On the Manipulation of Medicine and Justice to Dismiss a Defendant Responsible for Committing Crimes

August 12, 2002

Dr. Martin Cordero Allary , Medical Psychiatrist
Dr. Paz Rojas Baeza, Neuropsychiatrist
Dr. Andrea Bahamondes Moya, Medical Psychiatrist


On two previous occasions the doctors who endorse this document responded to reports on the health of Augusto Pinochet: in January 2000 in London, and on January 10, 11, 12 and 13, 2001 as part of a group appointed by Judge Juan Guzman.

First Report:
On the basis of the detailed analysis of the tests conducted by British doctors and supported by a broad bibliography, after noting the World Health Organization definition of dementia or mental derangement, we reached the following conclusions:

1) The medical examinations upon which Home Secretary Jack Straw founded his decision to release Pinochet fail to sufficiently prove that a state of dementia or mental derangement incapacitates him for facing trial in court.
2) That these tests have not been conducted under conditions recommended and required by the international medical community to found a thorough and rigorous diagnosis.
3) The commentaries the British doctors include in relation to many of the tests they performed on Pinochet fail to concur in an objective and informed interpretation, which lead us to question their conclusions.

Therefore, we conclude that on the basis of the information available, it is not possible to seriously and scientifically deduce that the Lifetime Senator is "impeded from attending a normal judicial proceeding."
This report was issued and made public April 17, 2000

Second Report:
As in the previous report a clinical analysis was made of each of the affirmations made by Chilean doctors, supported by an important bibliography. These are the conclusions reached:
A.- Observations on the final conclusion reached by the Chilean doctors.
The expert examinations the Medical Legal Institute practiced on Mr. Augusto Pinochet Ugarte detected signs of psychological and organic deterioration of probable vascular origin, estimated greater than normal for his age. Our analysis of the report explains why this determination is questionable. The brain damage detected by the tests, in our opinion, does not affect the subject's competency; nor does it comprise a dementia of a severity that should warrant exempting him from penal responsibility. Finally, we contend that, from a psychiatric standpoint, Mr. Pinochet is fully capable of participating in a judicial proceeding with the appropriate consideration for his age and problems of mobility.

B.- Observations on the final conclusion reached by Medical Expert Report regarding Augusto Pinochet Ugarte, Case Rol N�2.182 - A.
As a principal observation, the Medical Expert Report's clinical diagnosis limits its conclusion strictly to what the Judge literally and explicitly requests. In fact, the judge ordered a "report on the mental faculties and neurological condition of the individual previously identified so as to determine whether he is affected by psychosis or dementia, and, in the event these conditions exist, to what degree." The response to this request was: "the neurological, psychiatric and neuropsychological appraisal confirms the existence of a moderate subcortical dementia of vascular origin, according to existing international classifications of, DSM-IV, ICD-10, NINDS-AIREN."

This diagnosis is accompanied by two details, with no legal medical explanation:
1. That the diagnosis is based on three elements (multifocal neurological damage; tomographic study with multiple subcortical and basal strokes, and neuropsychological studies that indicate reduced attention span, concentration and memory, particularly short-term memory, learning, executive function, and intellectual processes)
2. That the result of the tests conducted does not suggest presence of drugs (certified by chemical-toxicological tests).

The report lacks any statement or interpretation as to the implications of the diagnosis for the capacity to stand trial, prognosis, risk, or recommended therapy. On the last point, it is important to bear in mind that the legal medical report is a written declaration concerning a legal situation related to a biological or medical condition, which must present causes, circumstances, and consequences.)

The "purist" perspective of strict literal adherence to a judicial request fails to provide information that permits forming a full and adequate opinion on the facts. In our opinion, Forensic Psychiatry requires not only determining the existence and origin of a mental illness , but it must also determine categorically and with well-founded reasoning indicate the existence of a mental illness and the degree of that illness. It is necessary to formally determine and state that the characteristics of the illness may be considered a cause compatible with extenuating circumstances that warrant discontinuing with a trial.

