance found in his body that contributed to the death.” The autopsy report, according to the ICTY,
establishes that Mr. Milošević’s death was caused by natural causes and excluded any toxicologically identified factors which could have contributed to his death….[The] results indicated that no poisons had been found in Mr. Milošević’s body, that a number of medicines, which had been prescribed for Mr. Milošević had been found.
So Milošević died of “natural” causes? Not really. For the greatest part of the report was given over to the accusation that, during his four years in detention at the ICTY, Milošević was “self-medicating”: He was allegedly not taking his prescribed medication while taking all manner of non-prescribed medication.
So why go on about this at such length unless to suggest that Milošević did indeed kill himself? But no, the ICTY insisted: “Mr. Milošević’s non-compliance with his therapeutic plan and his tendency to self-medicate…cannot reasonably be interpreted as a sign of suicidal intent.”
Was this alleged self-medication then the cause of the heart attack? The ICTY didn’t say so, and offered no evidence to support such a claim. Was Milošević self-medicating in order to feign illness? No, for Parker insisted that the ICTY provided Milošević with the best treatment imaginable and that nothing could have been done to prevent the heart attack.
The ICTY report was confusing, and meant to be so. In truth, the self-medication charges were a gigantic smokescreen to conceal ICTY culpability for, at best, negligence toward its most famous detainee and, at worst, something more sinister.
The ICTY relied heavily on Professor Uges’s various claims and suggestions. However, unlike Uges and the reporters who based their stories on his speculations about alleged dreams of escape to Moscow, the ICTY offered no explanation as to why Milošević would have been self-medicating and taking Rifampicin. If Milošević wasn’t suicidal, then why was he ignoring the ICTY doctors’ advice?
Revealingly, despite all of the ICTY rumblings and threats about uncovering the method by which Milošević had supposedly obtained the illicit drugs, the ICTY’s report came up with nothing: not one episode of Milošević’s being caught not taking his medication; not one episode of Milošević’s being caught taking non-prescribed medication; no mention of a single incident in which anyone was observed smuggling drugs into the prison; no name of any person who may be a plausible smuggling suspect; no account of any test having been undertaken to demonstrate how drugs could have been brought into the prison; no evidence indeed that any of the medication Milošević was supposedly ingesting illicitly had had any harmful effect on his health, let alone been the cause of his death. Most shocking of all, Parker’s report made clear that the ICTY’s basis for making the self-medicating charges was amazingly threadbare.
The ICTY helpfully released a number of internal documents to go together with this report. Doubtless, tribunal officials believed that these documents, consisting mainly of claims by prison officials and doctors that Milošević was not following his prescribed medical regimen and was carrying on in a way that undermined prison order, would either not be read or be complacently accepted as solid proof vindicating ICTY allegations. Yet, despite their highly selective and tendentious nature, the documents, time and again, show Parker to be at best confused and at worst deliberately lying. In fact, the documents not only reveal the extraordinary level of collusion between the Dutch doctors and the ICTY prosecutors, but also show the Dutch doctors to be acting as tribunal spies and prison enforcers rather than as medical professionals. The reckless charges the doctors throw around against their own patients and their repeated violations of doctor-patient confidentiality show that their chief priority was facilitation of the ICTY’s work, not their patients’ well-being.
To absolve the ICTY of any responsibility for Milošević’s death, Parker conceded at once that the tribunal had been aware since 2001 that Milošević was seriously ill:
Some time after his admission…reports of a detailed medical examination, including of a coronary angiogram, conducted on Mr. Milošević between 11 April and 13 April 2001 in the Military Medical Academy in Belgrade were made available to Dr Falke. These reports indicated that Mr. Milošević had a heart hypertrophy and a myocardial bridge, and that he suffered from unregulated hypertension with probable presence of angina pectoris.
Parker quoted Dr Zdravko Mijailović, chief of the clinic of cardiology at the Military Medical Academy in Belgrade, who had been Milošević’s treating cardiologist in Belgrade, who wrote to the detention unit’s resident doctor, Paulus Falke, sometime in 2001 that Milošević “was at a high risk of a stroke, a heart attack, a sudden cardiac death, or sudden malignant heart rhythm disorder.”[vii]
But this concession only compounded the ICTY’s difficulties. If the ICTY had known for years about Milošević’s dire health, why had it chosen repeatedly to accuse him of faking ill-health, manipulating his health, self-medicating and colluding with outside specialists to thwart his trial?
