781 Monday, 7 April 2008.
[Pre-Trial Conference]
(Open session)
[The accused Simatovic entered court]
[The accused Stanisic not present]
--- Upon commencing at 2.46 p.m.
JUDGE ROBINSON: The purpose of today's proceedings, as you know, is to hear from Dr. de Man. I notice, however, that the accused Stanisic is not present. May I ask the court deputy if he has any information about that?
[Trial Chamber and registrar confer]
JUDGE ROBINSON: The court deputy will inform us as to the information he has.
THE REGISTRAR: Your Honours, we got a report that the accused is still not feeling all right to attend proceedings today.
JUDGE ROBINSON: In the meantime, did we receive a report from the medical officer.
MR. GROOME: Yes, Your Honour, we have received a report today dated with today's date. I can give my copy up to the Chamber if the Chamber has not received such a copy.
JUDGE ROBINSON: Will you just read what it says for me.
MR. GROOME: It's today's date, Your Honour. It says: "Dear Deputy Registrar, further to my update of the 4th of April, 2008, I met with Mr. Stanisic and examined him this morning. I notice that there has been a decline in his psychiatric state over the weekend and have 782 discussed the matter with his treating psychiatrist, Dr. Petrovic, who is of the same opinion. The reason for this decline is likely to be due to multiple factors including the change in psychopharmatherapy (as mentioned in Dr. de Man's report of the 31st of March, 2008)."
THE INTERPRETER: Please slow down.
MR. GROOME: "Which requires time to take effect and the exacerbation of tertiary medical ailments as mentioned in my update of the 4th of April, 2008.
"I would advise that he does not attend court today due to this decline. Due to the combination of factors, I suggest it is unlikely that he will recover in the next few days. Should there be an unexpected upturn in his condition permitting attendance in court, I will inform you immediately. Otherwise, I will inform you of his condition in my weekly update on Friday, 12 April, 2008. Sincerely yours, Paulus Falke."
JUDGE ROBINSON: Thank you, Mr. Groome, I now have the report in front of me and so do my other colleague Judges.
We are going to proceed with the hearing of evidence from Dr. de Man relating to his report. I issued an order today allowing questioning of Dr. de Man in relation to the reports of certain specified doctors but I must caution that I have done so on the strict understanding that such questioning must be strictly relevant to the proceedings the parties are not at large, by any means. There was one report that was not sought by the Prosecutor and I have indicated that Dr. de Man may also be questioned on that report. So let Dr. de Man be brought in. 783 In principal, I will allow each party something in the range of 30, 35 minutes.
MR. GROOME: Your Honour, perhaps if I might make use of this time securing Dr. de Man's attendance, last week I asked for an opportunity to speak with the Prosecutor, Mr. Brammertz, regarding the Prosecution's position with respect to videolink. I believe I set out the case why it was technically and legally possible. I have had an opportunity to meet with Mr. Brammertz and he does support the use of videolink to deal with the special set of circumstances which the Chamber is now faced with. Thank you.
[The witness entered court]
JUDGE ROBINSON: Thank you for that information. Let the witness make the declaration.
THE WITNESS: I solemnly declare that I will speak the truth, the whole truth and nothing but the truth.
WITNESS: JOSEPH DE MAN
JUDGE ROBINSON: Thank you. You may sit. And Mr. Groome, you may begin or is it Mr. Docherty.
MR. GROOME: It's Mr. Docherty.
JUDGE ROBINSON: Mr. Docherty, you may begin your examination. Yes.
MR. KNOOPS: My apologies but the response motion of the Defence of last Friday would also include the specific request of the Defence to have a hearing of Dr. De Man conducted in private or closed session. And I believe the ruling, the order Your Honour gave this morning did not go 784 into that specific request. It did, I believe, in paragraph 10 say that Your Honours were not able to lift the confidentiality and ex parte nature of the reports and I'm reading from paragraph 5 of the order. The order was restricted to just the requests of the Prosecution to lift the confidentiality but in our response motion of last Friday, we argued that also on the basis of certain case law, we believed that the public interest have now been satisfied and therefore, the privacy rights of the accused should outweigh any further disclosure of medical details. This was a specific --
JUDGE ROBINSON: My impression was that the ruling dealt with that but I'm going to have a look at the ruling.
Mr. Knoops, the paragraph 2, I think, makes it very clear what the Trial Chamber's position is. The Chamber begins by referring to Rule 34 by stating the position that it had previously taken on the same request and by explaining that on those previous occasions, it had ruled that the medical information should be heard in public session because in the view of the Trial Chamber, at this stage of the proceedings, and in light of the extent of interference that has been caused by the illness of the accused, his illness had become a public matter. The paragraph finishes by saying: "In the Chamber's view, in those circumstances, it is entitled to take the action that it has and will take in relation to the current submission of the Stanisic Defence. The requirements under Rule 34 of the detention rules have been fully met."
The Chamber, therefore, quite clearly rejected the submission of 785 the Defence and determined that the hearing should be in public. Let us proceed.
MR. DOCHERTY: Your Honour, I don't wish to unnecessarily belabour the point but paragraph 5 of the Court's order of today indicates that the confidential and ex parte nature of the earlier reports should not at this stage be lifted. I was therefore under the impression that if I wished to speak to Dr. de Man about those earlier reports and I do briefly, it would be necessary to move into private session.
Am I correct that in that, Your Honour? May I ask that clarification before I commence my examination.
[Trial Chamber confers]
JUDGE ROBINSON: There will be no need to apply because consistent with the approach that the Chamber has taken in relation to the previous hearings concerning those reports which were in public session, it follows that these reports may be examined in public session.
MR. DOCHERTY: Thank you for the clarification, Your Honour. Cross-examination by Mr. Docherty:
Q. Good afternoon, Dr. de Man.
A. Good afternoon, sir.
Q. I think we're finally ready to commence. You conducted a psychiatric evaluation of Mr. Stanisic on the 28th of March; correct?
A. That is correct.
Q. And in general, Doctor, a psychiatric evaluation can include a number of different tools, one of which would be a clinical interview; is 786 that correct?
A. That's correct, yes.
Q. And what you did on the 28th of March was the clinical interview of Mr. Stanisic?
A. That's correct, yes.
Q. Now, the 28th of March was the first day on which you had met Mr. Stanisic, am I correct in that?
A. You are quite correct.
Q. So you did not have a personal history with him or a therapeutic relationship?
A. Especially not that but I did not know Mr. Stanisic in any capacity.
THE INTERPRETER: Could the speakers please make pauses between questions and answers. Thank you.