This task and determination pertains to Forensic Psychiatry and is the purpose of a medical expert report, which serve to validate such affirmations. (This entails illustrating to the judge aspects of the mental health of the defendant in relation to the crime charged, contributing scientific basis for judicial consideration of the mentally ill defendant, and determining the mental capacity of a person in the civil arena.) The process implies reviewing two fundamental concepts: penal responsibility and civil capacity."

- Our opinions were not taken into account and on July 1, 2002 in the Thirty-fifth whereas the judges of the Supreme Court's Penal Chamber concluded: "The participation of Augusto Pinochet Ugarte in the proceeding is partially and definitively dismissed".
Whereas Thirty-two concluded categorically: "That the defendant Augusto Pinochet Ugarte suffers from a mental derangement condition known as vascular dementia. … This condition produces symptoms that make the patient suffer a cognitive deficit manifested in memory loss, as described in reflection nineteen. This has caused him significant deterioration in his manner of acting, prevents him from organizing relatively complex actions needed to carry out a (such as touching fingers together, described in clause twenty-two.) It has also produced an alteration in his executive ability, that is, his ability to plan, organize, carry out sequential actions and abstractions, as described in paragraphs twenty and twenty-three. In effect, he fails to carry out commands and responds inadequately to problems posed to test his judgment. He is unable to function independently in work activities in his community and has abandoned more complex tasks such as reading."

In contrast with out previous comments that are founded upon the exams practiced by British and Chilean doctors, the medical psychiatric observations we pose below are based on analysis of the communications media - press and television - that reflect the behavior and statements made by Pinochet himself, his family or others close to him. We shall analyze his habits, his emotional expressions and his recent and long -term memory, as well as his ability to make decisions, plan, organize and carry out his own wishes and interests. Our analysis will demonstrate that the judges' statement in Article Thirty-five clearly is at odds with what may be discerned from his conduct and statements.

We must note that Pinochet's wife Lucia Hiriat informed medical experts in Santiago that her husband confused dates, filled in his mental lapses with confabulations, failed to recognize people who visited him, forgot important events; frequently forgot words, tended to lose the train of thought in conversation and that he had become inward and hardly expressive. Regarding general orientation, his wife stated that he had lost interest in hobbies that he no longer reads or writes, and rarely participates in social activities. According to Lucia Hiriart, his ability to reason and his problem-solving capacity were also affected.

However, it is well known that as senator Pinochet devoted an hour each day to sign autographs and allow people to take photographs with him, although he privately admitted that this bored him.(La Segunda, 7.05.02).
We must state first of all, that Pinochet shows no sign of suffering from any loss of his higher mental faculties, as diagnosed by the doctors and judges: he has no speech alterations (aphasia), does not show failure to integrate perceptive functions characterized by an inability to identify certain objects and forms (agnosia), nor does he show any indication of apraxia, as we have seen him with full ability to carry out voluntary actions, as observed in public activities carried by television broadcaster. He shows no sign of suffering from Parkinson's disease, which was diagnosed more than two years ago by the British doctors in their Final Report. Up to the present time, he has not been observed to be affected by the characteristic signs of the disease such as trembling and rigidity as we see in the Pope.

Secondly, we shall analyze the state of his memory, mental ability disturbed by dementia, whether light, mild or serious, in short-term and long-term memory. On January 23, 2001, after interviewing Pinochet, Judge Juan Guzman stated: "I confirm that Pinochet has a clear mental health" and added that he found him "extraordinarily normal." Earlier, on March 17, 2000, his son Augusto stated: "He remembers everything." On September 1, 2000 his daughter Jacqueline said his "memory is perfect".(Revista Caras).

