ANKARA - Stating that prison conditions are the only cause of dementia, Neurology Specialist Dr. Emel Gökmen explained her reasons in 10 questions, saying, "A patient in this condition cannot be prosecuted."

 

Kurdish politician Aysel Tuğluk, who is being held in Kocaeli No. 1 Type F Prison, was diagnosed with dementia after the results of the examination and test performed by the Departments of Psychiatry, Internal Medicine, Neurology and Forensic Medicine from Kocaeli University Hospital, where she was referred to in March 2021. It was stated that Tuğluk would not be able to stay in prison alone, and it was suggested that her execution and trial be postponed and she was released. However, Tuğluk was not released, but was repeatedly referred to the Forensic Medicine Institute (ATK) and was forced to give a defense in the Kobanê Case. Upon the court's decision, she must be prepared to give a defense in today's hearing.

 

Neurology Specialist Dr. Emel Gökmen answered 10 questions of Mesopotamia Agency (MA) about how a person in Tuğluk's situation should live, why can't a person in her situation can not be held in prison, the reasons that leads to the progression of the disease.

 

What is dementia and what are its symptoms?

 

The most well-known type of Alzheimer's is dementia. If we evaluate Alzheimer's for all dementias, it is the initiation of destruction in brain cells, namely neurons. This destruction affects activities of daily living. The rapid development of this destruction expected with age is called dementia. Although the most common symptom is memory impairment, it may begin with decreased occupational performance, use of ordinary daily tools, and impairment in activities such as self-care.

 

How is it diagnosed?

 

Mini Mental Test is applied to patients for the diagnosis of dementia. If dementia is suspected as a result of this frequently used screening test, patients are taken to a more detailed neurological and psychometric evaluation. The patient undergoes a comprehensive physical examination. Detailed information about the person's past is obtained from them and a relative. After the Mini Mental Test, biochemical tests, neuroimaging methods (MR, CT), neuropsychological tests and, if necessary, EEG, lumbar puncture can also be performed. In the light of these examinations, the differential diagnosis of dementia can be made. Diagnosis of the disease that causes dementia plays a major role in terms of prognosis and treatment.

 

What are the conditions that affect the progression of the disease?

 

Changing the environment of the dementia patient, taking them to different environments, forcing them to do certain things, asking something and forcing them to answer causes the disease to progress. Most importantly, being in environments that will affect them emotionally will negatively affect the disease. In terms of her emotional state, both the soldiers in prison, the courts, going to and from the hospital will  lead to the progression of the disease. She is not living in natural conditions. Isolation alone is a cause for dementia. This is scientifically proven fact. 

 

In which environments is the dementia patient more comfortable?

 

It is a little more comfortable in environments where they are used to. The change of environment, spatial and unfamiliar people cause them to feel very bad and causes progression rapidly. They need to be in places where they feel familiar with. There is no such stimulus in a prison where isolation is imposed.

 

What does it mean to keep a dementia patient in prison conditions?

 

The death penalty has been carried out in different ways throughout history. It was also done with injections in time.This is just like it but more slowly. Those who decide the continuation of this situation must know that they are executing a person.

 

Can someone with dementia answer the questions in court?

 

Since dementia patients experience fragmentary destruction in many areas of the brain, they have difficulty in accepting their disease. They constantly try to do something right with the neurons they did not yet lose but have a hard time doing them. 

 

Can the inconsistency in the reports be resolved by sending them to ATK?

 

When we look at the notes of both the university hospital and the ATK, there are similar observations, but the interpretations are different. There is a need for a center that specializes in dementia. In that sense, it is clear that the inconsistency of the reports can not be solved by sending them to the ATK. The answers to the questions asked by the court to ATK about whether she can make a defense or not, whether she should be released or not can come from a center specialized in this regard. But if we look at latest situation of Aysel, if we do not act politically, any place that includes neurology and psychiatry units can make this progress and this evaluation. But in this context, a center is needed for diagnosis.

 

How might the court's request for a re-evaluation from the ATK have affected Tuğluk?

 

The court's request for a re-evaluation to clarify the contradiction in the diagnosis of the two institutions has forced the patient to stay in an inhumane environment.

 

Can a person suffering from dementia be prosecuted? Is it possible for them to defend themselves?

 

Such a patient cannot be prosecuted. I am making a comment for a patient I have not seen, but the reports, testimonies, testimonies of lawyers and relatives are clear. I had the opportunity to meet with them in a one-on-one press release. It is clear that a person in this situation cannot defend herself. In addition, prosecuting her for her past is meaningless since she doesn't remember. She needs a serious treatment and a good environment for it.

 

What should be done urgently for such a patient?

 

The right of access to health should be provided for Tuğluk. She must be released and send to a specialised center for threatment. It is clear that she has dementia and the court should abandon making political decisions. It is also scientifically proved that isolation causes dementia. A dementia patient must live in a familiar environment, with people they love and trust and be treated.

 

MA / Zemo Ağgöz