MR. DOCHERTY: Doctor, what we are saying here is being translated into a number of languages and it would be very helpful to the interpreters if I wait for your answer to be finished before I ask my next question and if you similarly could please wait for my question to finish even if you know what I'm going to say before beginning your answer. It will make their jobs quite a bit easier.
Q. Now, I note in your report that Mr. Stanisic gave you permission to examine his medical file; correct?
A. That is correct, yes.
Q. Did you have the time to actually go and examine the file before conducting the interview? 787
A. No.
Q. And it was just before court today that you saw other evaluations that had been done by other mental health professionals earlier in this process?
A. That is correct. I did see a part of the notes you gave me from Mr. Blagojevic. They were in the file at the UNDU.
Q. All right. And just to be clear when you say that I gave you, do you mean what the court gave you?
A. The court gave me. Yes, of course.
Q. That's fine. Now, did you note that none of these other clinicians, and I'm talking about Dr. Mimica, Ms. Najman and your colleague from the Dutch Forensic Psychiatry and Psychology Institute, Dr. Smit, that none of these had noted in their report, the presence of any psychotic features in Mr. Stanisic's mental health picture?
A. Yes, that is correct.
Q. Now, you, in fact, did find psychotic symptoms and correct me if I describe them wrongly, you indicate that there are creatures, terrifying creatures, which he sees particularly at night-time which tell him to take his own life; is this correct?
A. It is correct up to the point that those creatures are described as threatening but I have not heard him say that they tell him to take his own life.
Q. All right. But they threaten him in some way?
A. They do.
Q. And during the course of your examination, you were made aware -- 788 or perhaps afterwards, talking with your colleague, Dr. Petrovic, you learned that she had been in some doubt as to whether these should properly be classified as psychotic or as something else; is that what Dr. Petrovic told you?
A. That is correct. Dr. Petrovic told me, as far as I can remember, in her exact words that she had been considering the diagnosis of psychosis in his case but thought that Mr. Stanisic was able to control those symptoms before he became worse.
Q. And when he was able to control those symptoms before he became worse, did Dr. Petrovic talk about how this was done?
A. She meant that -- at least that's what she told me, that Mr. Stanisic was reluctant to discuss these symptoms as he felt either threatened or ashamed of them.
Q. All right. But in any event, through some act on his part which perhaps he did not want to discuss because of his feelings about it, he was able to exercise some control over these symptoms that he reported to you and Dr. Petrovic?
A. Yes.
Q. In your report, I notice that you indicate that Mr. Stanisic was switched from an anti-depressant of the SSRI type?
A. Yes.
Q. To an antidepressant called mirtazapine?
A. Yes.
Q. And this switch occurred approximately one month before your examination; is that accurate? 789
A. That is correct, yes.
Q. And you then note in the very next sentence that there was a deterioration of his condition over the past month.
A. Yes.
Q. And so in other words, there was a deterioration of his condition coincident with the time that he was on the mirtazapine?
A. Yes, that's true.
Q. And are you aware that some sources, and I will particularly refer to the American regulatory agency, the Food and Drug Administration have reported vivid nightmares as a side effect of some patients who are taking mirtazapine?
A. No, I was not.
Q. And are you aware of an English study which found that 13 patients on mirtazapine out of a sample population of quite large, about 13.000, reported visual hallucinations while on mirtazapine?
A. No, I'm not familiar with that study.
Q. Are you aware of from any source of vivid nightmares or visual hallucinations as a side effect of mirtazapine?
A. Yes.
Q. And is that part of the reason why you talked with Dr. Petrovic about changing Mr. Stanisic's medication to a tricyclic type?
A. Yes, that is correct. Both that and the apparent ineffectiveness of mirtazapine as a sole agent.
Q. So would you expect that if the visual hallucinations, vivid nightmares are attributable to his taking mirtazapine, that once he 790 starts taking tricyclics or sometime after the tricyclics have begun that these symptoms may resolve, may clear up?
A. They should do that, yes, if the cause is mirtazapine.
Q. If the cause is mirtazapine.
A. Yeah.
Q. Now, these night-time hallucinations that Mr. Stanisic has, you reported a score on a scale called the General Assessment -- Global, excuse me, Assessment of Functioning?
A. Yes.
Q. And you reported a fairly low score down in the 20s; correct?
A. It's quite a low score and the clear difference with what has been ascertained before.
Q. Yes. For example, Dr. Mimica, who examined him, found a GAF of 65 to 70, I believe?
A. Yes.
Q. Would it be fair to say, Dr. de Man, that what is driving this Global Assessment of Functioning score down is the hallucinations?
A. I wouldn't think so. I think that the Global Assessment of Functioning scale is negatively influenced by several factors. One of them is the fact that he has psychotic-like symptoms, hallucinations, but the exhaustion, the fears, the -- and especially the very low mood of Mr. Stanisic have a lot to do with that also.
Q. With regard to the hallucinations, these are hallucinations that Mr. Stanisic reports to you, and they would have to be, there is no objective test for hallucinations, is there? 791
A. No.
Q. And you are aware, of course, from your years of experience as a forensic psychiatrist that sometimes people in situations like that of Mr. Stanisic think it might be in their best interests to appear sicker than they in fact are?
A. Of course.
Q. Of course. Okay. And when you examined Mr. Stanisic, he was in the middle of a treatment for a renal colic?
A. Yes.
Q. And renal colic is the medical term for the pain that is associated with kidney stones; am I right?
A. That's quite right.
Q. That pain is very severe, is it not?
A. Yes.
Q. In fact, this particular episode had caused Mr. Stanisic, as you note in your report, to be administered morphine during the 24 hours preceding your examination?
A. Yes.
Q. But even while in great pain, and having consumed morphine, in the words of your report, you found that Mr. Stanisic was oriented properly as to time, place and person; correct?
A. He was that, yes.
Q. You noted that he had no cognitive defects; correct?
A. That's correct.
Q. You noted that his attention span was limited but not accompanied 792 by any memory problems; is that accurate?
A. That is accurate, yes.
Q. And you noted that he was cooperative with you; is that correct?
A. That's correct also.
Q. And in your report, it appears that Mr. Stanisic was able to tell you in some detail what medications he had been on, for how long, what the dosages were --
THE INTERPRETER: The speakers are kindly asked to slow down for the sake of the interpretation. Thank you very much.
MR. DOCHERTY: My apologies.
