Doctors Say Ieng Thirith Has Dementia

Khmer Rouge minister may be ruled unfit to stand  trial for war crimes

A team of medical experts told the Khmer Rouge tribunal yesterday that the Pol Pot regime’s former Social Action Minister Ieng Thirith was suffering from “moderate dementia” likely due to Al­zheimer’s and would probably not be able to follow proceedings in the court’s showpiece Case 002.

The testimonies support several court observers’ expectations that the tribunal will find Ieng Thirith unfit to stand trial in Case 002, for which she and the Khmer Rouge’s other three top surviving leaders stand accused of genocide and war crimes.

“The four of you concluded that she did not have sufficient understanding” to follow the pending proceedings, said Trial Chamber Judge Silvia Cartwright, reading from the team’s report.

The court sought the team’s as­sessment after hearing testimony last month from New Zealand-based geriatrician John Campbell, who first diagnosed Ieng Thirith with dementia.

The four psychiatrists-two Cambodian and two foreign doctors-reviewed a stack of reports already compiled on her health, consulted a series of brain scans and performed three new exams on Ieng Thirith over two days last month.

To gauge her abilities in terms of memory, attention, understanding and general awareness, the experts had Ieng Thirith drawing pentagons, spelling words forward and backward, folding paper and recalling names and dates.

Their assessment was unanimous.

“Our view is that she has a diagnosis of dementia,” said Dr Seena Fazel, a lecturer on forensic psychiatry in the UK. “This was a consensus diagnosis, so we all agreed on this.”

While Ieng Thirith understood the questions put to her, he said, she had trouble understanding why she was being asked.

“We felt she had a limited understanding of the purpose of our interviews,” Mr Fazel said.

But the team scored Ieng Thirith lowest on her memory, her short-term memory especially.

“We found that she cannot recall the name of her family members, including her husband,” said Dr Huot Lina, deputy head of psychiatry at Phnom Penh’s Khmer Soviet Friendship Hospital. “She does not even know that she had a son.”

And while Ieng Thirith knew she was in Cambodia, he said she could not tell them the time of day, the day of the week or the year.

Past events she could recall she often mixed up.

“For example,” said Dr Fazel, “she said that she was a young girl at the time of the alleged offenses.”

Now 79, Ieng Thirith was in fact in her late 40s when the Khmer Rouge ruled the country.

All that considered, the team decided she would have a hard time making sense of the coming trial.

Said Mr Fazel: “She was not able to retain information long enough to weigh it… So we came to the conclusion that she would have considerable difficulty following court proceedings.”

The team also considered the chance that Ieng Thirith was feigning her condition to avoid prosecution, and deemed the odds “very unlikely.”

Mr Fazel said Ieng Thirith would forget simple details on the second day of exams that she remembered on the first-the name of the retired King, for example-and remembered others she had first forgotten.

“If you were intending to feign…you weren’t likely to fail on some of these simple items,” he said.

They said her dementia probably stemmed from Alzheimer’s, had gotten worse over the past several months, and would likely get worse yet. Medication, they decided, would make little if any difference.

Ieng Thirith sat through the hearing in silence, but appeared attentive.

Note for note, though, the team’s diagnosis matched the testimony Dr Campbell gave the court last month.

“Everything we heard today really confirmed what we heard from the first expert,” said Clair Duffy, a trial monitor for the Open Society Justice Initiative.

And while Ms Duffy would not predict what the court might decide about Ieng Thirith’s mental fitness, she called the expert testimony “categorical…and it has major implications for her ability to stand trial.”

Anne Heindel, a legal advisor for the Documentation Center of Cambodia, went a step further.

“From everything that has been made public, it seems guaranteed that Ieng Thirith will be dropped from the case,” she said.

“The judges will make legal findings based on the medical evidence presented. Despite the complexity of mental health analyses, it appears that in this case the medical assessments are fairly clear and consistent, and there is little the [other] parties can do to undercut them.”

The court is set to continue the hearing this morning with questions from Ieng Thirith’s defense team, the prosecution and lawyers representing the case’s civil parties.

Opening statements in the case are scheduled to begin Nov 21.



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