During the year 2001, his activities showed no appreciable change: he went to mass every Sunday, had no trouble following the service, went out to stores to purchase things, such as clothing for his grandchildren. (La Segunda, 4-06.01)

On October 5 , 2001 he sent a letter to his grandson Rodrigo in which he showed a very good abstraction ability, an indication that his intelligence and thought processes are unaffected: "I cannot attend [his grandson's birthday celebration]… but my thoughts and my heart are with you ".(La Segunda, 10. 5.01).\

Now we shall analyze his condition during the year 2002. On his wedding anniversary celebrated January 30, 2002: "He appeared relaxed and gave his wife a kiss, spoke in a strong voice, and took time to chat with guests." In other words, he recognized, acted and spoke in a normal fashion. Moreover, during those days he demonstrated the ability to analyze and make decisions, actions impossible for one whose memory fails: "He sent a letter to Margaret Thatcher, expressing his deep concern for her health. " (La Segunda 1.31.02)

He gives himself certain pleasures as last February when, "Together with his escorts Pinochet went to the Lomiton restaurant of Casablanca, surprising customers who were having lunch..". He was observed to be relaxed, smiling, with no motor difficulty, nor inappropriate words, associated with dementia. He was able to fulfill a whim, and returned to his old habits, in this case, eating in Lomiton restaurant.

He clearly selects the places he wants to go, as well as the clothes he wears, including his ties. He states that he has kept up a daily routine with no change except that now he gets up as 9AM not at 6 AM as he did when he was more active. Then he takes a walk and reads the daily newspapers in his private office. He takes a nap and asks to be brought La Dehesa mall to buy books and gifts for his grandchildren and says that he longs to visit the Foundation that bears his name. He constantly asks to go to his office on Malaga Street, and is a fanatic of the History Channel, which he says "he loves." (Revista Caras, 5.24.02, p.39).

On April 3, 2002 Cardinal Jorge Medina dined at Pinochet's house. "I found him like any person of his age, with the health of anyone of this age, trying to live a normal life. We talked about Valparaiso and many pleasant things. He is lucid and his memory is fine." (Revista Caras, 4.12.02, p.16)

On April 19, 2002 he ate at the Lo Curro Military Club, and exclaimed, "This place brings back so many memories!" A phrase impossible for a person who suffers from dementia or moderate mental derangement , revealing that his long-term memory is intact and that he continues to have the ability to evoke events and places he knew in previous years. He shows no alterations in judgment, as he is able to appropriately handle interpersonal situations. A close collaborator says he is obsessed with the idea of returning to Iquique. "He most recurrent topic of conversation is going to Mamiña and touring the north... He appears to be set upon the idea."

But, his family and lawyers put limits on the lifetime senator, even when he has his bags packed and ready to travel. "On other occasions attorney Pablo Rodriguez, who heads his defense staff has refused to allow Pinochet to move at all. In fact, some observers fear that if the former general makes another unnecessary visit, Rodriguez will abandon the case." (Revista Caras,5. 24.02, p. 36-37)

Again, on June 1, 2002 he attended Lo Curro Military Club. "He was in good spirits during the two hours he attended an event there." (La Hora. 3.06.02)

As of July 1, 2002, date on which the Supreme Court definitively dismisses proceedings against him due "incurable subcortical vascular dementia" that people who visit him repeat, "that he is a sick man with the appearance of a healthy person. "(Caras, 5. 24.02, p.37).
In our opinion more in keeping with reality are the remarks by Alfonso Marquez de la Plata , who visited Pinochet June 7, 2002 [ less than a month before the ruling]. Marquez de la Plata told the La Tercera newspaper that he had been with Pinochet who remembered an old acquaintance, the former CIA Assistant Director Vernon Walters, who died last February. Marquez de La Plata added, "He is not crazy as they try to make him out to be. He has a number of physical problems but his head is normal and his memory is perfect." (La Tercera, 7.5.02, p.5).