Milošević’s most important health issue was his heart condition. Yet it was this problem that the ICTY had left unattended, rejecting Milošević’s application for treatment in Moscow. Parker also revealed that yet another doctor from the Bakulev Center had examined Milošević as far back as January 2004. Professor Elena Golukhova had
found that Mr. Milošević had high blood pressure, which was poorly controlled by beta-blockers and ACE inhibitors, significant ECG abnormalities, namely signs of left ventricular hypertrophy, T-wave abnormalities and ventricular beats, borderline cholesterol level…. She recommended that T1 scintigraphy, coronary angiography, electrophysiology study and some other investigations be conducted on Mr. Milošević. She indicated that, according to the European guidelines relevant to his condition, Mr. Milošević had a high risk of fatal arrhythmias and sudden cardiac death.
However, Parker claimed, “no report from her appears ever to have been disclosed to the Tribunal or the medical officer at UNDU [United Nations Detention Unit, better known as Scheveningen] by Mr. Milošević.” That was certainly strange, for it is hard to see what advantage Milošević could have gained through sitting on her report. Nor is it clear how her visit could have escaped the ICTY’s attention. Rule 31(A) of the Rules Governing the Detention of Persons Awaiting Trial or Appeal states, “Detainees may consult a doctor or dentist of their choice at their own expense. All such consultations shall be made by prior arrangement with the Commanding Officer as to the time and duration of the consultation….The medical officer shall be informed of the outcome of all consultations of doctors or dentists.”[viii]
There was no way that Milošević, under continual surveillance as he was, could have kept her visit a secret. Parker evidently had no choice but to come clean about this consultation since the Bakulev Clinic obviously had a record of Golukhova’s visit and diagnosis and had handed it to the inquiry.
HOW THE ICTY JUSTIFIED IMPOSITION OF AN ATTORNEY
Most of Parker’s report was taken up with the self-medicating charges—an ICTY refrain since at least 2004. Prosecutor Geoffrey Nice had first raised these charges in September 2004 when he sought (successfully) to pressure the ICTY to impose an attorney on Milošević. Prosecutors had sought to impose an attorney on Milošević back in 2001. The court rejected the prosecution requests, invoking Article 21(4) of the ICTY statute, which said that a defendant is entitled to “to defend himself in person.”
During the prosecution phase of the trial, the ICTY had kept things under control through presiding judge Richard May’s continually interrupting Milošević’s often-effective cross-examination of witnesses. However, in March 2004, May was forced to step down on ground of ill health, and by July he was dead. With Milošević set to begin presenting his defense and calling witnesses in August 2004, panic was starting to set in within the ICTY and without. During the summer of 2004, the campaign to impose an attorney on Milošević went into high gear. Outside pressure was brought to bear on the ICTY. In July, David Scheffer, U.S. ambassador at large for war crimes issues during the Clinton administration, wrote in the International Herald Tribune:
Justice for the people and for the defendant simply is not well served when the right of self-representation is abused. Surely “the interests of justice” now require that the Hague tribunal impose courtroom lawyers on Milošević over his objections…. If Milošević cannot tolerate such common sense, then perhaps the time has come to force-feed the proceedings by video to his jail cell while competent counsel defend him.[ix]
Scheffer’s call for imposition of counsel on Milošević was followed by one in the Washington Post by Michael Scharf, professor of law at Case Western Reserve University and one of the architects of the ICTY:
In creating the Yugoslavia tribunal statute, the U.N. Security Council set three objectives: first, to educate the Serbian people, who were long misled by Milošević's propaganda, about the acts of aggression, war crimes and crimes against humanity committed by his regime; second, to facilitate national reconciliation by pinning prime responsibility on Milošević and other top leaders and disclosing the ways in which the Milošević regime had induced ordinary Serbs to commit atrocities; and third, to promote political catharsis while enabling Serbia’s newly elected leaders to distance themselves from the repressive policies of the past. May’s decision to allow Milošević to represent himself has seriously undercut these aims.
Scharf’s explanation had at least the merit of honesty. In countering NATO propaganda Milošević was undermining the purposes of NATO’s court. However, that wasn’t the reason for imposing an attorney on him. No, “Milošević’s antics and poor health have repeatedly disrupted the trial, justifying appointment of counsel to represent him in court for the remainder of the proceedings.”[x] Just what were these “antics”? “In addition to regularly making disparaging remarks about the court and browbeating witnesses, Milošević pontificates at length during cross-examination of every witness, despite repeated warnings from the bench.” Shocking!
