We, the undersigned health professionals, call on the Health Professions Council of South Africa to remove Dr Wouter Basson, head of the apartheid Chemical and Biological Warfare Programme, from the medical register in South Africa, as an appropriate sentence for his egregious violations of medical ethics (for a copy of the HPCSA's ruling in the Dr Basson case click here).

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The basis for our concerns regarding the sentencing of Dr Wouter Basson

On 18th December 2013, the Health Professions Council of South Africa found Dr Wouter Basson guilty of unprofessional conduct for acts committed whilst he was head of the Chemical and Biological Warfare programme of the South African Defence Force under apartheid. This came more than 13 years after a complaint against Dr Basson for unethical conduct was lodged with the HPCSA, and 16 years after he was first arrested on drug charges involving illegal possession of ecstasy tablets.

The basis for the decision of the committee related to four charges which were uncontested by Dr Basson. These included:

a) Dr Basson coordinated the production of large quantities of illegal psychoactive substances;

b) Dr Basson was involved in equipping mortars with teargas for use against Angolan government soldiers;

c) Dr Basson provided SADF operatives with disorienting substances to facilitate illegal kidnapping;

d) Dr Basson made available cyanide capsules to SADF soldiers so that they could decide to commit suicide to avoid revealing information under torture.

Dr Basson mounted nine arguments in his defence, each of which was carefully refuted in the judgement (see box for summary). The committee found that the conduct "was in breach of established ethical rules" and concluded that he was guilty of unprofessional conduct.   Sentencing is due in June.

Statement of Concern:

We wish to urge the HPCSA disciplinary committee to recognise the deep concerns of health professionals registered with the Council regarding this matter:

1. The ethical violations by Dr Basson are very serious in nature.

There have been many allegations made against Dr Basson, such as those contained in the Truth and Reconciliation Commission report, which have never had the opportunity to be tested in any court action.  However, the evidence on which Dr Basson was convicted by the HPCSA disciplinary committee was evidence uncontested at his criminal trial, and which Dr Basson did not dispute at his disciplinary hearing. One of the basic principles of medical ethics is first do no harm. We therefore believe these acts alone constitute very serious breaches of medical ethics and it is unfathomable that a medical professional should consider it consistent with medical ethics to conduct him or herself in such a manner. They are not trivial matters that should be met with a token sanction.

2. Dr Basson has at no time acknowledged any remorse for his action, nor shown insight into the ethically compromised nature of his actions.

Dr Basson has consistently denied any wrongdoing, in the lead-up to the hearing, during the proceedings and even after the findings of the committee. We find this deeply disturbing and indicate he is clearly out of touch with the ethical norms of his profession.

3. Dr Basson has argued that the matter belongs to the past and should be forgotten, and that he should be allowed to get on with his professional life.

We disagree. There were many doctors who faced difficult moral choices at the same time as Dr Basson decided to take on leadership of the Chemical and Biological Warfare programme of the apartheid military, and many of these doctors paid dearly for their choices, some with their lives. For them, it is not possible to undo what has happened. Moreover, we know from the experience of other countries that have emerged from dictatorships that acknowledgement of past collusion in human rights violations and unethical conduct is essential to re-establishing trust in the medical profession. We owe that to our colleagues who took the moral choice, to our current students and to future generations of doctors to ensure that there is accountability for egregious violations of medical ethics no matter when they occurred so that a clear message is sent to prevent recurrence of such failings. It is also worth noting that the delay in finalising the charges against Dr Basson were due largely to his legal team and the choices he made to oppose various legal processes.

4. Dr Basson has claimed that the disciplinary action is the result of a small group of doctors who have a vendetta against him.

He is mistaken. His actions are deeply disturbing to a wide range of medical professionals who believe in maintaining the highest standards of ethical practice. This is evidenced by the 41 health professionals who lodged the initial complaints against Dr Basson in 2000 and by the many health professionals who have signed on to this submission.

5. Impunity is a threat to democracy

The culture of impunity is a threat to our democracy. The culture of impunity involves, among other things, not knowing the truth about what happened in the past; avoiding bringing to justice those responsible for past violations; breaches of national and international laws; lack of transparency and patronage; weakness in the rule of law; a lack of trust in leaders, the judicial system and law enforcement; no redress for victims and as a consequence a re-victimization; no expectation of a healing process and failure to uphold ethical values. The Health Professions Council has an historic opportunity to take a firm stand against impunity and to strengthen democracy in South Africa.


In 1980, the then South African Medical and Dental Council failed to take appropriate action against the doctors who mistreated Steve Biko in detention allowing him to die as a result of torture at the hands of the security forces. This was a blot on the integrity of those who govern the medical profession. The SAMDC had to be forced to take disciplinary action against these doctors by a brave group of medical professionals who went to the Supreme Court for a court order.  Part of their legal argument was that the then SAMDC had a responsibility to maintain the ethical standards of the profession.

Luckily, today, we live in a democracy and we do not have to go to court to get the HPCSA to take action. The HPCSA has taken action and it has delivered a very strong judgement on the matter of Dr Basson's unprofessional conduct. We hope that, unlike the old SAMDC, the HPCSA will, in its sentencing, be mindful of it responsibility to maintaining the standards of the profession.

We call on the Health Professions Council of South Africa to remove Dr Wouter Basson, head of the apartheid Chemical and Biological Warfare Programme, from the medical register in South Africa. This would be an appropriate sentence for egregious violations of medical ethics.


The Basson Hearing - arguments and refutations

  1. The circumstances of war justified extreme measures
    The council reminded Dr Basson that medical ethics in times of war are the same as in peacetime, citing WMA declarations and evidence from a leading bioethics expert. As they put it, "medical ethics are identical during war and peace". The council rejected "the notion that regulations have to be interpreted in light of the prevailing circumstances. The WMA regulations are unambiguous in this respect";
  2. The respondent was under military orders
    The committee disagreed this could justify departure from accepted medical ethics. Rather, the committee's view as that "a medical doctor is responsible as an individual for his or her actions. Medical ethics require the independence of thinking of each medical doctor. A doctor cannot simply rely on a military order..."
  3. Dr Basson was acting as a solder and not a doctor
    The committee pointed out that his role could not have been performed by someone who was not a doctor; he was specifically recruited because he was a medical professional. If Basson was really simply acting as a soldier, he should have deregistered as a doctor. But it is a problem to "switch roles between being a doctor and being a soldier, while using the knowledge, skills and privileges of a doctor."
  4. Military ethics are different
    Basson's witnesses quoted an Israeli ethicist, a non-doctor, who argued that normal principles for medical reasoning are absent, doctors do not have autonomy.
    Council rejected this argument, pointing to numerous international guidelines that there cannot be two standards.
  5. There was no doctor-patient relationship so no ethical restraints needed
    Firstly, the Council pointed out that some international guidelines do not restrict themselves to patients, but speak of victims in, for example, the Tokyo declaration. Secondly, where a doctor's actions impact on people, he or she must take responsibility for their decisions and behaviour.
  6. Basson was a young inexperienced doctor so cannot be held responsible.
    Council reject this argument. In his particular case, he was not inexperienced when taking on this role; as head of the CBW programme he was not a young follower but a mature leader. He has to take responsibilities for his own actions.
  7. Basson was not aware of international codes and guidelines
    Council rejected this argument - Ignorance cannot be bliss. No person recruited to a job within a CBW programme would not think they need to check ethical and legal legitimacy when starting.
  8. Ethical standard changed and were not same in 1980s.
    While it realised that ethical emphasis changes, there was enough ethical guidance around in the 1980s to have conveyed very clear concern about this practice.
  9. Chemical substances developed were designed to be non-fatal.
    Council found that he used his medical skills for the purpose of abetting military operations, and that this was not compatible with professional standards, nor was supplying military operatives with suicide tablets.