It has become a common sight: an elderly, shrunken, hollow-eyed suspect brought to trial decades after being accused of horrific war crimes. They may be too aged to fully participate in their defense, or too debilitated by disease to endure a lengthy court case.

Now it is former Bosnian Serb military commander Ratko Mladic arguing he is too weak to stand trial. His lawyer said Monday that Mladic, 69, would die before his trial begins if he is extradited to the U.N. International Criminal Tribunal in The Hague to face genocide charges. He is said to have suffered several strokes and to have difficulty speaking.

Time and again, the questions have arisen: Are you ever too old or too ill to be judged for your past? Are justice and the public interest served by trying such infirm people? Most experts say it's justified — arguing responsibility doesn't diminish with age, especially set against the enormity of the crimes.

"Old age should not afford protection to people who committed very serious crimes — that's not a defense," said Efraim Zuroff, who pursues elderly Nazi war criminals with the Simon Wiesenthal Center.

"You have to keep in mind the victims who deserve that their tormenters are held accountable; the passage of time does not diminish the guilt."

Mladic follows John Demjanjuk, a 91-year-old retired U.S. autoworker convicted in Munich this month on 28,060 counts of accessory to murder. Demjanjuk's lawyers failed to convince the court that the former Nazi death camp guard was too sick to be tried because of a bone marrow disorder, kidney disease, anemia, and other ailments.

The age and medical condition of Khmer Rouge defendants is also a central issue at Cambodia's upcoming U.N.-backed tribunal, set next month to judge four of the brutal regime's top officials. The accused, ranging in age from 79 to 85, suffer from a variety of illnesses.

"To let them walk away because they are old means they would get away with it," Brad Adams, director of the Asia division of Human Rights Watch, said about the Khmer Rouge defendants. "They all appear to have some maladies but none of them have such significant illnesses that they are not competent to stand trial"

He said the Cambodian suspects are accused of masterminding the slaughter of up to two million people in their own country and should not be excused simply because they are infirm — or because it took so long for authorities to track them down.

"The reason they are so old is because of the failure of the states to track them down and charge them much earlier," Adams said. "They were living in Thailand and traveling around the world. It was a collective failure to deal with them."

Demjanjuk's case was one of the most extreme. After experts examined him, he was found to be fit to stand trial if hearings were limited to two 90-minute sessions per day.

He was brought to court in a wheelchair and placed in a hospital bed, where he lay listening to a translator throughout the proceedings, usually wearing dark sunglasses with a baseball cap pulled down low over his face. A doctor and paramedics remained in the court room throughout the trial. Roughly a dozen sessions were canceled for health reasons, including the need for blood transfusions.

Zuroff said it's imperative to try even ailing war crimes suspects in order to prevent future atrocities.

"There's also obviously the deterrence issue — it shows that if you commit a crime like that, that even many years later an effort will be made to bring you to trial."

And he said Mladic — and others who use this delaying tactic — are usually not as ill as they claim.

"These defendants become ten times worse than they really are as part of a public show to try and elicit sympathy," he said.

In Cambodia, International Co-prosecutor Andrew Cayley said there is a strong public interest in trying the Khmer Rouge defendants.

"The public here want them tried," he said. "They want this case done as quickly as possible. After all the four accused are alleged to have murdered over a million and a half of their own people. Nobody I know thinks age is a bar to vigorously addressing that fact."

He said the defendants — former head of state Khieu Samphan, chief ideologue Nuon Chea, former Social Affairs Minister Ieng Thirith, and ex-foreign minister Ieng Sary — will receive quality medical care and monitoring during the trial. The top Khmer Rouge leader Pol Pot died in 1998.

Theary Seng, a human rights lawyer whose parents were killed by the Khmer Rouge, said the fact that more than three decades have passed since the atrocities were committed has lessened the quality of the justice she and other victims will receive. She said victims are "bracing" for the possibility that one or two defendants will die before a verdict is reached.

"We are beyond the issues of fairness," she said. "It's an issue what is the highest quality of justice we can achieve in light of all the limitations and obstacles in our way. The advanced age of these four defendants is certainly one of the principal obstacles to quality justice. From the current standpoint, it's pretty shoddy justice we victims are getting from the Court."

If Mladic, accused in the 1995 slaughter of some 8,000 civilians in Srebrenica, is ultimately extradited, he would receive good medical care while detained at the war crimes tribunal in The Hague, officials said.

Spokeswoman Nerma Jelacic said the tribunal has a clinic that can provide assistance "around the clock" and can also take suspects to civilian hospitals if needed.

Nonetheless, its most high profile suspect, former Serb president Slobodan Milosevic, died of a heart attack in his cell in 2006, forever escaping judgment.

The tribunal's procedures are notoriously slow. The trial of Bosnian Serb political leader Radovan Karadzic began in 2009 and is still not finished.

Still, Zumra Sehomeriovic, a Bosnian woman whose husband was killed in Srebrenica, said prosecution of Mladic is necessary.

"This is proof that this type of crime never gets old and that the perpetrators will face justice," she said.


David Rising in Berlin, Mike Eckel in Phnom Penh, Grant Peck in Bangkok, and Aida Cerkez in Sarajevo contributed to this report.