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Medical Professionals in Armed Conflict: the Case Of MEDICAL PROFESSIONALS IN ARMED CONFLICT: THE CASE OF DR WOUTER BASSON GJ LÖTTER 10035428 Submitted in partial fulfilment of the requirements for the degree MAGISTER LEGUM in the FACULTY OF LAW UNIVERSITY OF PRETORIA PREPARED UNDER THE SUPERVISION OF PROF A G NIENABER OCTOBER 2019 BEDANKINGS Ek het besluit om my bedankings in Afrikaans te doen. Aan my studieleier, Professor Annelize Nienaber, dankie vir u uitstekende leiding ondersteuning en eindelose geduld om hierdie tesis tot die finale weergawe te volvoer. Hierdie navorsing sou nie moontlik gewees het sonder u nie. Dankie aan die personeel by die O R Tambo Regsbiblioteek vir julle bystand hierin en dat julle altyd bereid is om ekstra moeite te doen om nagraadse studente by te staan met die verkryging van skaars studiemateriaal. Aan my ouers, dankie vir die opofferings wat julle gemaak het om my die geleentheid te gee om te gaan studeer. Dit is ʼn voorreg waarvoor ek altyd oneindig dankbaar sal wees. Dankie dat julle my van kindsbeen af deurentyd aangespoor en bemoedig het om verder te studeer. Laastens, dankie aan ons Hemelse Vader aan wie ek alles verskuldig is. University of Pretoria Declaration of originality Full names of student: GYSBERT JOHANNES LÖTTER Student number: 10035428 Declaration 1. I understand what plagiarism is and am aware of the University’s policy in this regard. 2. I declare that this THESIS is my own original work. Where other people’s work has been used (either from a printed source, Internet or any other source), this has been properly acknowledged and referenced in accordance with departmental requirements. 3. I have not used work previously produced by another student or any other person to hand in as my own. 4. I have not allowed, and will not allow, anyone to copy my work with the intention of passing it off as his or her own work. Signature of student: __________________________ Signature of supervisor: __________________________ SUMMARY The thesis investigates the place and role of medical professionals in armed conflict and focuses specifically on the case in South Africa of Dr Wouter Basson. The thesis traces the role of medical professionals in armed conflict from early Roman civilisations until after World War II, and outlines medical health service in South Africa after World War II. The ethical and legal obligations of medical professionals during armed conflict are discussed, together with a brief overview of the Nuremberg Doctor’s Trial. This is done in order to highlight the international legal and ethical frameworks within which medical professionals operate in situations of armed conflict. Dr Wouter Basson and Project Coast are selected to serve as a case study. The circumstances under which Dr Basson operated as well as the national and international law elements of Project Coast are canvassed. Dr Basson’s criminal trial, his subsequent appeals as well as his disciplinary hearing before the Health Professions Council of South Africa are scrutinised. South African constitutional law, as well as the HPCSA’s Guidelines for Good Practice in the Health Care Professions as they apply to the case study are examined. The thesis concludes by offering answers to the research questions and proposing a number of recommendations. TABLE OF CONTENTS Chapter Description Page Chapter 1 Introduction 1 1.1 Background 1 1.2 Problem statement 5 1.3 Assumptions 8 1.4 Research questions 8 1.5 Methodology 9 1.6 Chapter outline 10 Chapter 2 Historical analysis of the place and role of 11 medical professionals in armed conflict 2.1 Introduction 11 2.2 Early Roman civilisations and medical 11 personnel 2.3 Renaissance 13 2.4 Rules of war and the wounded 13 2.5 Southern Africa and military medicine 16 2.6 World War I and World War II 18 2.7 Military health service after World War II 21 2.8 Conclusion 21 Chapter 3 Ethical and legal obligations of medical 22 professionals during armed conflict: International law and medical ethics 3.1 Introduction 22 3.2 Regulation of medical care during armed 23 conflicts 3.3 Medical professionals in armed conflict 31 3.4 Involvement of military medical personnel in 36 questionable conduct during armed conflict 3.5 Codes of medical ethics 43 3.6 The Nuremberg Doctors’ trial: United States of 46 America v Karl Brant et al 3.7 Conclusion 51 Chapter 4 Dr Wouter Basson: A case study 52 4.1 Introduction 52 4.2 Background 52 4.3 Project Coast 54 4.4 Basson’s criminal trial in the Gauteng Division 57 of the High Court 4.5 Subsequent appeals: The Supreme Court of 69 Appeal & Constitutional Court 4.6 Basson’s HPCSA disciplinary hearings 72 4.7 Conclusion 88 Chapter 5 Medical professionals in South Africa: Dr 90 Basson and municipal law 5.1 Introduction 90 5.2 Health Professions Act 56 of 1974 (as 90 amended) 5.3 HPCSA guidelines for good practice in the 98 health care professions 5.4 The Constitution, 1996 104 5.5 Conclusion 123 Chapter 6 Recommendations and conclusions 125 6.1 Introduction 125 6.2 Conclusions as to the research questions 125 6.3 Recommendations 130 Bibliography 133 1 CHAPTER 1 INTRODUCTION 1.1 Background The world has seen many an armed conflict during the past century. The twentieth century commenced with the political entities in South Africa engaged in a war between the British Empire and the Boer Republics.1 The South African war was followed by the Great War or First World War (WWI) in July 1914 and ending in November 1918, in which millions became entangled in the conflict to decide who should dominate Europe.2 The Second World War II (WWII) began in 1939, still more millions were dragged into a conflict initiated by the German Chancellor, Adolf Hitler, and suffered the atrocities committed under National Socialism.3 Conflicts on a smaller scale followed; the Korean War (1950 – 1953)4 and the Vietnam War (Second Indochina War) (1955 – 1975),5 as well as numerous others including civil wars and the Cold War that continued until 1989. In 1966 South Africa saw the start of a war on the border between South-West Africa (SWA) (now Namibia) and Angola, one of the many proxy wars fought in the twentieth century. After WWI the Union of South Africa administered SWA under mandate following the departure of the German forces from the colony. Under the Treaty of Versailles6 SWA was declared a League of Nations Mandate Territory.7 The 1960s saw a world-wide conflict between the Soviet Union and a Western alliance under the leadership of the United States of America known as the Cold War. 1 Schmidt, EA “The Anglo-Boer War in a century of peace” (2007) 52 Historia 155 – 171, available at http://www.sahistory.org.za/article/second-anglo-boer-war-1899-1902 (accessed on 21 July 2015). 2 “Armistice Day/Poppy Day: World War One feature” (2014) 10 Without prejudice 50 – 51, available at http://www.history.com/topics/world-war-i/world-war-i-history (accessed on 21 July 2015). 3 Available at http://www.history.co.uk/study-topics/history-of-ww2 (accessed on 21 July 2015). 4 Borch, FL “The cease-fire on the Korean Peninsula: the story of the Judge Advocate who drafted the armistice agreement that ended the Korean War” 8 (2013) Army lawyer 1 – 3. 5 Herring, CG “America and Vietnam: the unending war” (1991) 70.5 Foreign affairs 104 – 119. Also available at http://www.historynet.com/vietnam-war and http://thevietnamwar.info/ (accessed on 21 July 2015). 6 Dugard, J International law: A South African perspective (2013) 17. 7 Ibid. 2 The South African government increasingly became engaged in an armed conflict with a liberation movement in SWA, the South-West African People’s Organisation (SWAPO), which was demanding independence. In its revolt against the apartheid system SWAPO sought support in the international community, particularly from the Soviet Union and its proxy, Cuba.8 The communist-supported insurgency in SWA led to the South African government taking military action. South Africa’s conscript armed forces were sent to provide military support against SWAPO on the SWA–Angola border.9 The South African government declared the indigenous opponents terrorists. The war on South West Africa’s border lasted for 23 years. This conflict saw a young medical doctor, Wouter Basson, start his military career. Dr Basson joined the SADF in 1979 as a medical officer in the South African Medical Services,10 and those in command soon recognised his leadership potential and intellect.11 Within two years Dr Basson had qualified as an internal medicine specialist and served as a specialist advisor at Defence Headquarters.12 Dr Basson’s knowledge of biochemistry and medicine made him the ideal candidate to head the chemical and biological weapons research and development programme of the SADF called Project Coast. Basson soon was promoted to Project Officer for Project Coast.13 In 1985 Dr Basson was promoted to the rank of colonel and in 1988 became a brigadier-general and head of Medical Staff Operations.14 His rapid rise in the military ranks was unprecedented and with every project he became more influential and powerful.15 South Africa’s military withdrawal and Namibian independence were followed by majority democratic elections in South Africa. Dr Basson left the military for private practice, and subsequently was criminally charged in the High Court for his involvement 8 Geldenhuys, JJ Ons was daar - wenners van die oorlog om Suider-Afrika (2011) 45 – 50; see also https://sites.google.com/site/sabushwarsite/overview (accessed on 21 July 2015).
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