In truth, Pinochet is a healthy man who tries to appear or simulates as someone who is mentally ill. All actions chronicled in the press to obtain his resignation from the Senate also show that he is a person capable of making decisions and determining a course of action. He has a sequence of clear, independent actions that reveal purpose and evaluation of meaning and understanding of the importance of his role . He decides for himself the text of his letter of resignation, and decides who will read it for him in the Senate. Some of the basic ideas Pinochet gave for the content of the letter was: explain the reasons he remained in power 17 years and indicate the reason that justifies his retirement. On the basis of the ideas he gave, the lawyers, mainly Pablo Rodriguez composed the letter. Is it possible to consider a person judicially and procedurally dismissed when he has perfect recollection of the most important moments of the 17 years of his government as well as reasons for retiring? (La Tercera, 7.5.02, p.3)

Cardinal Errazuriz is asked to read the letter of resignation and pick it up at Pinochet's home. There, on July 4, 2002, as reported in the newspaper, Pinochet: "Aware of the importance of the day, rose early, appears nervous, dressed in a somber, but elegant dark suit, to await the Cardinal's visit." The Cardinal gives Pinochet the rosary that his mother used throughout her life. Earlier, Pinochet remarked to the Senate President Adolfo Zaldivar: "I am not crazy, although I do have a health problem. My age does not allow me full use of my faculties." (La Tercera, 7.7.02,Reportajes- p. 11 and 10).

Later the Cardinal stated on Radio Chilena: "I found that he felt relief at having taken the decision, smiling and moved, because of the significance of the action he was about to take... that is, sign his letter of resignation… He revealed wish to have witnesses present when he signed the letter. He wanted witnessed that he freely signed the letter. He signed it with a firm hand." (La Nacion, 1.7.02). Errazuriz exclaimed: "That's how presidents sign!" (La Tercera 7.7.02, Reportajes, p.11)
Pinochet's hand did not tremor; he did not hesitate or show any neurological weakness. In this act in which he demonstrates his will, as in all previous intentional actions accompanied by powerful feeling, Pinochet showed that he is no way affected by apathy. How can a signature from a person declared demented be legally valid?
Earlier, Zaldivar, who orchestrated this resignation, spoke about his meeting with Pinochet: "His position was coherent, which means he was in sound judgment. " And he adds, "As a notary public would say." (El Mercurio, 07.6.02, C 5) As if to offer an explanation, Zaldivar went on to say, "In these diseases, there are periods of higher and lower lucidity." (La Segunda, 7-5-02, p.13).

After signing his resignation, Pinochet immediately took the telephone and called Army Commander-in Chief Cheyre. "It is the first time they speak directly, without intermediaries. Pinochet asks the Army chief to inform the institution that compelling reasons motivated his resignation." .(La Tercera, 7.7.02, Reportajes, p.11).

Unlike what the judiciary says about him, Pinochet is clearly capable of organizing relatively complex actions to carry out a task. He retains his executive ability, that is, the ability to plan, organize, abstract, belying through his actions the statement of whereas Thirty-two of the Supreme Court's resolution dismissing proceedings against him.

As we read in the La Segunda newspaper, it is the opinion of a person close to Pinochet that: "General Pinochet has plenty of things to do yet." And, "…despite his retirement from political life, he will continue to provide reason for talking about him." (La Segunda, 7.5.02, p.17). This opinion clearly refers to an individual whose thinking and acting abilities are intact.
People close to Pinochet informed the press of his reaction upon learning of the Supreme Court dismissal of proceedings against him: "It lifted a weight that was pressing down on him." (La Segunda, idem). This indicates that he was aware of the situation, the serious nature of the ruling, and that he expressed relief at the favorable outcome.
The day after his resignation, July 5, 2002, Pinochet asked Senator Romero to his Malaga Street office. This time he wore a light-colored suit with a pearl in his tie.. Romero described him as :"He is in good spirits and he looks great. " He added that Pinochet feels "free after the pressure of the long trial and tells me that he had been thinking about retiring for quite some time." Also, Pinochet informed Romero that "He wants to travel and… He told me wants to come to see me at the Senate… I got the impression that he is like any person who wants to visit his former classmates." (El Mostrador, 7.5.02)

That same day, Pinochet invited Providencia Mayor Cristian Labbe to lunch. The two friends, who know each other 30 years, laugh and joke together. During the lunch that lasts from 13:30 to 15:00, Pinochet begins to plan his trip to Iquique. He commented to Labbe about a book he read "some months ago" called "Medico de cuerpo y alma" [Doctor of body and soul], an indication of an excellent memory.(La Segunda, 5.07.02, p.17).
It is worth noting that a person with such a busy calendar of activities, slightly hard of hearing, worried about legal cases and takes 12 medications each day (La Segunda, idem), has a right to rest. This in no way would deteriorate his ability to judge situations, to plan, and take actions, and in no way brings about symptoms of apathy. Apathy is a classic indication of brain damage, as previous reports have established, and there is no indication that Pinochet suffers apathy.