Q. He was able to tell you in some detail what medications he had been on, for how long, dosages. Am I correct that the source of that information in your report was what Mr. Stanisic told you?
A. The information he gave me on that respect were quite limited.
Q. And at one point, in fact, while undergoing this treatment and having this renal colic, Mr. Stanisic was even able to describe his present situation to you by drawing an analogy to the legal practices of ancient Rome; correct?
A. I understand that is one of his hobbies, yes.
Q. So would it be fair to say, Doctor, that these visual hallucinations, if they exist, do not impair Mr. Stanisic's daytime functioning?
A. That is correct.
Q. Your estimate is that Mr. Stanisic might be better in three months, but he might be better in double that, six months? 793
A. Yes.
Q. So I understand, of course, the limits that you have to work with but it is somewhat speculative as to how long it might be before Mr. Stanisic is better; correct?
A. Yes.
JUDGE ROBINSON: Just a minute. In his report, did the doctor say that Mr. Stanisic would be better in three months or did he not say that he would not expect him to be better before three to six months?
THE WITNESS: That is the exact wording I used, yes.
MR. DOCHERTY: I take those as roughly similar because he is saying he would not expect him to be better before three to six months. But I certainly, Your Honour --
Q. Doctor, the exact wording from your report is that you would not expect him to be better for three to six --
A. I would not predict -- dare to predict the course in any case, not judging Mr. Stanisic within a period like that.
JUDGE ROBINSON: I think there is a difference. I would prefer if you stick to what the doctor said exactly, Mr. Docherty.
MR. DOCHERTY:
Q. But as you say, you would not care to predict, and you are aware that the other mental health professionals who have evaluated Mr. Stanisic have also declined -- those who find him unfit have declined to give an estimate as to the time that would be needed; is that correct?
A. If you say so. I have not read the things given to me so exactly that I can refer to that wording. 794
Q. I understand. And when you say in your report that Mr. Stanisic would not "be fit," did you have in mind or did you -- were you aware of the legal standard for fitness that is used by this Tribunal?
A. Not exactly, no.
Q. Okay. But you do understand that fitness to stand trial is something that would be decided by the Judges after they have heard the facts?
A. Of course, yes.
MR. DOCHERTY: Okay.
THE WITNESS: If I may, Mr. Chairman.
JUDGE ROBINSON: Yes, you may.
THE WITNESS: Thank you. I was given to understand that the fitness to stand trial was the core goal of my examination.
JUDGE ROBINSON: If you are given to understand that, I'm afraid that that doesn't accord with what the Trial Chamber asked you to do. The Trial Chamber did not ask you to comment on the accused's fitness but nonetheless, I accept that you may have been given that impression.
THE WITNESS: I was afraid that might be the case.
MR. DOCHERTY:
Q. Doctor, this evaluation, this interview, was it conducted through an interpreter?
A. It was conducted with the assistance of an interpreter, yes.
Q. And it was about 60 minutes in length?
A. That was about the maximum time possible, yes.
Q. You say that and that accords with what I saw in your report 795 which said that it was cut short by the accused's medical condition.
A. Yes.
Q. So you would have wanted to continue --
A. I would have liked to examine him for a longer period of time in order to get a better view of the situation and to also I would have liked to have examined him on different moments in time, but as the Court ordered me to give a report immediately after, it was not possible.
MR. DOCHERTY: Your Honour, could I have a moment to consult with a colleague?
JUDGE ROBINSON: Yes.
MR. DOCHERTY: Thank you.
[Prosecution counsel confer]
JUDGE ROBINSON: Yes, Mr. Docherty.
MR. DOCHERTY: Thank you, Your Honour, and thank you, Doctor. I have no further questions.
JUDGE ROBINSON: Doctor, may I ask you whether, in light of the evidence that you gave that the hallucinations could have been caused by mirtazapine, whether you took that factor into account in arriving at the conclusions that you did as to the mental state of the accused?
THE WITNESS: I did take that into account, sir, but I also took into account that there were many other possible causes of those visual hallucinations that the examined person described.
JUDGE ROBINSON: And as for the morphine that was administered to the accused prior to your examination of him, to what extent would that have affected the condition in which you found the accused, and to that 796 extent, your own conclusions?
THE WITNESS: We know that morphine also can cause many disturbances of mental functioning, but I do not -- I did not consider morphine to be the prime cause of those hallucinations because they existed long before the moment that he had -- only had been administered morphine that night before I examined him.
JUDGE ROBINSON: Yes, Mr. Knoops or Mr. Jordash?
MR. KNOOPS: Mr. Jordash will examine the witness.
JUDGE ROBINSON: Mr. Jordash. Cross-examination by Mr. Jordash:
Q. Just briefly, if I may deal with your qualifications, it's right looking at your CV that you have -- you are a consultant psychiatrist and have been practising since 1985; is that right?
A. That's correct.
Q. And in 1985, practising for the Ministry of Health and now working for the Ministry of Justice?
A. Yes, I am, in part time.
Q. Part time?
A. Yes.
Q. And the assessment you conducted with Mr. Stanisic, is this something which is a normal part of your occupation?
A. No, it's not part of my duties as a civil servant. I was asked to do this as a private practitioner.
Q. But as a consultant psychiatrist, this is something which isn't unusual for you? 797
A. I have experience in making these kinds of evaluations, yes.
Q. Thank you. Now, you were --
JUDGE ROBINSON: And do you make them -- those evaluations wholly on the basis of a clinical examination?
THE WITNESS: Mainly, but I also try and make assessments using structured interviews and rating scales, if they are possible to be used. Besides, most of the examinations done for Dutch courts are done multi-disciplinary way, meaning that a psychologist and a psychiatrist work together and giving the psychologist also the opportunity to support the findings by psychological testing.
MR. JORDASH:
Q. If I can take you, Dr. de Man, just briefly to your conclusion which is on page 5 of the report. Conclusion that the subject is suffering from major depression with psychiatric -- psychotic features and is clearly unfit to stand trial on psychiatric grounds. You expressed no reservation or qualification to the conclusion?
A. No.
Q. Can we assume from that you had no reservation about your diagnosis?
A. I have no reservation of my diagnosis and -- yes.
JUDGE ROBINSON: You have no reservation, even taking into account the possibility that the hallucinations could have been caused by mirtazapine.
THE WITNESS: No, that is not a reason for me to doubt the psychiatric -- deep psychotic notion. It's still whatever the cause may 798 be, it's still a psychotic depression. The classification, according to the DSM which we use in the Netherlands as well as in America, does not clarify the cause, only the disorder as such.
