During X Spaces organjsed by Agora on bail and the right to healthcare on Tuesday, former Uganda Medical Association (UMA) president Dr Ekwaro Obuku said the issues raised by Lukwago’s case extended beyond one individual and touched on the ethical obligations of medical professionals working in custodial settings.
Drawing on principles of the World Medical Association (WMA), Obuku said a doctor’s primary responsibility is to the patient and that clinical decisions should remain independent of non-medical considerations.
He described the challenge as one of “dual loyalty” — an ethical dilemma in which healthcare workers may face competing obligations between their patients and the institutions in which they operate.
The discussion followed submissions by Lukwago’s lawyer, Abubakar Ssekanjako, who said the defence had written to the Uganda Prisons Service seeking implementation of recommendations made by specialists following Lukwago’s medical assessment.
According to Ssekanjako, prison authorities responded that they were unable to provide some of the specialised care required.
“The Commissioner General of Prisons wrote back to us and said, ‘We can’t handle his medical needs,’” Ssekanjako told participants.
He argued that the response raised questions about whether Lukwago’s continued detention was compatible with his health requirements.
Ssekanjako further alleged that recommendations made by medical specialists, including a referral for specialised treatment abroad and measures to manage Lukwago’s spinal condition, had not been fully implemented.
Citing WMA ethical guidelines, Obuku said physicians are expected to prioritise patient welfare, maintain professional independence in clinical decision-making and advocate for appropriate medical care.
He also raised broader concerns about healthcare in detention facilities, arguing that prisons should minimise avoidable health risks for inmates, particularly those living with chronic illnesses.
The former UMA president further stressed the importance of patient confidentiality, saying families should not have to publicly disclose sensitive medical information in order to secure access to treatment.
“We need to speak up for all prisoners, even those who are not known,” Obuku said, adding that ethical standards should apply equally to all people in custody regardless of their social or political status.
Lukwago, 56, was arrested on June 15 and later charged with misprision of treason, the same charges he had been defending his clients Dr Kizza Besigye afainst.
He has denied the charges and has been denied bail.
Last week Lukwago told court he needed to see specialist doctors in India.
His legal team has previously told court that he is managing multiple chronic conditions, including hypertension, spinal complications, gastritis and respiratory complications.
The panel also examined concerns about the broader legal environment surrounding pre-trial detention.
Ssekanjako argued that bail, which is provided for under Uganda’s Constitution, was increasingly being treated as an exception rather than a routine judicial process.
“Ordinarily, we seek bail first, and remand comes later. Now we are surprised and celebrating when bail is granted, as if it is not a basic right,” he said.
Journalist and human rights advocate Agather Atuhaire urged Ugandans not to become desensitised to alleged rights violations or shift blame onto those affected.
“If we have reached the point of blaming the victim of impunity, then impunity has become the new normal,” Atuhaire said.
Lukwago’s lawyers said they are pursuing both administrative and court processes to secure implementation of the medical recommendations while his High Court bail application remains pending.