As the summer wore on, the ICTY moved inexorably toward its decision to impose counsel. On July 6, the Milošević trial court issued an order, instructing the ICTY registrar to “identify a cardiologist, with no prior involvement in the treatment of the Accused, and instruct that cardiologist to carry out an examination of the Accused and consider all relevant information pertaining to his health in the context that he represents himself and report quam primum to the Trial Chamber on the fitness of the Accused to continue to represent himself and the likely impact on the trial schedule should he continue to do so.”[xi]
In due course, a cardiologist was identified—one Dr. Rene Tavernier, chief of clinic in the Department of Cardiology of the University Hospital in Ghent and a professor of cardiology at the Medical School of the University of Ghent. Tavernier’s diagnosis: Milošević was too ill to represent himself, but not too ill to stand trial. In the words of Parker’s report, Tavernier concluded that
despite treatment with five antihypertensive drugs in adequate doses [Milošević’s] blood pressure remained high, a phenomenon known as resistant hypertension. In his view, this was due to a combination of severe pre-existing essential hypertension, Mr. Milošević’s lifestyle involving three-day a week work on his defence, and his poor adherence to his therapeutic plan. He concluded that Mr. Milošević was not fit to represent himself and that resumption of trial under these conditions would result in early recurrence of very high blood pressure.
Needless to say, Tavernier’s opinion had no medical value. Tavernier was in no position to determine which would be more stressful, and hence deleterious to Milošević’s health: Milošević’s continuing to organize his defense and preparing witnesses or his being denied the right to organize his defense and being forced to watch a defense campaign in which he played no part. Tavernier’s opining on matters of which he had no knowledge showed him to be an ICTY flack, not a medical professional.
According to Parker’s report, Tavernier’s view was endorsed by Paul van Dijkman, the cardiologist who had treated Milošević in prison. Suspecting, Parker recounted, that Milošević wasn’t “adhering to his therapeutic plan,” van Dijkman arranged to have samples of Milošević’s blood sent to Daan Touw, chief of the Clinical Pharmaceutical and Toxicology Laboratory of the Pharmacy of The Hague Hospital. Touw
found that the serum concentrations of metoprolol, one of Mr. Milošević’s antihypertensive drugs, were lower than norms stated in literature for ingestion of his prescribed doses, and that nordazepam, a benzodiazepine derivative used in the case of anxiety, which Mr. Milošević had refused to take from UNDU medical staff when it was prescribed, was detected in the two blood samples taken from Mr. Milošević. On the basis of specific testing of samples Dr Touw was also able to dismiss the possibility that the low concentrations of Mr. Milošević’s antihypertensive medications in his blood may be due to a rare condition known as rapid metabolism.
And, Parker added, “this coincides in time with the finding of non-prescribed medications, including nordazepam, in the ‘privileged’ office in UNDU which was used by Mr. Milošević for his defence preparation.”
However, Parker was engaging in serious deception here. There had never been any allegation of Nordazepam being found in Milošević’s cell or office. The Nordazepam issue had been raised by van Dijkman in his Aug. 18, 2004, report. He claimed, “Nordazepam was repeatedly found” in Milošević’s blood.
Geoffrey Nice had seized on the Nordazepam issue in his Feb. 1, 2006, motion opposing Milošević’s provisional release to receive treatment in Moscow. In this motion, Nice charged,
The Accused has been found with potentially fatal quantities of non-prescribed drugs on two occasions in 2004 (during a search of the private office assigned to him by UNDU some time in August, and during a routine cell inspection in the week starting 29 November 2004).
According to Nice, van Dijkman in his report had claimed that medication seized during a search of Milošević’s cell in August had been examined by Touw and found to be Midalozam (“a powerful sleeping pill”) and Prazepam (an “anxyolitic”). The two drugs “were contained in an envelope labelled ‘Misa.’ ” Milošević had explained to the prison authorities at the time of the discovery that the drugs were brought into the prison and put into a drawer in the office by their owner, Dragoslav Ogjanović (whose nickname is “Mischa” or “Misa” in Serbian), who was one of Milošević’s legal associates.
Actually, though the documents and Parker’s report referred to something going by the name Midalozam, such a drug doesn’t exist. The ICTY probably meant Midazolam. Both Prazepam and Midazolam are benzodiazepines; they belong to a group of medicines that slow down the central nervous system. Their chief side-effect is hypotension or low blood pressure.