JUDGE ROBINSON: Is the hallucination the main basis for your conclusion that he has some psychotic depression?
THE WITNESS: The hallucination is the main reason by saying that the depression has a psychotic nature. That's one of the reasons. The other is the extent of the depression which is much deeper than it used to be, according to the data I was given.
JUDGE ROBINSON: Tell us what is meant by "a psychotic condition" or "psychotic depression."
THE WITNESS: We speak about psychosis when there is thought disturbance and/or disturbance in the senses, meaning that either hallucinations or a particular disturbance of thinking which is not compatible with functioning reality testing.
JUDGE ROBINSON: Yes, I'll come back after Mr. Jordash has asked some more questions.
MR. JORDASH: Thank you, Your Honour.
Q. Dr. de Man, I wanted to ask you firstly about the process you followed in coming to your conclusion and then move on to the actual conclusion. You were contacted, is this right, to come to the detention centre to carry out an assessment. You were not quite sure what that assessment was supposed to be but presumed it was fitness for trial.
A. I had in my possession an internal note by Mr. Monkhouse which stated that fitness to stand trial was the goal of the examination. 799
Q. Right. And the question -- sorry to interrupt.
A. That's quite all right. I wanted to add that this was sent to me from UNDU by fax.
Q. Right. And you told the Court a moment ago that you had not had the opportunity, when you arrived at the detention centre, to see the medical file. Did you have time to speak to the various personnel who were present, who you refer to, I think, on page 2 of your report underneath the title "report"? I'm particularly interested first of all in Mr. McFadden? Were you able to speak to him before, during or after your examination of Mr. Stanisic?
A. I spoke to him shortly but only in acknowledging his presence and him thanking me to be able to come to the help of the Tribunal on such a short notice, but we didn't discuss the case formally.
Q. Right. Was there any stage you did discuss the case formally with Mr. McFadden?
A. Not with this specific fellow. I did confer with my colleagues, Dr. Falke and Dr. Petrovic.
Q. And which one and when did you consult with first?
A. I consulted with Dr. Falke, who informed me on the medical condition of Mr. Stanisic before examining him, and mainly in telling me that he had been transferred to the prison hospital and why. And I conferred with Dr. Petrovic afterwards, which was my choice, because I wanted to have Mr. Stanisic's permission in order to discuss his case.
Q. Right. So the information you went into the diagnosis with was the information from the Court, Mr. Monkhouse, Dr. Falke, who detailed 800 his physical condition?
A. Yes.
Q. And then after the clinical examination, you spoke to Dr. Petrovic?
A. Yes.
Q. And is it your understanding or was it your understanding that Dr. Petrovic has been treating him or is effectively his treating psychiatrist at the moment?
A. Yes, that was the policy in which I spoke to her.
Q. And whilst your examination of Mr. Stanisic was limited because of his physical condition, at the end of that examination, did you feel as if with consult, with further consultation with the medical personnel at UNDU, you would have sufficient information?
A. Yes, I did have and -- yes, I did have.
Q. And when you spoke to Dr. Petrovic, did she appear knowledgeable of Mr. Stanisic's condition at that time, psychiatric condition?
A. Yes, she did.
Q. And were you able to consult in detail concerning her observations of it and your own observations of it?
A. Yes, we were able to do so especially because we were assisted by interpreters at that moment.
Q. On the issue of interpreters, there was an interpreter who assisted you during the examination of Mr. Stanisic.
A. Yes.
Q. Is the fact that an interpreter -- what was the fact that there 801 was an interpreter at some point of concern for you or were you able to receive the information you felt you needed?
A. No, I think that the examination was partly conducted in English of which Mr. Stanisic has some knowledge, and the interpreter, Mrs. Snezana Ojdanic has been working at the UNDU for a long time and is very well acquainted with most of the detainees.
Q. Right. So that is not -- the fact that the examination was in part through an interpreter, is that something you need to take into account when considering your conclusions?
A. No, at the moment, many of the examinations I have to undertake are with the aid of an interpreter also for Dutch courts, so I didn't feel hampered by the presence of the interpreter, on the contrary.
Q. Thank you. And at the end of the consultation with Dr. Petrovic, did you have any concerns about not having enough information to go away and write your report?
A. As I said, I would have liked to have the opportunity to examine -- to examine the -- Mr. Stanisic at another moment, but I felt, especially due to the severity of the depressive disorder I witnessed, I was -- I thought I had enough information for that moment.
Q. Thank you. And Dr. Petrovic and yourself, I'm getting this from your report, appeared to have agreed on the diagnosis and agreed on the need for a change in the treatment?
A. For a change to the treatment in order to get more effect, yes.
Q. And that agreement which you observed when you consulted her, to what extent was there agreement? Was there agreement on the severity of 802 the depression?
A. Yes.
Q. And was there agreement, at that stage, on the psychotic features?
A. Yes.
Q. And agreement on the Global Assessment Functioning score?
A. We didn't discuss the score but we did discuss the -- the exact score, but we did -- we were in agreement on the fact that the general situation of Dr. -- of Mr. Stanisic had deteriorated to a large extent.
Q. And Dr. Petrovic had observed this deterioration in the weeks before you arrived?
A. Yes. I think she was back from Belgrade for a week at the moment when I examined Mr. Stanisic, and she had been seeing him -- she had been there for four weeks, so she had the possibility to witness a certain interval.
Q. Right. You've read the report which, I think you read them today, that have been compiled in relation to an earlier hearing?
A. Yes.
Q. And there's obviously a degree of variance of opinion in the report, but all agree that Mr. Stanisic is depressed.
A. Yes.
Q. And it would appear has been depressed for some time. In light of that depression, were you surprised or from a psychiatric point of view, that there could have been this deterioration in this period of time? 803
A. No. I had -- of course I cannot make sure in every case what elements are -- will cause deterioration, but in this case, it seems that there were many factors which might contribute to a worsening of the situation. One of them possibly being the fact that the medication did not have the desired effect.
JUDGE ROBINSON: And tell us what the others might be.
THE WITNESS: The others might be the fact that Mr. Stanisic is suffering from a debilitating gastrointestinal disease, that he has kidney stones giving him considerable trouble, and that some of the medication he is given for both his colitis -- for his colitis does give him complications causing him pain in the musculoskeletal system.
