The Steve Biko affair

Steve Biko, a leader of the Black Consciousness movement in South Africa, died in 1977 while being detained by security police. The inquest into his death revealed gross inadequacies in the treatment he received from the two doctors legally responsible for his medical care. These doctors, Ivor Lang and Benjamin Tucker, were called in to examine Biko after he had sustained head injuries during interrogation by the security police. Over the five days in which they attended Biko, Lang and Tucker failed to take his condition seriously. The doctors failed to examine Biko under proper conditions despite clear signs of possible brain damage; they failed to take a history, they failed to do simple tests of Biko’s mental state, and allowed the police to be present during their examination and to influence their diagnosis and management. (The police had variously suggested that Biko had suffered a stroke or that he was shamming.) Lang then wrote a false medical certificate in which he claimed to have found no evidence of abnormality or pathology. He failed to note the injuries to Biko’s face and chest, his ataxic gait, and his slurred speech—all of which had been evident from the beginning. With subsequent deterioration in Biko’s condition, further examinations (including those performed by an independent physician in consultation with a neurosurgeon) revealed a left-sided positive Babinski sign, left-sided weakness, urinary incontinence, and blood in the cerebrospinal fluid, in addition to the earlier signs of brain damage. Nevertheless Lang then wrote in his patient’s notes: