Dr. Steven Miles had waited three years for this moment. From the witness stand, he could see the man he had flown halfway around the world to confront: Dr. Wouter Basson, a South African physician known as "Dr. Death."

The only time they had met before, Basson had seemed confident, almost jovial. This time, Miles noticed, the man wouldn't look him in the eye.

That was the scene two weeks ago, when Miles, a medical ethicist at the University of Minnesota, appeared as the star witness in an extraordinary legal proceeding in Pretoria, South Africa, about the abuses of the apartheid regime.

Miles, 61, made a name for himself with his 2006 book "Oath Betrayed," about the role of medical personnel in torture during the U.S. war on terror. He compiled an archive detailing the abuses at Abu Ghraib and Guantanamo, and became an authority on the medical ethics of wartime. The Basson case was right up his alley.

"I think we have to speak publicly," Miles said. "Otherwise, the monsters win."

Miles was invited by the Health Professions Council of South Africa to help it pass judgment on Basson, who led a secret chemical and biological warfare program during the 1980s.

In this case, Basson isn't fighting for his freedom. He was acquitted of all criminal charges -- including murder, conspiracy to murder and drug dealing -- nine years ago. This hearing was more symbolic: to determine whether Basson, a cardiologist in Cape Town, should be stripped of his license to practice medicine for violating the ethics of his profession.

"History's not always just. The fact is that most war criminals go free," said Miles, who also serves on the board of the Center for Victims of Torture in Minneapolis. This, he said, may be the last chance to hold Basson accountable for his actions.

The Basson case raises the kinds of questions that date back to the famous Nuremberg trials after World War II: What is the moral or ethical line for physicians in battle? Basson argues that he was acting as a soldier, not a physician, defending his country. "The target is not my patient,'' he testified at his criminal trial, "My concern, as a military doctor, is for the South African citizen."

But doctors are forbidden by international codes of ethics from using their medical skills to harm or kill people, even in wartime, said Miles. "All of his work was in procuring and designing and developing offensive weapons," he said. "The question is ... can a person call themselves a physician while they're engaged in this type of activity?"

Germ warfare, poisonings

Miles was first contacted about the case in 2008, when he was asked to replace another expert witness who had, in the words of one reporter, "crumbled" under questioning from Basson's lawyer. The South African medical council turned to Miles because he "is regarded as an international expert in the field of ethics," said spokeswoman Lize Nel.

Miles studied up on Basson. Born in 1950. Personal physician to South African president P.W. Botha in the 1980s. Ran "Project Coast," a clandestine military program linked, according to news reports, to chemical and germ warfare, assassinations, poisonings, kidnapping and even plots to sterilize the country's black population. Arrested in 1997 on 67 criminal charges. Acquitted in 2002.

By 2007, Basson had built up a thriving medical practice.

Miles' first appearance before the health council, in 2008, was cut short when Basson's lawyer won a delay. Miles returned to the United States without testifying, but not before his first face-to-face encounter with Basson, an imposing man with a graying beard.

"The hearing recessed, and I turn around and he's right in my face," Miles recalled. "He held out his hand, 'Hi, Dr. Miles, I want to introduce myself.'"

Miles was stunned by Basson's carefree demeanor. "He said, 'After this is all done, you and I will sit down and have a beer together.'" Miles declined and told his lawyer: "I don't want him anywhere near me."


When the hearing resumed last month, Miles was the only prosecution witness. He used Basson's own admissions, from his criminal trial, to show that his actions flouted international codes of conduct.

Developing chemical and biological weapons? Unethical, Miles said, according to the World Medical Association, of which South Africa is a member. From its Geneva Declaration in 1948: "I will not use my medical knowledge contrary to the laws of humanity." From its Regulations in Times of Armed Conflict, 1956: "Medical ethics in times of armed conflict is identical to medical ethics in time of peace." From 1990: "It would be unethical for the physician, whose mission is to provide health care, to participate in the research and development of chemical and biological weapons. ..."

When Basson's lawyer, Jaap Cilliers, started asking questions, Miles closed his eyes and appeared to meditate. "It allowed me to focus on the question better," he said. "Also, it had the effect of really irritating the guy who was asking me questions."

Miles, wrote the Daily Maverick, "gives every impression of relishing his time under cross-examination."

Cilliers did not respond to requests for an interview. But Tshepo Boikanyo, general manager for the health council, said Miles "handled all questions with great professionalism," adding that the outcome "will be of critical interest to the South African and international publics."

With his face splashed on TV and newspapers, Miles became a minor celebrity.

"It struck me that there is this deep sense that this man is untouchable," he said. "They talked about, even if we lost, that this struggle was important."

Miles returned to Minneapolis last weekend. A ruling is expected early next year.

If Basson loses, Miles believes it will send a message: "It basically says there's no place to hide," he said. "It doesn't matter that it happened 20 years ago. A judgment, and sanctions, will follow."

And if Basson wins? Miles shrugs, and recalls Josef Mengele, the infamous Nazi doctor who fled before he could be brought to justice. "Mengele got away," he said. "He didn't escape the judgment of history."

Maura Lerner • 612-673-7384