JUDGE ROBINSON: Mr. Jordash, you asked about deterioration in a short time. What time is that? Would you put that precisely to the witness?
MR. JORDASH:
Q. Well, perhaps I can ask the witness to clarify what the witness meant about deterioration and from your consultations with Dr. Petrovic, would you be able to assess the time of deterioration?
A. Not because I have only examined him once, I cannot speak from my own experience, but looking at the case notes and hearing from Dr. Petrovic what her ideas were on the subject, I would say that his condition deteriorated significantly in the last month.
Q. Would you agree that you were able to say that because of what you learned from Dr. Petrovic, her assessment, and then your assessment and a comparison of the two? 804
A. Yes, and also the -- what I heard the findings of Dr. Dominecus were when he examined Mr. Stanisic, I think some six weeks ago.
MR. JORDASH: Yes, I think 19th of February, 2008. If I can remind you that Dr. Dominecus noted at that point that there was no psychotic disorder but --
JUDGE ROBINSON: In our decision, did we not deal with Dr. Dominecus's report? I'm prepared to reconsider it but my impression is that we --
MR. JORDASH: Your Honour, I beg your pardon, you did deal with that --
JUDGE ROBINSON: Yes.
MR. JORDASH: -- and you denied its use so I will move on from that question.
JUDGE ROBINSON: Just a second, please.
[Trial Chamber confers]
JUDGE ROBINSON: May I ask the parties what is the view that they take as to Dr. Dominecus's report? That, you will remember, had been the subject of some discussion in the earlier proceeding. I think principally I should ask the Defence first. Yes.
MR. JORDASH: We don't object to the use of the report at this time.
MR. DOCHERTY: We had earlier applied to have that report made a part of the record which the Chamber decided was not appropriate at that time. I would ask that -- first of all, I have no objection to Dr. de Man testifying as to what effect that report had on his 805 conclusions, but if that is going to happen, I would ask that it be made a part of the record of the case or of this hearing in the case in order that we have a complete record.
[Trial Chamber confers]
JUDGE ROBINSON: The Chamber will allow the doctor to say how Dr. Dominecus's report influenced him and why and it will become part of the record.
MR. JORDASH:
Q. Do you have a copy of the report with you?
A. No, I do not. I saw it on the day of examination as part of the medical file.
MR. JORDASH: I don't know if Your Honours have a copy of that report. I'll just dip into it, if I may.
JUDGE ROBINSON: Yes, go ahead.
MR. JORDASH:
Q. I think Dr. Dominecus found that Mr. Stanisic had an adapted disorder with depressive mood. Does that ring a bell?
A. I know that that was his opinion, yes.
Q. And as I said before, he found that there was no psychotic disorder, and I quote, "There would be PTSS, post traumatic stress syndrome, however, this does not seem to be at the foreground at this time concerning the personality of the examined, there are certainly narcissistic traits." Does that, again, ring a bell?
A. That does ring a bell, yes.
Q. Am I correct that you are giving evidence that there had been a 806 deterioration from this point or certainly after this diagnosis?
A. Yes.
Q. Does it surprise you that Mr. Stanisic moved from a non-psychotic disorder to psychotic features in the period of time between the two diagnoses?
A. No, it does not, not in view of the general deterioration that took place because the presence or absence of psychotic features in depression is also a function of severity of the disorder as such so I would expect psychotic features to be part of a depression of said severity.
Q. And are you able to provide further information as to what was the general deterioration, putting aside the psychotic features?
A. What I can say is that as Dr. Mimica before me, but I did not put it in the report at the moment because as I used to do, I did use a rating scale and the same rating scale also used by Dr. Mimica the year before, which was the Hamilton rating scale for depression. And if I am correct he came to a rating of 24 and I came to 37 at my examination which means that there is a very severe deterioration in this period.
Q. And are you able to put into layperson's words what 37 --
A. 37 means a very severe depression and the score Dr. Mimica recorded is a depression of moderate severity which also was a conclusion.
Q. And what is the extent of the scale? How far does it go?
A. 37 is about as far as you can get.
Q. And the assessment, is it the Hamilton? 807
A. Hamilton Depression Rating Scale, the 17-question version, the same version as Dr. Mimica used.
Q. And you -- is it based upon observable objective criteria?
A. That's the reason why I did not put it in the report. It's a rating scale which is -- also uses observation, so the clinical examination is the basis for the -- for the rating but at the same time, it does give a certain amount of inter-subjectivity.
Q. Right. Did you discuss the scale with Dr. Petrovic?
A. No. I filled it in afterwards.
Q. Right.
A. It's not something you have to do with the patient in front of you.
JUDGE ROBINSON: Of course you can be severely depressed to the degree that you found the accused with a rating that you attributed to him without having psychotic features.
THE WITNESS: The presence or absence of psychotic features is not part of the rating scale. It's rated but it's not counted. So you mention whether there is a psychotic feature but it does not influence the total scale, the result.
JUDGE ROBINSON: No, but my question was different. It is whether one can suffer from depression without being necessarily psychotic.
THE WITNESS: That's true, you can. Yes.
MR. JORDASH:
Q. I think you might have misheard my question before the 808 Learned Judge spoke. I asked you whether you discussed the Hamilton scale with Dr. Petrovic?
A. No.
Q. No. Picking up on the Learned Judge's question and having a look at the Global Assessment of Functioning scale, 21 to 30, can you reach 21 to 30 without psychotic features with perhaps, say, a severe depression scale of 37?
A. Yes.
Q. Are you able to assist in relation to whether, without the reported hallucinations, Mr. Stanisic would remain within the 21 to 30 Global Assessment Functioning scale?
A. It would not make a great difference. It might be that he moves up five or ten points, but that still means that he has a very low assessment of function for the moment that I examined him.
Q. May I ask if you have a copy of the Global Assessment of Functioning scale? I would like to have a look at it briefly.
A. I do not have it on me because it's part of the diagnostic --
MR. JORDASH: I hope Your Honours have the copy that was handed to you on the last hearing. If I can ask that that same copy be handed to Dr. de Man, please.
Q. Would you just have a quick look at that and confirm whether it's an accurate reflection of the GAF scale, please.
A. Yes, this is the same scale as I have used.
Q. So 11 to 20, some danger -- sorry, 21 to 30, "behaviour is considerably influenced by delusions or hallucinations or serious 809 impairment in communication or judgement." Would you agree, therefore, that your assessment of 21 to 30 was made as a consequence of both the reported delusions and your assessment of a serious impairment of judgement?
A. Yes.
Q. And taking away the reported hallucinations at best, would we move to 31 to 40?
A. At best, 31 to 40, yes. There is always a certain amount of subjectivity, of course.
Q. So you would -- Mr. Stanisic might move to some impairment in reality testing or communication, speech is at times illogical, obscure, irrelevant or major impairment in several areas such as work or school, family relations, judgement, thinking or mood."
Would that be --
A. That would be the realm of possibility but the earlier assessment was -- is also could be supported, I think, but my findings even without taking into account the psychotic features, especially due to the fact that there are -- is a third reason for scoring 21 to 30 being inability to function almost all areas.
That has something of a circular argument, of course.
Q. Certainly. Does that have a bearing in relation to Mr. Stanisic, that third explanation?
A. Yes.
Q. So effectively, you found all three descriptions met, were applicable to Mr. Stanisic? 810
A. Yes.
Q. You spoke previously to my learned friend for the Prosecution about exhaustion, fears, and very low mood.
A. Yes.
Q. And what are the significance of these factors here?
A. They do -- what is the significance of the factors?
Q. Well, the mood, I think, obviously we've dealt with, but the exhaustion and the fears, perhaps that's a better question.
A. Of course they, too, contribute to the level of functioning and in this case of lowering the level of functioning.
Q. Right. Thank you. Just to confirm, I don't want to belabour the point, but 21 to 30, the impairment of judgement and the inability to function in almost all areas, was that the basis upon which you -- the principal basis upon which you decided Mr. Stanisic was not fit for trial?
A. Yes.
Q. And did you take into account your finding, I think on page 4, paragraph 2, where you note: "His mood is extremely low, showing despair and a clear wish to die."
A. Yes.
Q. And in your view, that stated clear wish to die was a cause of the impairment of judgement?
A. No, the impairment of judgement was mainly caused by the fact that he had intrusive thoughts and ruminations of this kind which didn't give him the opportunity to address his capacities to the matter at hand, 811 being this trial.
Q. The last sentence there on that same line, "There is pervasive anhedonia"?
A. Yes.
Q. Could you explain what that is, please.
A. Yes, the word "anhedonia" has something to do -- is -- means the inability to perceive pleasure and positive emotions.
Q. Thank you. Could I pick up on an answer you gave to my learned friend for the Prosecution. When asked about the visual hallucinations and whether they impaired Mr. Stanisic's daytime functioning, you answered no. Could I ask you to clarify that in light of the Global Assessment Functioning scale, 21 to 30 --
A. Mm-hm.
Q. -- where the scale appears to, at least in part on 21 to 30, be an assessment of behaviour being influenced by hallucinations?
A. Yes, that's one of the pillars on which the distraction on that level can be grounded. It's -- in this case -- okay, I was looking for my scale, sorry. In this case, there are several other reasons in order not to be able to function.
Q. Right.
A. And because the hallucinations being limited in time, they are not the main cause for this function in daytime.
Q. So to summarize, his daytime functioning is impaired to the extent reflected by 21 to 30 and the principal cause for that impairment are factors other than these reported hallucinations? 812
A. Yes, that's correct.
Q. Thank you. Could I ask you to assist with an explanation of how this fits in with the finding you make at page 4, paragraph 2 of your report where you note: "There are no signs of cognitive deterioration." Could you make a distinction between this impairment you have found and this separate issue of cognitive functioning?
A. Cognitive functioning in the sense of lowering of intelligence and -- has not been found.
Q. So his intelligence is still there --
A. His intelligence is still there, but he's at this moment, not very well able to put it to good use.
Q. Right. And in terms of your prognosis, the three to six months which you quote --
A. Yes.
Q. -- is this based principally on your expectation of how this new therapy, medicinal therapy works?
A. It's even the therapy described -- the old gold standard of depression treatments being a tricyclic anti-depressant but the time frame within which somebody gets better if he suffers from a disorder like depression is relatively uninfluenced by the kind of treatment you give him. Even if somebody gets better on his own, then you still need three months in order to get your facilities back.
Q. Right.
A. There is not -- it's not a function of which treatment you give him. If any treatment works, it will take that time. 813
Q. So you've noted the depth of the depression, the mental disorder, and as a normal rule, it would take between three and six months to recover?
A. Yes.
Q. And can we assume that that assessment relies upon the patient being in optimal conditions, conditions which perhaps relieve some of the stresses?
A. I'm not quite sure --
Q. Perhaps I can be clearer.
A. Yes.
Q. Is three to six months your assessment if Mr. Stanisic remains in custody or if he's out of custody?
A. I would -- I'm not able to judge whether his treatments can take place within the confinement of detention. I think that that's one bridge too far based on this evaluation only.
Q. I won't push you on that, then, Dr. de Man. But finally, without treatment, without rest, is there a probability that Mr. Stanisic will deteriorate further?
A. Yes, but he doesn't have far to go, I'm afraid.
Q. And --
JUDGE ROBINSON: What do you mean by that?
THE WITNESS: It means that he can't deteriorate much further, he's at a very low point, and I'm very worried about his general condition. That's the reason also why I went to Dr. Petrovic and conferred with her. 814
JUDGE ROBINSON: Yes.
MR. JORDASH:
Q. In terms of participating in a trial, or participating in any relatively involved exercise at this time, is that likely to assist a recovery or is it likely to disinhibit a recovery?
A. I think that added stressors of this kind are dangerous at this moment.
Q. Am I correct that you, having seen him, having consulted with Dr. Petrovic, do expect him to recover if the conditions are right?
A. I -- we had a discussion -- Mr. Stanisic and I had a discussion on this matter, and I told him that I do not believe in hopeless cases, which he thought himself to be, and that I will gladly repeat that in this Chamber.
MR. JORDASH: Thank you. I've got nothing further, Your Honours. Thank you.
Sorry, could I in fact ask one more question?
JUDGE ROBINSON: Yes, go ahead.
MR. JORDASH: A few more questions, in fact. I beg your pardon.
JUDGE ROBINSON: Even three, if you wish.
MR. JORDASH: No, two are fine, I hope.
Q. The reports you read this morning, was there anything in those reports this morning that made you alter your conclusions you or made you reflect upon the conclusions?
A. Of course they were cause for reflection as any good written report is, but I do not think that in view of the later developments, 815 that there is such a great contrast between the reports and what I found if you consider the deterioration.