However, neither Midazolam nor Prazepam had ever been found in Milošević’s blood, and Milošević had always denied taking these drugs. What Van Dijkman had actually said was that “Nordazepam was repeatedly found in the Accused’s blood,” not that Nordazepam had been found in Milošević’s cell. The distinction is crucial for, as Touw himself pointed out, “Diazepam is transformed into nordazepam inside the body.” And Milošević had been prescribed Diazepam on a regular basis. Diazepam, a member of the benzodiazepine family (like Nordazepam), is better known under its trade name of Valium. It is a sedative that causes depression of the central nervous system and is used in treating anxiety, insomnia, seizures and muscle spasms. In other words, there was nothing surprising about the presence of Nordazepam in Milošević’s blood.
As Milošević’s assigned counsel would subsequently point out, “There is no evidence that the Nordazepam…came from the ingestion of Prazepam.” In addition, they wrote, Milošević’s “treating doctors have not asserted that the presence of Nordazepam…may have a harmful or detrimental effect upon his health.” In fact, they quote van Dijkman as claiming that “benzodiazepines” should not “have a direct effect on the patient’s blood pressure. This medication is not at all expected to cause a rise in the blood pressure, on the contrary, it would be expected indirectly to lower it.” Whether out of ignorance or deceptiveness, Parker was both maligning Milošević and talking nonsense.
Incidentally, as we have already noted, van Dijkman’s purported concern that Milošević wasn’t “adhering to the therapeutic plan” was, to say the least, at odds with the equanimity about Milošević’s condition that he expressed a year later in his Nov. 23, 2005, response to the diagnosis of the independent experts. Then, he declared that Milošević’s
blood pressure is acceptable, and even the strain in the ECG is somewhat less pronounced. Clearly, the trial sessions are so stressful that the blood pressure increases, together with the heart rate….In view of the current work schedule, it is understandable that the patient feels fatigued. He has three court sessions per week, and spends the rest of the time preparing for them, including interviewing witnesses. There is not much time for rest. It is predictable that the blood pressure will increase again during stressful trial sessions.
No mention here of self-medication or willful sabotage of his prescribed treatment.
Yet, none of this stopped Parker from claiming that Milošević “was prepared to put his own life and health at risk by using nonprescribed medications.” Parker’s claim that the authorities had uncovered Milošević’s secretly hoarding Nordazepam—medication that had not been prescribed but the presence of which in Milošević’s blood was entirely explicable—was sheer deception. Parker offered no evidence to buttress the self-medication charge.
Later in his report, Parker went further. He asserted,
blood samples had been taken from Mr. Milošević on 15 July and 29 July 2004. Nordazepam and prazepam were detected in both samples. Neither of these had been prescribed for Mr. Milošević. As confirmed to the Inquiry by a consultant toxicologist, Professor Uges, these results indicated that Mr. Milošević was in fact taking prazepam in July 2004 and are consistent with him having been doing so on 9 July 2004.
But not one document released by the ICTY disclosed any finding of Prazepam in Milošević’s blood. In his Feb. 14, 2006, submission to the court, John Hocking, deputy registrar of the ICTY, wrote that “ ‘Prazepam’…[had] arrived with the Accused’s belongings when he was originally admitted to the UNDU.” He made no mention of any finding of Prazepam in Milošević’s blood. Hocking’s disclosure cast an odd light on Parker’s claim that Milošević “always had refused to take similar drugs to prazepam when these were prescribed for him by his treating doctors at UNDU.” He had supposedly arrived with Prazepam, but refused to accept Prazepam when prescribed by the ICTY. And Uges’s role became ever more peculiar. He had no involvement in the case until January 2006. Yet he pronounced on blood tests carried out in the summer of 2004.
[i] “Provisional findings concerning the death of S. Milošević.”
[ii] “Dutch Autopsy on Milošević Finds No Evidence of Unusual Drugs,” New York Times, March 18, 2006.
[iii] “No poison or toxic medicine found in Milošević’s body, war crimes tribunal says,” The Associated Press, March 17.
[iv] “UN court has ‘no ready answer’ for Milošević drug doubts,” AFP, March 17.
[v] “Some Milošević doctors call care by tribunal inadequate,” New York Times, March 16.
[vi] New York Times, op. cit.
[vii] “Report to the President: Death of Slobodan Milošević,” paras. 41 and 42.
[viii]https://www.icty.org/x/file/Legal%20Library/Detention/161115-it38-rev10-rules-of-detention.pdf
[ix] “Enough of Milošević’s Antics,” International Herald Tribune, July 13, 2004.
[x] “Making a Spectacle of Himself; Milošević Wants a Stage, Not the Right to Provide His Own Defense,” Washington Post, Aug. 29, 2004.
[xi] Prosecutor v. Milošević, “Order on Future Conduct of the Trial,” July 6, 2004.