The legal drama surrounding former Philippine President Rodrigo Duterte has reached a critical and unprecedented juncture, transforming from a geopolitical conflict into a high-stakes medical mystery. In a development that has captured the attention of the global judicial community, the International Criminal Court (ICC) Pre-Trial Chamber One recently issued a crucial order: the former leader must undergo a mandatory medical examination to determine his “fitness to stand trial.” This examination, which will decide whether the confirmation of charges hearing can finally move forward, has unintentionally become the subject of national intrigue, amplified by a baffling conflict in public statements emanating directly from Duterte’s inner circle—a conflict that may ultimately determine his destiny.

The ICC’s decision to order a medical review—to be conducted by a panel of three specialized experts, including a forensic psychiatrist, a neuropsychologist, and a geriatric and behavioral neurologist—came amidst a flurry of conflicting narratives regarding the former President’s mental and physical condition. For months, reports circulated suggesting Duterte was increasingly frail, dealing with various health issues, and, at times, allegedly suffered from significant cognitive impairment, leading to claims that he was “senile” or “unfit” to fully comprehend the proceedings against him. The narrative of the ailing former leader was often subtly or overtly promoted by his allies, potentially laying the groundwork for a defense that could stop the trial before it even began.

However, the medical claims suffered a profound and confusing blow when his own daughter, Vice President Sara Duterte, stepped into the public eye to offer an update. The Vice President lamented that her father was deeply “sad and dismayed” that he could not actively help the government address the ongoing corruption issues in the country. This statement, while seemingly a benign commentary on his patriotism, carries immense legal weight. As ICC Assistant to Council Attorney Kristina Conti pointed out, a person who is mentally incapacitated or impaired would typically not possess the cognitive ability to care about, or be interested in, the state of corruption in the country. Therefore, the Vice President’s testimony of her father’s political awareness and emotional engagement could, ironically, be used by the prosecution as strong evidence that he is lucid, aware, and completely fit to stand trial. This clash between the narrative of the “senile patient” and the “politically conscious elder” has created a public spectacle, raising questions about whether the conflicting stories are the result of genuine confusion or a sophisticated, if flawed, legal strategy.

The core of the legal drama rests on the implications of the medical report, which the panel of experts has been given a deadline of October 31 to submit to the ICC Registry. The public, and the families of the victims of the deadly anti-illegal substance campaign, are intensely focused on two possible outcomes, but both lead to the same shocking conclusion: the case is not going away.

According to the interpretation offered by Attorney Conti, if the former President is declared “fit to stand trial,” the confirmation of charges hearing will proceed with all due speed. This is the scenario desired by the victims’ families, who have consistently prayed and campaigned for the judicial process to move forward, viewing the proceedings as their last, best hope for accountability and justice for the widespread killings that occurred during the government’s drug sweep.

However, the scenario where Duterte is declared “unfit to stand trial” is equally dramatic and, from a legal perspective, more chilling. The lawyer explains that such a declaration would not result in a dismissal of the case. Instead, the proceedings would merely be suspended—put on indefinite hold—while the former President would remain under the official jurisdiction and custody of the ICC. Furthermore, the case would be subject to a legal review every four months to check on his medical status. This legal loophole creates the terrifying possibility that, even if medically incapacitated, the former leader could remain under the legal shadow of the ICC for the rest of his life, with the case never fully closed and the specter of trial always looming. This protracted, 8-to-10-year process would keep the focus on his involvement in the alleged crimes, preventing a full and final acquittal in his lifetime.

The fate of this historic case now hinges on the highly specialized medical opinions of the three experts. They are tasked with navigating the highly politicized waters of the former leader’s health, distinguishing genuine medical conditions from potential legal maneuvering. For the victims’ families, this is a moment of deep anxiety and hope. They, too, are relying on divine intervention, praying not for the former President’s good health, but for the clarity and courage for the truth to be revealed so that the pursuit of justice, long delayed, may finally be realized.

Ultimately, the Duterte case before the ICC has transcended simple legal parameters. It has become a crucial test of international justice, highlighting the complex dance between national sovereignty, the reach of global courts, and the powerful role of political and personal narratives. The image of the former President—either in sound mind or physically frail—is now inextricably linked to the legal future of his controversial term. Whether the medical report delivers a green light for an immediate trial or suspends the case into indefinite legal limbo, one thing remains clear: the International Criminal Court’s grip on the former Philippine leader is not weakening. His legal fate, regardless of his eventual physical or mental state, appears to be tied to the jurisdiction of The Hague for the long term, cementing this case as one of the most consequential in the region’s legal history.