Q. It's a troublesome word.
A. It's a troublesome word, at least for me. But if you consider that, it's -- one finding can lead to another.
MR. JORDASH: Right. And with Your Honour's leave, I'd like to put Dr. Falke's or part of Dr. Falke's latest assessment, if I may, and ask the witness to comment. I'm particularly interested in the report dated the 7th of April, 2008 and events over the weekend.
JUDGE ROBINSON: Yes, you may.
MR. JORDASH: A report was received by Dr. Falke for the purposes of the court and ongoing assessment and Dr. Falke noted on the 7th, so today, of April, 2008, that there had been a decline in Mr. Stanisic's psychiatric state over the weekend and one of the reasons -- well, let me read it to you: "The reason for this decline is likely to be due to multiple factors including the change in psychopharmatherapy as mentioned in Dr. de Man's report of 31st of March, 2008, which requires time to take effect and the exacerbation of tertiary medical ailments as mentioned in my update of the 4th of April, 2008." Does that surprise you?
A. No.
Q. Consistent with --
A. Consistent with the fact that these kind of medication do take some time to take hold and generally, two weeks at least are to be expected. 816
Q. Right.
A. And also the second aspect of this is that the kind of medication prescribed noratriptyline has to be given in incrementary doses. Start low, go slow is one of the -- the rules taken and we do take -- it will take sometime to get the medication to an adequate blood level which will, however, be checked by Dr. Falke and Dr. Petrovic.
MR. JORDASH: Thank you very much, Doctor.
JUDGE ROBINSON: What you have explained I understand to mean that the medication will take some time to have effect.
THE WITNESS: That's correct, sir.
JUDGE ROBINSON: I believe you said -- what was it? A certain number of weeks.
THE WITNESS: Yes.
JUDGE ROBINSON: But what explains the decline? Does the medication explain the decline in his condition?
THE WITNESS: I'm not sure about that because I haven't examined Mr. Stanisic for the last week. I'm not -- I'm not aware of his general physical condition and the other medication which is mentioned by Dr. Falke. There are several factors who may contribute to the fact that now he's even worse than he was when I saw him.
Questioned by the Court:
JUDGE DAVID: I would like to ask the expert on the nature of the influences caused by delusional hallucinations. You had put Mr. Stanisic on the category 21 to 30, if I recall, of the Global Assessment of Functioning. 817
A. Yes.
JUDGE DAVID: And the paragraph reads, "Behaviour is considerably influenced by delusions or hallucinations or serious impairment in communications or judgement." Is that what the paragraph says?
A. It also says "or inability to function in almost all areas." There are three possible reasons for a classification in this area.
JUDGE DAVID: How with one interview, as you had with the subject, is it possible to assert, while at the same time you recognise right orientation in time, place, and person at the end of your report, that his behaviour is considerably influenced by delusions or hallucinations? The question also has to do with the importance of episodic happenings of hallucinations and the difference between episodic happenings of hallucinations or systematic structural psychosis with hallucinations, as it is a case of schizophrenia or paranoid schizophrenia, you know?
A. Yes. In many people functioning at this level, the hallucinations are the main cause as in schizophrenia or paranoid delusions. In this case, the problem with reading DSM, and this is part of DSM, is that it's a polythetic system. You do not have to have all the different signs in order to be able to make the diagnosis. In this case, there are three possible causes to be functioning at that level, three possible descriptions who do not have -- who are neither mutually exclusive but do not have to be the case at the same time. You have to have just one. The fact that somebody is in bed and functions at a very low level, the fact that he is in a hospital and 818 admitted into medium care facility and being treated hand and foot by nurses means that you will function at a low level. So this -- you have to judge this at one moment, but it is possible that when you see somebody again, that you make another judgement. It's not a -- it's even so that when you give the -- are given the task to treat somebody, that you are judged as a doctor by the fact that someone's GAF goes up, it's not something that you find for the whole time.
JUDGE DAVID: In the situation of psychosis, is it correct in contemporary psychiatry to equate episodic instances of hallucinations with structural situations of hallucinations due to a severe psychosis? Because, as I understand, there are certain moments bequeathed by physical factor, medications or bad experience even in the day, you might have hallucinations at night, yet these hallucinations might not constitute a structural part of a syndrome which it could be bipolar disorder, paranoia or schizophrenia or a combination of the three.
A. I quite agree with you, sir. The presence of psychotic features does not mean that I diagnosed Mr. Stanisic with a process psychosis as we call it in Europe, like schizophrenia, which is an all-encompassing illness having impairing judgements, 24 hours of the 24. So this is the hallucinations are such -- are no more than a feature of a psychotic nature.
JUDGE DAVID: So in the case of Mr. Stanisic, you might have not impaired judgement and yet have hallucinations because impaired judgement for me is part of a structural situation that affects you beyond the instant. 819
A. Yes.
JUDGE DAVID: Is that correct?
A. You use both sides of the table, I'm afraid, we use a different definition of the term psychosis. When we look at the process of psychosis like schizophrenia, it -- the fact that somebody's psychotic causes his dysfunction. If somebody has a depression with psychotic features, the psychotic features may not be the cause of the depression but the depression may well be. I think in this case, the depression is the main cause of dysfunction and the psychosis is not -- is, in my view, not much more than a sign of severity.
JUDGE DAVID: The Chamber has studied very carefully and have critically examined all the reports that you will have a chance or you have had a chance to study. In none of these reports anybody spoke of any structural psychosis or even of permanent hallucinations. They only referred to the fact in two instances that he had some episodic hallucinations with no impairment of judgement. And most of the experts agree that his cognitive functions, his judgement as to time, place and person as you have said could and are fit to stand trial, that's why the Chamber has decided that he is able to stand trial.
Are you able to say today that facing the symptoms you have described, and being put in the category 21 to 30, are you asserting that he is unfit to stand trial according to the standards you might read later that the Chamber has put to each one of the experts?
A. I told the gentleman of the Defence already that I do not see a great discrepancy with the other papers I was presented with just an hour 820 ago, and -- but I do see a very strong change in severity between those, those several moments.
JUDGE DAVID: When you refer to a standard of fitness, because your conclusion again of your report said that: "In order to -- I do not expect the subject's fitness to be restored." Were you aware when you talk about the fitness of the previous situation of Mr. Stanisic, or you were alluding to an ideal state of fitness?
A. I was alluding to a state of fitness from the point of view of psychiatric, clinical expertise. There is of course has to be -- a translation has to be made into the legal field which I am not able to, that is something which it is for the Learned Judges to do. I gave my professional opinion as a doctor, and my view of somebody being able to stand trial is in view of the general definition of the term and not the legal definition of the term.