On July 12, 2002, Pinochet traveled to Iquique, in northern Chile. He did not postpone his arrival in the city of Iquique, despite injuries two bodyguards sustained in a serious traffic accident. (La Tercera, 7.12.02). El Mercurio, July 13, 2002 reports: "Pinochet will spend the winter in Iquique. He was observed to be in good spirits and responded to greetings by waving his hand high… He arrived very happy, opened the car window and began to greet the people." Then he got out of the car, acknowledged people greeting him, hugged them and gave the ladies a kiss. And that same afternoon he visited the Iquique duty-free zone. (El Mercurio, 7.13.02,C6) Once again, he repeated his actions on the return from England: the sick person walked, waved, smiled, and felt happy. There is no evidence of the apathy that allegedly afflicts him in any of his public appearances.

"Is the idea to change the image of a demented person who was dismissed due to mental illness and who never proved his innocence?", asked "La Tercera" on July 13, 2002, and added, "the idea is not to hide him anymore. "
On July 14, 2002 "He attends mass, receives communion and during the Eucharist greeting stretched his hand to the faithful who he greets with a smile and wishes for peace. "(El Mercurio, 7.15.02).
The newspaper El Diario Estrella de Iquique describes his visit to the walled duty-free zone and the La Segunda newspaper of July 16 quotes him: "I have come to see my friends." It also describes that he greeted all the people who approached him and even had his picture taken with workers and his friend, the business executive Lombardi, who he gives a hearty hug.
La Segunda adds that Pinochet remarked on " the progress Iquique has made and that he really liked the remodeled Costanera Avenue, the park and the beach; also that he could remembers every detail of the downtown area."
After the unfortunate episode in which his bodyguards threatened three teenagers who were off to catch crabs, beating them up with their rifles, La Tercera reports (July 17, 2002): "La Moneda is annoyed with the frequent outings of Pinochet. The government wants him to lower his profile."

Why should La Moneda be annoyed when it never attempted to expose the orchestration it mounted even in England in order to free him?

Before returning to Santiago, Diario El Nortino, carries an interview with Pinochet's wife Lucia Hiriart. When asked: "Has the general traveled to Iquique for personal reasons or for other reasons?," she replied, "Of course, dear, why shouldn't the trip be a personal decision? After all he is boss and master of his decisions. I hope you don't believe that stupid thing about him being crazy or demented?" (Quoted in Spain's daily El Pais, de 7.3.02).
Comparing his behavior in public and the Supreme Court's ruling, we observe a surprising and clear contradiction, which is notorious when comparing his wife's statement to the doctors and her response to the journalist in Iquique. This leads us to one of two conclusions: either the information handled by the medical experts was falsified or Mr. Pinochet has completely recovered from an illness that even the Supreme Court had considered incurable.

El Mercurio of July 23, 2002 writes: "On recommendation from his doctors, Pinochet suspended his trip to Arica and returned to Santiago. …He had spent 10 days in Iquique. During his stay, he attended mass, visited the Zofri duty-free zone, visited downtown Iquique, visited Alto Hospicio [scene of a serial murder uncovered earlier in the year], and had lunch in Pica and Playa Yape. He received visitors every day."

The courts and the government of Chile owe the Chilean people an explanation about this farce
, especially the doctors who attended him, relatives of victims of the Caravan of Death, and all family members of persons made to disappear, executed and tortured during the 17 years Pinochet ruled this country. The judiciary must act coherently and deprive him of immunity derived from his condition as "former president" which this very government enacted to free him once and for all.



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