JUDGE DAVID: I am very clear on that. But also what I was referring to is when you said restore his fitness, you were talking about the normal condition of a well-functioning personality or were you aware of the problems that he had faced in the past? For instance, one of the psychiatrists refer, Dr. Najman, to an anal sadic personality, a condition that came from the childhood, according to the theoretical explanation of sadic anal personality in Freud terms or --
A. I'm old enough to be familiar with those terms.
JUDGE DAVID: I know, Doctor. Excuse me that I use sometimes my modest gross knowledge of the field. 821
A. No, no, that's fine. I must tell you that I only had a few minutes to look at Dr. Najman's report, as there was some problem with the photocopy machine and half of it was not legible, but we put that right. But maybe I can say that on reading Dr. Mimica's report which I have had plenty of opportunity to do, I had -- did not have the -- in retrospect, would not have agreed -- disagreed with his judgement based on the findings he made. So I do not think that on -- it is -- it is my opinion that is so much different from that of the other colleagues.
JUDGE DAVID: In paragraph 76 of his evaluation, Dr. Mimica said: "I found the accused to be depressed. He also found the accused to be an eloquent man who provided detailed answers. His memory was normal. He had the impression that the accused -- he didn't have the impression never that the accused did not understand him. When he conducted the evaluation, the accused was not suicidal." Paragraph 76. And also, he says that the accused could read and understand and testify.
A. His findings were, in essence, very much different from the one I made on examining Mr. Stanisic.
JUDGE ROBINSON: And so you think that perhaps were he to examine Mr. Stanisic today, his findings might be different?
A. Might be different from the ones he made then, yes.
JUDGE ROBINSON: Very well. Thank you. We are going to adjourn. You will have to return. Before we adjourn, I'm going to consult my colleagues.
[Trial Chamber confers] 822
JUDGE ROBINSON: We are adjourned for 20 minutes.
--- Break taken at 4.20 p.m.
--- On resuming at 4.47 p.m.
JUDGE ROBINSON: Now, Doctor, you had given what I had considered to be important evidence in relation to the health of the accused, and among the things that you said and that struck me is that the main or principal basis for your conclusion as to accused's unfitness was the impairment of judgement and the inability to function in almost all areas. Those are extracted from the 21 to 30 category in the scale. You also told us that you made this determination of unfitness using your own criteria, criteria which you use as a psychiatrist, and which you correctly acknowledged might be different from that which is used in the court.
It seems to the Chamber to be only reasonable and fair that the Court should put to the doctor the five questions that were put to the other experts.
Now, Doctor, if you are in a position to answer those questions immediately, you may do so, but if you need some time to consider the answers, then let us know. This is not a trivial matter by any means, you know.
THE WITNESS: I know, yes.
JUDGE ROBINSON: And you should be put in the same position as the other experts who would have had some time, certainly more than you would have had, were you to give the answers today in coming to their conclusions. 823 I'm going to try my best to explain to you what the questions mean.
The first question is whether, in your opinion, the accused is able to understand the nature of the charges and the proceedings against him to include the consequences of a conviction on those charges. The accused is charged with a number of crimes, the indictment charges him with crimes against humanity, war crimes such as murder. And the simple question there is whether he understands the nature of those charges and what it means if he is convicted. If convicted, he stands to be sentenced up to a term of life imprisonment.
The second one is perhaps the most important because it has to do with the level of his communication skills. Is the accused able to instruct counsel as his defence? He is represented by counsel, so he must be able to instruct him, to tell him what his defence is. Otherwise, counsel will be of no assistance to him. Counsel will not be able to put his case to the Chamber. He must be able to pinpoint the main areas of strength in his case, the main areas of weakness in the Prosecution's case, as the Prosecution's case unfolds. So he needs to be able to communicate with counsel and instruct him as to his defence. The third one is perhaps even more important, perhaps the most important. Is the accused able to testify on his own behalf if he elects to do so? He has a right to give evidence. It's a right which he has. He is not obliged to do so but if he does so, then that procedure will involve his own counsel, first, examining him in a manner that one would say is favourable to his case, to elicit from him the main points from 824 his case, the answer that he's giving to the charges against him. But even more significantly, he's going to be cross-examined by the Prosecutor.
So we want you to say based on the examination that you carried out whether he is able to testify on his own behalf, that is to give evidence in chief, and to be cross-examined. What is prompting me to ask you these questions is what you told Mr. Jordash, that your conclusion was principally prompted by the impairment of judgement and the inability to function in almost all areas that you say you found in the accused. The fourth and fifth questions are more of a procedural nature. Is the accused physically able to -- well, I don't know why physically is there, I would say is the accused able to withstand full-time trial proceedings, that is, normally five days a week and approximately five hours a day.
The last one is: Does the accused's health situation require any particular accommodation to support his ability to stand trial? Those are the five questions that were put to the experts and we had their views. They came to court and they were examined in relation to the answers that they gave.
Would you be in a position to answer those questions now or would you like the benefit of the evening to consider your answers?
THE WITNESS: I think I would choose the last option, if that's open to me.
JUDGE ROBINSON: Yes.
THE WITNESS: Because I would like to formulate my answers as 825 succinctly as possible.
JUDGE ROBINSON: I believe that that's the best course, Doctor, and the fairest course. But will you be able to return tomorrow?
THE WITNESS: I will make myself available to the Court.
JUDGE ROBINSON: We very much appreciate that, Doctor, and so tomorrow, we are resuming at 2.15.
THE WITNESS: 2.15.
JUDGE ROBINSON: Now, I'm going to ask the court officer to make available to the doctor the questions that were posed so that he has them written.
Does any party have anything to say in relation to this matter? Yes, Mr. Docherty.
MR. DOCHERTY: Will Dr. de Man also have the earlier evaluations he was able to look at today, will he have copies that he can take with him?
JUDGE ROBINSON: Yes, those should be made available to him as well.
THE WITNESS: Thank you. I'm very much obliged.
MR. DOCHERTY: Including that of Dr. Dominecus which was just added to the record today.
JUDGE ROBINSON: Yes. Yes.
MR. DOCHERTY: Thank you.
JUDGE ROBINSON: We will adjourn until 2.15 tomorrow when we will be in Courtroom III.
--- Whereupon the hearing adjourned at 4.55 p.m., 826 to be reconvened on Tuesday, the 8th day of April,
2008 at 2.15 p.m.